| Currently accepted non-operative management options for patients with adolescent idiopathic scoliosis consist of either observation or bracing. Exercise is thought not to effect the scoliotic spine in a positive way, and most, if not all, clinical and research organizations say the same thing. This is in spite of numerous research and review articles suggesting otherwise. The purpose of this work is to develop and test a quantified trunk rotational strength training protocol for the management of adolescent idiopathic scoliosis.;An isometric rotational strength testing and strength analysis protocol was first developed and determined to be reliable in a group of 20 healthy adults. Data analysis procedures were particularly focused on measuring absolute and relative amounts of rotational strength asymmetry. Small but significant strength asymmetry was found in both males and females when first pre-rotated 36°.;The next step was to identify a rotational trunk strength profile for 26 healthy adolescent females and 14 adolescent females with scoliosis. A slight left contraction direction weakness was found in the healthy adolescents when pre-rotated 36° to the right. In the scoliosis group larger strength asymmetries were found when rotating towards the concavity of their curve when pre-rotated towards the concavity and neutral positions.;The final step was to test a rotational strength training protocol, aimed at strengthening and equalizing trunk rotational strength, on a group of 16 adolescents with idiopathic scoliosis. The protocol consisted of four months of supervised rotational strength training on an isotonic trunk rotational machine. This was followed by four months of a home training protocol using a heavy weighted Thera-BandRTM. X-rays and other clinical measurements were taken at baseline and every four months after that. Results indicate at 77% success rate of stopping curve progression >5° and 100% in stopping progression >10° for patients with curves <45°. All scoliosis patients were made significantly stronger at the end of the supervised training and appeared to have maintained their strength during the home training program.;While still preliminary, these results are promising. A hypothetical mechanism for the trainings effectiveness and an area for future work are discussed. |
