Physiotherapy Scoliosis Specific Exercises PSSE
SOSORT accept PSSE to be part of the Integrative Scoliosis Care Model.
Specific Exercises performed by physiotherapists to treat scoliosis, under medical prescription, have been considered an European historical tradition ( XVIII, XIX and XX centuries), more or less accepted. The non acceptance, from medical doctors, gained its popularity when modern medicine became more evidence based, due to the lack of evidence in favor of PSSE.
During this last period, PSSE where only performed in some european centers, as a part of the protocolized treatment, in spite of the lack of evidence, just following tradition. After the SOSORT was established in 2004-2006, evidence has been slowly increasing in favor of PSSE, but it is still little and low evidence.
Thus, although we can say that PSSE can help to improve posture, muscle balance, back asymmetry when scoliosis does not progress, pain, and in some way health related quality of life (QoL), we cannot state and we personally do not state that PSSE can prevent curve progression, in an otherwise progressive scoliosis, during the riskiest period of rapid growth. We have been using in our center the so called Schroth principles, with some evolution after 50 years.
This is a long clinical experience. We currently call our PSSE program BSPTS- Schroth based program, and we prescribe it only in cases where we think it can help, according to medical criteria and following SOSORT international guidelines. What others do with any name, BSPTS, Schroth or any other name is out of our own control.
Our recommendation will be always about following the indications and prescriptions of a good specialized scoliosis team formed by Medical Doctor, physiotherapist and Orthotists. Generally speaking… usually, the best scoliosis treatment is the best one you can get close to the place where you live. PSSE, in any case, can be recommended as a first after surveillance, once the patient gives some clear signs of progression or has a symptomatic scoliosis, in children or adults, and bracing is not yet indicated. However, expectations must be clarified, according to the above written information.
Bracing is the only treatment, which has demonstrated to be effective in reducing the risk of progression in scoliosis with potential to reach 50 degrees. We always recommend, when possible, to combine bracing with PSSE, also according to SOSORT guidelines.
Read more about bracing in the next section…