Scoliosis quizlet

Cobb's angle

"a standard measurement to determine and track the progression of scoliosis. measured by drawing lines parallel to the upper border of the upper vertebral body and the lower border of the lowest vertebra of the structural curve, then erecting perpendiculars from these lines to cross each other, the angle between these perpendiculars being the 'angle of curvature

What 5 types of diseases are listed under Mesenchymal scolisos that hav resulted from insufficiency of passive stabilizers of the spine

1. Marfan's syndrome, 2. mucopolysaccharidosis, 3. osteogenesis imperfecta, 4. inflammatory diseases or 5. postoperative after thoracic surgery (open heart surgery).

Within each type of scoliosis, what are the types of characteristics seen?

1. Rate of curve progression 2. degree 3. pattern of the 3D deformity

What 2 generic instruments to assess health related quality of life can be used for scoliosis?

1. SF-36 questionnaire 2. EuroQol5D instrument

what are the two outcome measures that are disease specific and recommended to use for scoliosis?

1. SRS-22 Patient Questionnaire 2. The quality of life profile for spinal deformities (QLPSD)

What are the 7 types of characteristics/clinical presentation of scoliosis?

1. Sideways curvature of the spine 2. Sideways body posture 3. One shoulder raised higher than the other 4. Clothes not hanging properly 5. Local muscular aches 6. Local ligament pain 7. Decreasing pulmonary function is a major concern in progressive severe scoliosis.

What can assess the perception of the trunk deformity and body image according to the patient

1. Walter - Reed Visual Assessment Scale (WRVAS) 2. spinal appearance questionnaire (SAQ) 3. trunk appearnce perception scale (TAPS)

How are scoliosis patients classified? (different types)

1. age of onset 2. etiology 3. severity 4. type of curve

what are the 8 categories of thorax deformity

1. anterior chest angulation 2. area enclosed by rib cage 3. coronal asymmetry 4. hemithorax depth asymmetry 5. hemithorax width asymmetry 6. posterior rib asymmetry 7. sagittal depth 8. sternum deviation

What can be used to measure the impacts of the brace used?

1. bad sobernheim stress questionnaire 2. brace questionnaire

the prevalence of idiopathic scoliosis is dependent on what two factors?

1. curvature of the spine 2. gender of the patient

3 major subgroups of Idiopathic scoliosis

1. infantile 2. juvenile 3. adolescent

What are the two things that the progress of scoliosis will lead to?

1. thoracic cage deformity 2. concomitant pulmonary compromise

What are the 6 types of passive stabilizers mentioned with mesenchymal scoliosis?

1. vertebrae, 2. facet joints, 3. intervertebral discs, 4. spinal ligaments (like ligamentum flavum and ligamentum longitudinale anterius), 5. joint capsules and 6. passive muscle support

3 major subgroups of Non-Idiopathic scoliosis

1.congenital scoliosis 2. neuromuscular scoliosis 3. mesenchymal scoliosis

an angle difference of more than what indicates a poor prognosis and rapid progression within infantile scolisosis

20

Bracing is recommended for females with a cobb angle of:

25-35 degrees

What is relaxed position exercises

3 movements per exercise, where the patient must repeat each exercises three time for five minutes. All exercises must be performed rapidly

Cobb Angle

A standard measurement to determine and track the progression of scoliosis

Adam Forward Bend Test

A test used to make a distinction between structural scoliosis or non-structural scoliosis of the cervical to lumbar spine. The test can be performed in the standing and sitting position.

Scoliosis

A three-dimensional deformative abnormality of the spine.

How do you distinguish structural vs non structural

Adam Forward Bent Test

what is the gold standard for transverse plane thorax deformity characterization?

CT imaging

Characteristics of Scoliosis

Cobb's angle, vertebral rotation in the transverse plane, and hyper kyphosis in the sagittal plane.

Quality of Life Profile for Spinal Deformities (QLPSD)

Disease-specific outcome measure of scoliosis, more recommended than generic QOL measures.

