45 degrees
How can we design a space purely responding to the specific needs of scoliosis rehabilitation?
Treatment Methods
Figure 9
Physical Exercises
Specially designed for the person exercises that push the exact sides of torso to aline so the back is going to a straight line. These exercises are put together by patients personal orthopedic therapist.
Scoliosis SOS
It is an intensive 4 weeks physical therapy treatment program that helps to strengthen the right muscles of the spine. First a patient gets assessed, so the curve angle and degrees are checked and then the exercises are catered particularly for the patient. It is a perfect method for people with a mild or moderate scoliosis to stop the increase of progression of the spine’s curvature. (Scoliosis SOS, 2015)
Schroth Method
“The basis of correction is a properly aligned pelvis. A scoliotic pelvis is often not only shifted laterally but also tilted and rotated. Therefore the spine, which attaches to the pelvis via the sacrum, has a misaligned foundation. The Schroth method first addresses the patient's pelvis position with five corrections.
The treatment can then focus on spinal elongation, and on derotation by means of individually designed scoliosis exercises.
One of the primary Schroth tools is strengthening exercises tailored to the individual patient. Another, the unique rotational breathing technique, focuses on vertebral derotation using the ribs as levers, as well as on increasing the patient's vital capacity.” (Schroth Method, 2014)
Schroth Exercises for Scoliosis
Exercises are tailored to each patient:
· Consist of a combination of stretching, strengthening, and breathing techniques
· Halt curve progression, eliminate pain, and improve posture for life
· Can be done at home and as part of daily life
Figure 10
5-year-old boy, scoliosis resulting from polio (First).
After 3 weeks of intensive Schroth treatment (Second).
After 8 weeks of Schroth scoliosis exercise therapy (Third).
Bracing Treatment
A back brace is a plastic body jacket used in the treatment of adolescents with idiopathic scoliosis. The brace, wraps under the arms and around the rib cage, lower back, and hips in order to cast the spine into a straighter position.
Bracing treatment is typically prescribed for patients when the spine’s curvature is between 25 and 40 degrees, and a lot of growth remaining (patients who are skeletally immature). The brace is typically worn full-time (18 to 23 hours per day) to minimize the risk of curve progression.
The primary goal of orthotic treatment (a back brace) for idiopathic scoliosis is to stop the progression of the spinal curve. Bracing does not typically reduce the degree of the curve/amount of angulation already present.
Since bracing only works to stop the progression of the curvature in a growing child, it is not used for those children who are already skeletally mature or almost mature. It is only used for younger children (e.g. girls who are about 11 to 13 years old, and boys who are about 12 to 14 years). (Spine Health, 2014)
These are some of the back brace images dating 19th century and at present. It is clear from the images that a lot has changed in scoliosis bracing treatment, because of new technologies and materials. 19th century back brace is made out of leather and while, today's back braces are made of plastic and now you can get a custom made 3D printed brace. Figure shows how adolescent girls were treated by pulling and making a plaster cast to wear (images are dated 1877)
Views of children from my questionnaire: Research into Scoliosis – Physical and Emotional Battle, share their experience that they had with a back brace.
‘The main physical struggles I faced was that it was hard to adjust to at first and it also became very uncomfortable. It hurt a lot too because if feels like everything was being squished together but it got better over time. Emotionally I was kind of scared at first because when I first got it I had to stay in the hospital for a week so they could teach me how to use it. I felt different than everyone else and was afraid that when I was in school that everyone was going to make fun of me. I felt out of place but my friends and family helped me through it because they still cared about me no matter what.’ – Female, Europe, wore a back brace for 4 years.
‘It was physically uncomfortable, especially in the beginning. And I had to wear loose-fitting clothes so the brace wouldn’t show because I didn’t want to draw attention to it.’ – Female, Europe, wore a brace for 18months.
Spinal Fusion Operation
"Surgery for adolescents with scoliosis is only recommended when their curves are greater than 45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees. Unlike back braces, which do not correct spinal curves already present, surgery can correct curvature by about 50%. Furthermore, surgery prevents further progression of the curve.
There are several approaches to scoliosis surgery, but all use modern instrumentation systems in which hooks and screws are applied to the spine to anchor long rods. The rods are then used to reduce and hold the spine while bone that is added fuses together with existing bone.
Once the bone fuses, the spine does not move and the curve cannot progress. The rods are used as a temporary splint to hold the spine in place while the bone fuses together, and after the spine is fused, the bone (not the rods) holds the spine in place. However, the rods are generally not removed since this is a large surgery and it is not necessary to remove them. Occasionally a rod can irritate the soft tissue around the spine, and if this happens the rod can be removed." (Spine Health,2014)
3D Animated Spinal Fusion Surgery
Postoperative Care
"Following scoliosis surgery, patients usually can start to move around about 2 to 3 days after the procedure. The total hospital stay is usually about 4 to 7 days. Patients can return to school about 2 to 4 weeks after surgery, but activity needs to be limited while the bone is fusing.
