What is the Schroth Method?A CONSERVATIVE physical therapy treatment approach consisting of mental and physical training that brings together proper breathing techniques with self-perception to prevent or minimize spinal curve progression.
The Schroth Method is a therapy plan that entails cognitive, sensory-motor, and kinesthetic training to teach the patient to improve her/his scoliosis posture. The program is an intense routine of auto-elongation exercises and stretches, rotational breathing, muscle facilitation, stabilization education and postural awareness techniques. The goals of this non-surgical treatment are to stop/limit curve progressions, improve cosmesis, improve general health, to help the patient cope with the deformity and the treatments, and most importantly diminish functional limitations. A study by Zaborowska-Sapeta, et al, showed that the combination of bracing and the Schroth Method helped to improve scoliosis curves.
The treatment approach has been practiced successfully in Germany and Spain for several decades now, and, with a growing body of practitioners in the United States, we are seeing similar results. Bill Block, DPT received his C1 certified training through the Barcelona Scoliosis Physiotherapy School in March of 2011 and has been using the Schroth Method of treating idiopathic scoliosis since that time with positive patient feedback. In October 2013 he earned his C2 certification through the Barcelona Scoliosis Physiotherapy School, further enhancing his knowledge of treatment for clients of all ages.
Frequently Asked Questions:Am I a candidate for physical therapy?
- The focus of the Schroth Method is to stop progression of the spinal curve prior to needing more intense treatment options such as surgery. The target population is adolescents between the ages of 10-18. Younger children and/or adults without a history of spinal/back surgery may also benefit.
- Treatment lasts 30 minutes to 1 hour based on the custom Plan of Care created for each individual. Typically a patient will be seen for 8 weeks (1-2 visits per week). After treatment ends, patients will receive a home exercise program to continue treatment independently.
Scoliosis Case Study
By: William Block, DPT 2013
Background: The effectiveness of conservative management of Scoliosis in the adolescent population continues to require further investigation. A study by Stefano Negrini et al (1). supports that the combination of bracing and Schroth based exercises reduced patients scoliosis curve progressions. The aim of this case report is to further increase the literature available to support these findings.
Subject: The subject in this case report was a 10 year old female who was diagnosed with idiopathic scoliosis on 5/16/12. Her initial Cobb angles were measured to be 32° right thoracic curve, with a 19° left lumbar prominence. Axial trunk rotation through the thoracic spine was defined by Raimonde of 14°. She was a 0-1 on the Risser scale. Schroth classification was a right thoracic 4-curve pattern. The subject is active with karate, basketball, and volleyball. She has not undergone any other treatments for scoliosis prior to our initial evaluation. She is highly motivated, with a great support system from her family.
Methods: This is a retrospective case report, single subject. The subject began the Schroth based method of physical therapy for her scoliosis on 6/11/12. Our initial plan of care entailed 2 visits per week for 6 weeks. All clinic sessions were 1 hour in duration. This plan included a total of 12 visits from 6/11/12 through 8/8/12. Her home exercise program (HEP) consisted of 15 minutes of Schroth based exercises per day, 6 days per week. The subject was fit for a 23 hour Rosenberger brace on 6/28/12. The subject's in brace x-ray revealed a 12° correction of her thoracic curve. Her scoliosis curve improved from 32° to 20° in brace.
Phase 2: After her original plan of care was completed, we decreased her frequency of visits to 1x/week for 10 weeks from 9/5/12-12/27/12. Frequency of visits was decreased due to her increased independence in technique efficiency and accuracy. At this time, HEP was continued 15 minutes/day for 6 days/week. The subject had her first follow-up x-ray at the end of this second phase plan of care. Her thoracic Cobb angle improved from 32° to 21°, her lumbar curve remained at 19° and her degrees of rotation improved from 14° to 11°.
Phase 3: The third phase of treatment included a plan of care consisting of 1 visit every other week for 20 weeks. This phase was carried out from 1/7/13-6/20/13, and consisted of 10 visits. At this time, patient and her mother reported full independence with the HEP, but patient was highly motivated by clinic exercise sessions and new challenges. During this time, Schroth based method postures were progressed and accessory exercises for core and total body strengthening were further progressed. Follow-up x-rays were taken on 6/20/13, upon completion of phase 3 plan of care. Her thoracic Cobb angle had improved to 17° and her lumbar curvature improved to 15°. The patient is currently wearing her brace 23 hours/day, and continues her home exercise program only. Follow-up phone calls are used for tracking progress.
Results: The subject participated in the Schroth based method of physical therapy program from 6/11/12 to 6/20/13. She had a total of 32 visits during this 1-year span. Her and her family report great compliance with her 15 minute/day, 6 days/week HEP. She also reports great compliance with her Rosenberger brace 23 hours/day regimen. Since beginning her conservative treatments for scoliosis management, the subject’s thoracic Cobb angle has improved from 32° to 17°. Her Lumbar curve has improved from 19° to 15°. Her thoracic rotation classified by Raimonde has improved from 14° to 11°. The numbers observed in this case suggest that conservative treatments were successful in significantly reducing Cobb angles.
Conclusion: The combination of Schroth based physical therapy method and 23-hour bracing were found to be successful in significantly reducing Cobb angles in this case. This suggests that in the case of mild to moderate idiopathic scoliosis, good compliance with conservative treatments can be effective in reducing curvatures.