SRS-22 Patient Questionaire

Disease-specific outcome measure of scoliosis, more recommmended than generic QOL measures

1st Step of Functional Exam

Examination of the active movements(flexion, extension and side flexion) of the spine in the cervical, thoracic and lumbar segment.

SF-36 questionnaire and EuroQol5D

Generic instruments that can be used to assess health related quality of life of those with scoliosis

Functional Vital Capacity (FVC)

Gives an assessment of lung volume

Walter-Reed Visual Assessment Scale (WRVAS), Spinal Appearance Questionnaire (SAQ), Trunk Appearance Perception Scale (TAPS)

Group of outcome measures that assesses patient's preception of trunck deformity and body appearance as it relates to scoliosis

Adolescent idiopathic scoliosis(AIS)

Has the highest prevalence of the three categories. Present at age ten and lasts till the end of growth. Its prevalence is dependent on the curvature of the spine and gender of the patient. More frequent is girls (4:1 ratio)

Non-idiopathic Scoliosis Outcome Measures

Have not been sufficiently validated and analysed

2nd Step of Functional Exam

Have the patient perform the Forward Adam Bend Test

Types of scoliosis based on age presentation

Infantile, juvenile, or adolescent idiopathic.

Important thing to focus on while doing exercises

Learn to breath correctly during exercise

Characteristics of congenital scoliosis

Longitudinal and rotational imbalance

3rd Step of Functional Exam

Measure the Cobb Angle

4th Step of Functional Exam

Measure trunk asymmetry or trunk axial rotation with scoliometer

Relaxed Position Exercises purpose

Metabolic recovery & relaxation of the used muscles

Goal of flexibility on the step chair w/ a spring positioned in the rings to provide major resistance

Mobilize the spine & stretch the paravertebral thorax & lumbar muscles

Are all patients w/ scoliosis actually suffering from this spine deformity?

NO

Do patients who are professionally active return to work if the job included physically demanding tasks following surgery?

No, but they usually stopped working before surgery due to pain limitations

Surgical Treatment

Offered to children under 10 who's major lateral curvature is progressing despite conservative treatment. (Cobb angle greater than 50 degrees)

Bad Sobernheim Stress Questionnaire (BSSQ) & Brace Questionnaire (BrQ)

Outcome measure used to assess impacts of a brace used in treatment of scoliosis

Upper Rolling Stretch

Patient lies supine w/ arms besides the body. Patient has to raise both legs till the toes touch the floor. Then unroll spine slowly (vertebra by vertebra). Goal: stretching the posterior chain, mobilizing the spine, & strengthen the abdomen

Child Position Stretch

Patient sits in a four support position & has to strectch the spine, arms, & push the hands against the floor. Then lower the spine. Goal: stretching the thoracic paravertebral, lumbar, and gluteal regions & mobilizing the vertebral spine

Spine Forward Stretching

Patient sits on floor w/ straigt back & legs stretched. Patient has to bring the trunk forwards. Goal: Stretch the posterior muscle chain & mobilizing the vertebral spine

85%

Percentage of scoliosis cases that are idiopathic

Forced Expiratory Volume

Provides an assessment of flow function

5th Step of Functional Exam

Pulmonary function testing with spirometer

What is the major problem of elderly patients following surgery?

Residual back pain mostly as an expression of muscle spasms & pain due to unbalanced or chronic contractures of the paravertebral muscles

Congenital scoliosis

Scoliosis that is present from birth. Represents a spinal malformation due to defects of formation, segmentation or mixed ones.

What are commonly used for clinical assessment and their inter-relationship has been widely documented

Scoliosis-induced lateral spine curvature in the coronal plane and vertebral rotation

Goal of inverted abdominal skills w/ a ball (55 cm diameter)

Strengthen the infraabdominal region & the ischiotibial muscles

Goal of rising into a seated position

Strengthening the M. Rectus abdominis

Goal of hip movements w/ a large ball (65 cm diameter)

Strengthening the gluteal muscles & developing equilibrium

Goal of lateral spine movement

Stretching the lateral muscle chain according to the direction of convexity of the scoliosis

Goal of lateral spine movement on a step chair w/ a spring positioned in the rings to provide major resistance

Stretching the lateral muscle chain according to the direction of convexity of the scoliosis

what 3 things can be used for a very precise diagnosis.

