Schroth Method

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Schroth Method

• A 3-D Treatment Approach to Treating Scoliosis
  According to the Principles of C.L. Schroth
• Michelle Dwyer, DPT
• Schroth and SEAS Certified for the Treatment of
  Scoliosis and Spinal Deformities

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U.S. History- Challenging the Current Model

• Parents- Too much wait and see
• Patients- Lack of knowledge regarding how to
  help themselves beyond bracing and waiting
• Therapists- Inadequately educated and equipped
  in scoliosis treatment
• Orthotists-Traditional bracing lacks 3-D
  corrections, resulting in flat back and other
  poor cosmetic changes
• Doctors- Is there a way to help patients
  sooner?

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Traditional PT

• Postural Awareness
• Stretching/ Strengthening
• Hip ROM
• Spinal Stability
• Body Mechanics

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Challenging the Traditional Model of PT

• Schroth Based PT - Barcelona Physical Therapy
  School
• SEAS
• - ISICO, Stephano Negrini MD, Milan, Italy
• Team Approach
• PCP/ Pediatrician, Orthotist,
  Orthopedic/Neurosurgeon,
• Other?
• Community Involvement
• Curvy Girls, Hopes Closet, local meeting and
  support groups.

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Schroth ( BSPTS) Principles

• Primarily Adolescent Idiopathic Scoliosis
  Treatment
• Deformities in the Sagittal Plane (
  Scheurmanns, Hyper-Kyphosis and Hyper- Lordosis
• Curve Specific
• Cognitive, sensory- motor, kinesthetic,
  neuromuscular
• exercises to reduce scoliosis posture

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History and Goals

• Germany 1921
• Inpatient
• Spain 1968
• Outpatient
• USA 2005
• First certified therapists
• 2011 First US course held Stevens Point, WI

• Correct scoliosis posture
• Reduce risk of progression
• Strengthen asymmetrically
• Improve respiration
• Diminish functional limitations
• Reduce pain
• Improve body mechanics
• Improve self image and quality of life

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Treatment Guidelines

• Precautions
• Osteoporosis
• Post- Surgery
• Juvenile Hypermobility Syndrome (JHS)
• Osteogenesis Imperfecta
• Spondylolisthesis
• Contraindications
• Reactive Scoliosis (tumor, disease, etc)
• Inflammatory diseases- during active phase
• Psychiatric Issues

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Treatment Guidelines

• May be treated but with limitations
• Syndromic and Neuromuscular Scoliosis
• Post Surgery
• Adult Degenerative Scoliosis
• Infantile (Age 0-3), Juvenile (age 4-9)
  SRS Classification

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Treatment Guidelines

• Risk of Progression Factor
• Patient Age
• Risser Score
• Cobb Angle
• Age patient is first seen

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Assessment

• Screening- Adams Test
• Angle of Trunk Rotation- (ATR) Using
  Scoliometer
• gt5 in sitting Screen
• Postural- Frontal, Sagittal and Aerial
• X- Ray- Cobb, Apex, Rotations, CSL, Risser
• Height Measurement Sitting and Standing
• Vital Capacity
• Thoracic Function
• Pain
• Quality of Life SRS 22, SRS 36, TAPS, QLSPD

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Schroth Exercises

• Prone on Knees-Transverse Plane Anterior
  Gravity Assisted

• Semi-Hanging Sagittal Plane

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Schroth Exercise

• Standing 3D Correction

• Supine Gravity Assisted- Transverse Plane

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Assessment Photos
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Assessment Photos
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In Brace Correction
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Pre/ Post Brace Comparison

• In Brace X- Ray

• Pre Brace X-Ray

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Sagittal Plane Correction

• Visit 3

• Visit 1

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Exercises Using Schroth Principles
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Exercises Using Schroth Principles

• Visit 1 - Uncorrected

• Visit 3 - Corrected Posture

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Exercises Sport Specific and In-Brace
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Sport Specific Training In Corrected Posture
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Case Study

• Visit 1

• Visit 1

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Sagittal Visit 1
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Visit 2 Sagittal Plane Correction

• Sagittal Correction

• Psoas Stretch

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Stretching- Stabilization

• Supine Hamstring Stretch

• Scapular / Core Stability

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Sagittal Correction

• Visit 1

• Visit 6 - 2 month follow up

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Patient Follow Up

• Visit 1

• 2 Month follow up

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PT Treatment Options

• Local Program
• Basic Program 2x wk- 8wks
• Progression
• Monthly, Quarterly, Bi-Annually
• Until Risser 5

• Immersion Program
• Basic Program for 5 consecutive days
• Progression
• First yr every 3 months
• Bi-Annually to Risser 5

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Assistants