| Abstract [eng] |
The prevalence of scoliosis in the paediatric population is increasing every year. The treatment of idiopathic scoliosis in Lithuania is based on traditional physical therapy,and is not always effective. Schroth method nowadays is the most widely used evidence-based conservative scoliosis treatment method. DIERS 3D diagnostic system is one of the most modern diagnostic methods for the spine and posture analysis. The aim of the study was to assess the effectiveness of the Schroth method treatment for girls with idiopathic scoliosis using diagnostic DIERS 3D test method. The objectives of the study: to evaluate posture and spine parameters using DIERS 3D diagnostic test method before and after rehabilitation; to determine the static endurance of trunk muscles, and spine mobility of the subjects before and after rehabilitation; to assess the quality of life of respondents after the implementation of the rehabilitation program; to compare the effectiveness between Schroth method and traditional physiotherapy treatment. The organization and methods of the study. The study was conducted in 2016-2017 at Department of Physical Medicine and Rehabilitation, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos. In the study participated 50 girls aged 9-17 years with idiopathic scoliosis. The patients were divided into two groups: the study group (n=25) and the control group (n=25). Schroth treatment method for the study group and a traditional physiotherapy for the control group were used. For patients were applied 10 procedures of physiotherapy (for 30 minutes, 5 times a week). DIERS 3D diagnostic test method, trunk muscles static endurance and spine mobility tests were applied. SRS-22 questionnaire was used for health-related quality of life assessment. SPSS 21.0 and MS Excel were used for statistical analysis. The study results and conclusions. The analysis of the treatment effectiveness using DIERS 3D device revealed that in the experimental group the estimate of trunk length significantly increased (from 403mm to 406mm). The assessment indicator for trunk imbalance (from 2.88mm to 2.04mm),the surface of rotation degree (from 6.04º to 5.32º), lateral deviation (7.84mm to 5.96mm), and kyphotic angle degree (from 46.88º to 43.44º) significantly decreased (p<0.05). In the control group, significant decrease in pelvic torsion parameter (from 4.36mm to 3.32mm) was observed;a significant decrease in trunk length (from 429mm to 422.16mm), was revealed, indicating a negative change. After rehabilitation there were no significant differences between the study group and control group for the mentioned indicators,p>0.05. Trunk muscles static endurance results after rehabilitation were significantly higher in the study group than in the control group, p<0.05. The analysis of the average changes in results between the groups showed that in the study group abdominal muscles (16.08s more), left (6.98s more) and right (7.84s more) side trunk muscles results significantly changed. Results of spine mobility significantly improved in both groups after rehabilitation(p<0.05). Trunk flexion amplitude estimated to have significantly greater improvement in the experimental group. The results of the survey revealed that quality of life of all respondents were rated for 4 points. This indicates a good health-related quality of life assessment. Patients, who used Schroth method, were more satisfied with the treatment;they would choose this treatment again. The treatment using Schroth method significantly improved the trunk muscles static endurance indicators and mobility of the spine during spinal flexion. When analyze the results inside the groups, the significant change was shown in the majority of spine and posture-related parameters in the study group. When compare the results between two groups obtained with DIERS 3D device, no significant differences between the study and control groups were found. |