Surface electromyography (EMG) examination, magnetic resonance imaging or static and dynamic postural evaluation

True of False: It is important to know that the available instruments to evaluate the treatment for non-idiopathic scoliosis have not been sufficiently validated and analysed.

TRUE

True or False: the prevalence of idiopathic scoliosis is higher among females, who have been observed to have more sever curvature

TRUE

Forward Leg Pull

The patient sits in a four support position. Then raises the right arm & leg while the spine stays aligned. Then the same exercise but change arm & leg. Goal: stretching the concavity of the vertebral spine

what is used to diagnose disturbances of transfer of the force of gravity in patients with IS

The static postural evaluation

what serves to measure body sway and changes of the projection of the centre of gravity in a free standing position.

The static postural evaluation

what uses a platform to record ground reaction forces in a static standing position

The static postural evaluation

Pilates Intervention

Warm up for eight minutes on treadmill or elliptical followed by stretches including spine forward stretching, upper rolling, child position, & forward leg pull

When is surgical treatment offered?

When conservative treatment fails

Torsion-scoliosis

When rotation component in scoliosis becomes more pronounced. Causes a gibbus.

According to questionnaries about overall daily activities, do patients improve following surgery regardless of age?

Yes

Are outcomes less favorable following surgery for older adults?

Yes

Scoliosis is not just a lateral curvature of the spine, but it is:

a three dimensional condition

What age group does spinal surgery usually occur in?

adolescence

This type develops at the age of 11-18 years and accounts for approximately 90 % of cases of idiopathic scoliosis in children.

adolescent

This type as a prevalence of 2,5 % in the general population with a Cobb angle larger than 10 degrees

adult scoliosis

this type is caused by degenerative changes in the aging spine

adult scoliosis

this type of scoliosis has a prevalence of more than 8 % in adults over the age of 25 and rises up 68 % in the age of over 60 years

adult scoliosis

The severity of the curvature can cause pressure on what structures?

airways and lungs

When should spinal surgery be performed?

as early as possible to prevent development of severe local deformities and secondary structural deformities that would require fusion later

What are the aims of physical therapy?

autocorrection 3D, coordination, equilibrium, ergonimical corrections, muscular endurance/strength, neuromotor control of the spine, increase ROM, respiratory capacity/education, side-shift correction, stabilization

What is the strategy of the Scientific Spine Institute?

based on a specific form of Active Self-correction (ASC), that is taught individually to each single patient. Thi achieve the maximum possible correction. ASC is then associated with stabilizing exercises that include neuromotor control, proprioceptive training and balance

Why is important to incorporate breathing techniques?

because structures can become compressed, should combine with thoracic mobilizations

The following factors can be helped with exercise:

cobb angle, angle of trunk rotation, thoracic kyphosis angle and lumbar lordosis and improving the quality of life in patients with AIS.

This type is caused by a malformation of vertebrae like hemivertebra, unilateral bar, or block vertebra

congenital

this type may not be clinically evident at birth but develops until adolescence

congenital

within this type of scoliosis, genes that are associated with vertebral malformation have been identified in several studies, and similar defects have been induced in animal models by hypoxia or toxic agents

congenital

What is goal of bracing idiopathic curves?

control the curve, prevent progression, & avoid surgical intervention

What is the Schroth 3-dimensional method of treatment?

curve-specific exercises and corrective breathing techniques. purpose is to derotate, deflex and correct spine in the sagittal plane while elongating the spine

