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Copyright of Scienza Riabilitativa is the property of Associazione Italiana Fisioterapisti and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Scienza Riabilitativa is the property of Associazione Italiana Fisioterapisti and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. SpineCor is a dynamic brace that showed good results in scoliosis treatment. But data suggest that its efficacy is reduced as curves magnitude increase, and no comparisons exist versus exercise alone. The objective of this double study is to compare the short term results of the SpineCor versus SEAS exercises and versus rigid SpoRT brace for AIS. Methods. Study design: 2 retrospective controlled studies. Population 1: 56 consecutive AIS patients (39 female; age 13±1, Cobb 21±4°; ATR 11±4°): 28 patients (19 females; age 13±1; TRACE 6; Cobb angle 22±4°; ATR 12±4°, Risser 0-3) treated by SpineCor 20/24 hours; 28 patients (20 females; age 13±1; TRACE 5; Cobb angle 20±4°; ATR 9±3°, Risser 0-3) treated by SEAS exercises. Population 2: 103 consecutive AIS patients from our prospective database (85 females; age 13±1, Cobb 24±5°; ATR 8±4°): 29 patients (19 females; age 13±1; TRACE 6; Cobb angle 22±5°; ATR 9±3°, Risser 0-3) treated by SpineCor 20/24 hours per day; 74 patients (66 females; age 13±1; TRACE 5; Cobb angle 25±4°; ATR 8±4°, Risser 0-3) treated by SPoRT Brace 18 to 23 hours per day. The short term results of treatment, both clinical and radiographic, were evaluated after 18 months. Outcome measures: N° of rigid brace prescribed, TRACE, Cobb angle (changes > ±5), ATR (changes > ±2). Results. Study 1: the N° of patients prescribed with a rigid brace was not significantly different in the 2 groups. TRACE was stable for SEAS while decreased for SpineCor (p<0.05). Considering the number of patients changed > ±5° Cobb in the SEAS Group we found 39.3% improved and 14.3% worsened vs 25% and 21.4% in SpineCor (NS); no differences for ATR. Study 2: Both the treatment showed to be effective in improving the TRACE. Considering the other parameters, the SPoRT brace seems to be slightly more effective than the SpineCor both for the Cobb angle and the ATR. Conclusion. Short term results showed the SpineCor's efficacy to be between rigid brace and exercise for treatment efficacy for AIS. [ABSTRACT FROM AUTHOR]

SEAS is an acronym for “Scientific Exercises Approach to Scoliosis”. Main characteristics of SEAS are team approach and cognitive-behavioural approach because in our view these are two indispensable elements in chronic disease rehabilitation. In this article we describe the main differences between SEAS approach and other exercise techniques as well as theoretical bases and therapeutic goals. We illustrate practical application of SEAS concept and scientific results in order to reduce the patient's progress of scoliosis so that a brace would be needed. When compared to usual care, improvement of scoliosis parameters and balance normalization in scoliosis patients. [ABSTRACT FROM AUTHOR]

Background. In the literature the rate of surgery for AIS (Adolescent Idiopathic Scoliosis) of 30° ranges from 22.4% to 31% when braces are used, versus the natural history rate of 28.1%. When a complete conservative approach is used (braces and exercises), this rate decreases to the range of 3.8% to 7.3%. All these studies are retrospective. Aim. The aim was to evaluate the final results of a prospective set of patients treated in a center fully dedicated to a complete conservative treatment (exercises and braces) of AIS. Materials and Methods. This is an everyday clinical, retrospective study on a prospective data base. The population included 112 AIS patients, 13.2±1.8 years old, with 23.4±11.5° Cobb degrees at the start of treatment. All the patients had been treated with a full set of conservative treatments, including exercises, according to their individual needs. We used the SEAS (Scientific Exercises Approach to Scoliosis) protocol and the ISICO approach, while the orthosis used included: Risser cast, and the Lyon, Sforzesco-SPoRT, Sibilla-Chêneau and Lapadula braces. The patients had been followed up by the same physician, braces had been made and exercises had been applied by the same team. The outcomes were established for each single patient: The absolute aim was to avoid surgery, while the minimal and optimal outcomes were defined according to the starting curve. An efficacy analysis and worst-case analysis had been performed. Results. The rate of surgery was 0.9% (efficacy analysis), and 4.5% (worst case); the minimal outcomes had been obtained in 99% of patients and the optimal ones in 84%. Overall, the curves over 40°, which numbered eleven at the start of observation, were reduced to three. In total, eight patients exited the presumable area of risk in adulthood (final curve over 30°). The treatment produced a statistically significant reduction in the worst curves, and the best results have been obtained in the curves over 40°. Conclusion. Provided the use of a complete conservative approach, there is very little doubt that it is possible to reduce the rate of surgery in AIS treatment. [ABSTRACT FROM AUTHOR]

The Lyon school has proposed a preparation to brace wearing through an intensive mobilization in order to obtain a better reduction of the braced scoliotic curve. Our aim was to verify this hypothesis. Design: a prospective controlled study on consecutive patients having idiopathic scoliosis with brace management. Outcome: results after 5 months of brace wearing were reviewed by radiographic examination without the brace. Treatment: SEAS Group exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002); CONT Group various type of exercises. Population. 110 patients (34 females), 13.5±2.4 years, 31.1°±11.1° Cobb (°C), 14.4°±6.0° Bunnell (°B). All parameters improved at follow-up in both groups. SEAS had better results than CONT for °C. Clinical results (variations of at least 5°C and 2°B) were better in SEAS than CONT. This study proves the efficacy of SEAS.02 exercises preparatory for bracing. Bracing demonstrated its short term efficacy. [ABSTRACT FROM AUTHOR]