It is important to note that the more immobile the spine is kept the better it will fuse. Bending, lifting, and twisting are all discouraged for the first three months after surgery. For this reason, some surgeons will prescribe wearing a back brace for a period following the surgery which helps to restrict movement. Any physical contact or jarring type activities are restricted for about 6 to 12 months after surgery.
Generally the patient will be monitored with intermittent examinations and X-rays for 1 to 2 years after the surgery. Once the bone is solidly fused no further treatment is required." (Spine Health, 2014)
Examples of Post-Surgery
Figure 11,12,13
Swimming
“Swimming is a beneficial exercise for someone with scoliosis because the movements are not jarring and there is less pressure on the spine. Swimming creates buoyancy, which reduces body weight forces acting on the body. The water also provides resistance, which can work your muscles and improve endurance and flexibility. Swimming with scoliosis can help to build the muscles of your arms, legs and back, which could improve your overall balance and muscle strength.
Depending on how severe the case of scoliosis, swimming may be challenging. Most people with scoliosis can participate in sports, although some movements may be difficult because of the affected muscles. Additionally, for those with severe scoliosis that affects the lungs, swimming competitively or for long distances may be difficult because of reduced lung capacity. Some types of swimming strokes could be tough initially when using the back and arm muscles, but most people with scoliosis are able to swim, even with modified movements.” (Brannagan, 2011)
Alternative Treatment Methods
Quantum Touch
Another alternative treatment to aline spine bones and a posible scoliosis solution is quantum touch healing method.
"Quantum-Touch is a method of natural healing that works with the Life Force Energy of the body to promote optimal wellness. Life Force Energy, also known as “chi” in Chinese and “prana” in Sanskrit, is the flow of energy that sustains all living beings.
Quantum-Touch teaches us how to focus, amplify, and direct this energy, for a wide range of benefits with surprising and often extraordinary results.
Quantum-Touch is an effective method for reducing back pain , realigning structure, balancing organs, glands and systems, reducing muscle aches, healing injuries, healing burns, and so much more." (Quantum-Touch, 2014)
Osteopathy
"Osteopathy is a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints.
Osteopathy is based on the principle that the wellbeing of an individual depends on their bones, muscles, ligaments and connective tissue functioning smoothly together. Osteopaths believe their treatments allow the body to heal itself. They use a range of techniques but do not use drugs or surgery." (NHS, 2013)
Crystal Therapy
Crystal therapy is an ancient holistic treatment method, which involves placing particular crystals on precise body spots, as well as around the room.
Western healthcare focuses on treating a particular body symptom or ailment at a time. Crystal therapy, however, addresses the whole body focusing both on physical and spiritual recovery.
Even though there is very little scientific evidence on the medical effectiveness of crystal therapy, its many thousand-year usage history suggests that there might be more to them than only pretty rocks. Often people describe feeling peaceful, relaxed and healthier after receiving crystal therapy. (Therapy Directory, 2014)
Figure 14
Acupuncture
"Acupuncture is a treatment derived from ancient Chinese medicine in which fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.
Western medical acupuncture is the use of acupuncture after a proper medical diagnosis. It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue.
This results in the body producing pain-relieving substances, such as endorphins. It is likely these substances are responsible for any beneficial effects seen with this form of acupuncture.
Traditional acupuncture is based on the belief that an energy, or "life force", flows through the body in channels called meridians. This life force is known as Qi (pronounced "chee").
Practitioners who adhere to traditional beliefs about acupuncture believe that when Qi does not flow freely through the body, this can cause illness. They also believe acupuncture can restore the flow of Qi, and so restore health." (NHS, 2014)
Figure 16
Figure 15
Massage Therapy
"Massage can benefit those with structural and functional scoliosis. It helps relieve pain caused by scoliosis. Massage relaxes the muscles of your back and body and helps improve flexibility. A 2006 case report by Michael Hamm, LMP, found massage to be effective at relieving pain, improving sleep and increasing the ability to conduct daily activities for people with scoliosis. A skilled massage therapist can use a combination of massage strokes, sustained pressure, positioning and stretches to help balance the muscles of the back and body to relieve or eliminate functional scoliosis. Increased body awareness will allow you to change movement habits that contribute to functional scoliosis." (Troncao, 2015)
Breathing Therapy
Learn how to breathe and relax the body, release the tension. Understand how breathing is related to the whole body and can affect it.
Respiratory Function
"Lung (pulmonary) function may slightly decline after scoliosis surgery. To improve breathing function steadily with time, it is helpful to perform respiratory exercises every one to two hours for the first three weeks after surgery. Respiratory exercises include deep breathing using the incentive spirometer provided at the hospital and frequent coughing. Lung function is routinely checked during regular office visits." (Lonner, 2013)