Purpose of Functional Exam

distinguish between faulty posture and actual idiopathic scoliosis

Risk factors that may result in a higher curve progression

female, age 10-12, absence of menarche, presence of thoracic curves, curve size at presentation > 25 degrees, Risser sign of 0-1, and residual growth potential

thorax deformity in the AP and ML planes is primarily assessed how?

for clinical purposes using planar radiographs

When is physical therapy and bracing indicated?

for milder forms of scoliosis to maintain cosmesis and avoid surgery

Gibbus

hump or a rounded eminence

What are the two main groups of scoliosis?

idiopathic and nonidiopathic

When can conservative treatment work in mild cases of formation failures?

in the first 3 years of life

This type develops at the age of 0-3 years and shows a prevalence of 1 %.

infantile

there is a regression of scoliosis in more than half of the cases of this type of scolisosis

infantile

What are the three important tasks of a physical therapist?

inform, advise, and instruct

This type develops at the age of 4-10 years and comprises 10-15 % of all idiopathic scoliosis in children

juvenile

curves in juvenile scoliosis of 30 and more tend to progress, 95 % of these patients need a surgical procedure.

juvenile

untreated curves may cause serious cardiopulmonary complications,

juvenile

In regards to muscle lengthening and shortening, what should you attempt to correct as a therapist?

lengthen concave side mm, and shorten convex side mm

this type is caused by insufficiency of passive stabilizers of the spine like

mesenchymal

What is a commonly used type of brace?

milwaukee brace

Surgical treatment of this type is associated with the highest rate of complications compared to other types of scoliosis

neuromuscular

this type is caused by insufficiency of active stabilizers (including the muscles and tendons surrounding the spinal column like the musculus longus capitis or the musculus longus colli) of the spine like cerebral palsy, spinal muscular atrophy, spina bifida, muscular dystrophies or spinal cord injuries

neuromuscular

Is spinal fusion recommended in children below ages of 10?

no because it prevents spinal growth and pulmonary development

Is there good evidence on bracing?

no, it is limited. more research is needed

What is a MCGR?

nobel technology that enables non-invasive spinal lengthening in an awake patient in an out-patient setting

This type of scoliosis can be corrected

non structural

This type of scoliosis occurs due to posture or compensation of the spine

non structural

What should be included in the evaluation of scoliosis treatment that can be obtained with the use of patient - reported outcome measures?

patient's perspective

What patients will not benefit from conservative treatment?

patients with specific types of segmentation failures, or >20 degrees in infancy

What does conservative therapy consist of?

physical exercises, bracing, manipulation, electrical stimulation and insoles

What are some respiratory treatments constructed by solache-carranco and sanchez-bringas?

respiratory education techniques, postural drainage and vibration to evacuate mucus and decrease the resistance of the airways, relaxation techniques to make sure the patient would have better control of respiration

The most common spinal disorder in children and adolescents

scoliosis

How is a scoliosis characterized

side to side curvature of the spine >10 degrees, usually combined with rotation of the vertebrae and most ofte a reduced kyphosis in thoracic curves

Two types of scoliosis

structural and non structural

this type of scoliosis are deviations that cannot or just partially be corrected

structural and non structural

What should you do if there is a great risk of pulmonary is too high?

surgery

what uses a platform to record ground reaction forces as well as body sway during walking and the centre of gravity during jumps and different activities.

the dynamic posture evaluation

This was the reason for the radical decrease in number of infantile scoliosis in the 1980s,

the recommendation of prone position for the infants.

what is helpful in examining spinal muscle work.

the superficial EMG

To manage scoliosis you need to work in how many planes?

three: sagittal, frontal, and transverse

What are goals of spinal surgery?

to prevent progression and to improve spinal alignment and balance

What are back braces for?

to prevent progression or development of secondary curves, not to fix the action problem

Why do you prescribe a brace?

to prevent worsening of scoliosis

How long can back braces be applied?

until skeletal maturity

is spinal surgery safe?

yes

Does exercise benefit scoliosis?

yes, it has beneficial effects on patients with idiopathic scoliosis