There is low evidence on the possible efficacy of exercises to treat idiopathic scoliosis, graded as C by the existing Italian Guidelines. Our aim was to verify if exercises quality has an effect on results. Design: prospective controlled study on idiopathic scoliosis patients that performed only exercises to avoid progression. Treatment: SEAS Group make exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002). The CONT Group performed exercises at a local structure according to different protocols preferred by the treating therapists. Population. SEAS: 48 patients (37 females), 12.5±2.2 years, 15.1°±5.7° Cobb (°C), 9.0°±3.3° Bunnell (°B). The difference in the number of braced patients within the first year has been almost statistically significant (P=0.07): 1 in SEAS vs. 5 in CONT. Cobb degrees improved with treatment (P<0.05) only in the SEAS group. Clinical results (variation of at least 5°C or 2°B) were better in SEAS than CONT. Not all exercises for scoliosis have the same efficacy: this study proves the short term efficacy of SEAS.02 when compared to usual care. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Clinical evaluation of the ability of a proprietary scoliosis traction chair to de-rotate the spine: 6-month results of Cobb angle and rotational measurements," by Stitzel and colleagues in the 2014 issue is presented.

Objective: To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis., Design: Prospective controlled cohort observational study., Patients: Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously., Methods: Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation., Results: There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened., Conclusion: These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.

SEAS is an acronym for "Scientific Exercises Approach to Scoliosis". Main characteristics of SEAS are team approach and cognitive-behavioural approach because in our view these are two indispensable elements in chronic disease rehabilitation. In this article we describe the main differences between SEAS approach and other exercise techniques as well as theoretical bases and therapeutic goals. We illustrate practical application of SEAS concept and scientific results in order to reduce the patient's progress of scoliosis so that a brace would be needed. When compared to usual care, improvement of scoliosis parameters and balance normalization in scoliosis patients.

Background: In the literature the rate of surgery for AIS (Adolescent Idiopathic Scoliosis) of 30 degrees ranges from 22.4% to 31% when braces are used, versus the natural history rate of 28.1%. When a complete conservative approach is used (braces and exercises), this rate decreases to the range of 3.8% to 7.3%. All these studies are retrospective., Aim: The aim was to evaluate the final results of a prospective set of patients treated in a center fully dedicated to a complete conservative treatment (exercises and braces) of AIS., Materials and Methods: This is an everyday clinical, retrospective study on a prospective data base. The population included 112 AIS patients, 13.2+/-1.8 years old, with 23.4+/-11.5 degrees Cobb degrees at the start of treatment. All the patients had been treated with a full set of conservative treatments, including exercises, according to their individual needs. We used the SEAS (Scientific Exercises Approach to Scoliosis) protocol and the ISICO approach, while the orthosis used included: Risser cast, and the Lyon, Sforzesco-SPoRT, Sibilla-Chêneau and Lapadula braces. The patients had been followed up by the same physician, braces had been made and exercises had been applied by the same team. The outcomes were established for each single patient: The absolute aim was to avoid surgery, while the minimal and optimal outcomes were defined according to the starting curve. An efficacy analysis and worst-case analysis had been performed., Results: The rate of surgery was 0.9% (efficacy analysis), and 4.5% (worst case); the minimal outcomes had been obtained in 99% of patients and the optimal ones in 84%. Overall, the curves over 40 degrees , which numbered eleven at the start of observation, were reduced to three. In total, eight patients exited the presumable area of risk in adulthood (final curve over 30 degrees ). The treatment produced a statistically significant reduction in the worst curves, and the best results have been obtained in the curves over 40 degrees., Conclusion: Provided the use of a complete conservative approach, there is very little doubt that it is possible to reduce the rate of surgery in AIS treatment.

Unlabelled: There is low evidence on the possible efficacy of exercises to treat idiopathic scoliosis, graded as C by the existing Italian Guidelines. Our aim was to verify if exercises quality has an effect on results., Design: Prospective controlled study on idiopathic scoliosis patients that performed only exercises to avoid progression., Treatment: SEAS Group make exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002). The CONT Group performed exercises at a local structure according to different protocols preferred by the treating therapists. Population. SEAS: 48 patients (37 females), 12.5+/-2.2 years, 15.1 degrees +/-5.7 degrees Cobb (degrees C), 9.0 degrees +/-3.3 degrees Bunnell (degrees B). The difference in the number of braced patients within the first year has been almost statistically significant (P=0.07): 1 in SEAS vs. 5 in CONT. Cobb degrees improved with treatment (P<0.05) only in the SEAS group. Clinical results (variation of at least 5 degrees C or 2 degrees B) were better in SEAS than CONT. Not all exercises for scoliosis have the same efficacy: this study proves the short term efficacy of SEAS.02 when compared to usual care.

Unlabelled: The Lyon school has proposed a preparation to brace wearing through an intensive mobilization in order to obtain a better reduction of the braced scoliotic curve. Our aim was to verify this hypothesis., Design: A prospective controlled study on consecutive patients having idiopathic scoliosis with brace management., Outcome: Results after 5 months of brace wearing were reviewed by radiographic examination without the brace., Treatment: SEAS Group exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002); CONT Group various type of exercises. Population. 110 patients (34 females), 13.5+/-2.4 years, 31.1 degrees +/-11.1 degrees Cobb (degrees C), 14.4 degrees +/-6.0 degrees Bunnell (degrees B). All parameters improved at follow-up in both groups. SEAS had better results than CONT for degrees C. Clinical results (variations of at least 5 degrees C and 2 degrees B) were better in SEAS than CONT. This study proves the efficacy of SEAS.02 exercises preparatory for bracing. Bracing demonstrated its short term efficacy.