Scoliosis is an abnormal spinal lateral curvature. The bones at the back appear to have a sideways curve. On an X-ray rear view, the person’s spine resembles like a letter ‘S’ or a ‘C’. It usually appears during the adolescent period, but may also affect adults.
Scoliosis is classified according to three factors, namely; etiology, age of onset and the presence or absence of other medical conditions.
Scoliosis is often caused by conditions such as spine deformities present since birth due to genetics and environmental factors during conception and gestation. It can also be due to limb malformations and children’s conditions like cerebral palsy, spina bifida, spinal muscular atrophy and tumor development.
Individuals with scoliosis are known to have one or more of these signs:
- Observable curvature of the backbone resembling ‘S’ or ‘C’
- Prominence of one rib or a shoulder blade
- The hips, arms and legs are uneven in length
Some people with scoliosis reported slow nerve action, which might relate to the disturbance of the physiological and structural position of the nerves affected by the dislocation. In severe conditions, the scoliotic condition might decrease the lung capacity, thus affecting physical activities and heart workload.
Management: Physical and Occupational Therapy
Aside from preventing the progress of the curvature, one of the vital goals of physical therapy for individuals with scoliosis is to help them return or maintain their ability and eagerness to perform their usual daily activities. Therapists are expected to assist the scoliotic person from assessment through till rehabilitation. Objectives may cover preventing the loss of function, intervention of the range of motions and reducing pain for activities that require stooping and carrying loads. Factors to consider during therapy are body image, self-care, exercises, productivity, and leisure.
One of the exercises basically performed in scoliosis is the spinal muscle exercise in order to correct and prevent curvature of the bones. Muscles are important in supporting and maintaining spinal column and shape. It could also help by sustaining spinal curve through the strength of the torso muscles on each side of the body. This exercise is done in prone position with shoulder flexion and hip extension, alternately.
People with scoliosis have certain physical limitation in performing daily activities. Moreover, surgeries and other treatment such as braces and positioning can cause disability and dependence of self-care. Activities that comprise regular persons’ daily life are eating, grooming and personal hygiene, work, and the likes. It is one of the primary responsibilities of the therapist to help the individual maintain the self-care abilities and independence as much as possible. Specialized equipment and assistive technology may be used such as long-handled reacher, shoehorn, and cutlery for dining.
Productivity implies activities that usually composed of all-in-a-days-work such as jobs, house chores, personal and civic activities, entertainment, and others. It is both physically and psychologically important for the person to maintain his daily expected outcomes. Work productivity despite of the limitations brought by the condition reveals commitment and loyalty to the current employment. At the same time, it can help in boosting the individual’s confidence and self-esteem. Occupational therapy can assist the scoliotic person of all ages to attain the maximum productivity level, thus, maintain quality of life.
Another role of therapy is to ensure that the person with scoliosis still enjoy the activities that gives him or her pleasure and entertainment such as sports and outdoor activities even though there are medical limitations. The most common technique useful among people who love mild physical sports is the use of braces. Modifications of the leisure activities such as swimming and yoga can also be used as intervention.
These are a few of the several ways in which the therapist and the scoliotic individual explore in order for the latter to meaningfully participate in activities without compromising the condition and medical management.