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Active exercises and prevention of progression of an idiopathic scoliosis.

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Active exercises and prevention of progression of an idiopathic scoliosis.

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Samenvatting

Objectives
Among the treatment alternatives for adolescent idiopathic scoliosis (AIS) in Norway, only bracing and surgery are mentioned as generally accepted forms of treatment. There exists a lot of controversy on this issue; therefore a descriptive research is used to highlight the different aspects concerning the subject. The project group wants to focus on AIS from a physiotherapeutic point of view and try to investigate if other countries have a different approach on this subject. The objectives of the project were to find interventions used to detect adolescent idiopathic scoliosis, and the different treatment interventions used on an adolescent idiopathic scoliosis to prevent progression of the curve. The importance of early detection of idiopathic scoliosis and what other interventions that can be carried out instead of surgery have been highlighted. The physiotherapy role concerning the treatment has also been focused on. Before handling the questions concerning screening and treatment, background information on idiopathic scoliosis was written to make it easier to interpret the analysed articles, and make the reader understand why disagreements concerning the different screening methods and treatment interventions exist.

Method
The method used for the project was a descriptive research. Copies from 46 articles/books were gathered. All the information collected made the project group capable of comparing and discussing the different aspects of the objectives of this project. Literature was selected after thorough considerations by using inclusion and exclusion criteria's and a data extraction list. The material was assorted into a theoretical framework and a descriptive research (including the results, discussion and conclusion). The theoretical framework gives a thorough description of an idiopathic scoliosis, screening, and treatment of adolescent idiopathic scoliosis. In the descriptive research the findings from the articles reviewed are included. This research was carried out to find the value of screening and different treatment methods of adolescent idiopathic scoliosis. These results were analysed by the project group in the discussion part. The project group paid a visit to the Sint Maartenskliniek in Nijmegen to get information from an expert in the field about the side-shift therapy for adolescent idiopathic scoliosis. Expert comments were also included from an interview with an orthopaedic engineer in Norway.

Results
The results from the descriptive research answered the two main questions of the project. The descriptive research shows that school screening is carried out to enhance early non-operative management of scoliosis to effectively arrest a progressive spine. The measuring instruments used to assess the magnitude of the progressions of curves have been questioned regarding their reliability. This goes for the use of the scoliometer, the Adam's forward bend test as well as the Cobb method. Still these measuring methods are universally accepted. From the articles reviewed, bracing has shown to be the most effective treatment alternative. In general the results of the effect of treatment for adolescent idiopathic scoliosis show a low reliability.

Conclusion
There is a great variance of treatment forms for adolescent idiopathic scoliosis, and the disagreements on the effects of the treatment methods are even greater. The project group can conclude with the results found from the articles. The all-over interpretation of the articles is that full-time bracing gives the best effect in preventing the curve of adolescent idiopathic scoliosis progressing. The treatments with active exercises are most probably of a good concern for the patient, but little research and testing on exercises have been done, and the exercises come up with less effective or varying results for the patients. Taking these results into consideration, the project group feel capable of stating that the conclusion from the project group coincide with the conclusions from most of the articles. Further research on adolescent idiopathic scoliosis, its screening and treatments methods to find the most effective and ideal way of halting the progression or even improve a scoliotic curve is required.

Keywords: adolescent, idiopathic, scoliosis, treatment, screening, bracing, effect.

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OrganisatieFontys Hogescholen
OpleidingFysiotherapie
AfdelingFontys Paramedische Hogeschool
Jaar2002
TypeBachelor
TaalEngels

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