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1.
J Phys Ther Sci ; 36(1): 44-50, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38186967

RESUMO

[Purpose] To present the case of the amelioration of chronic pain and disability in a patient suffering from failed back surgery syndrome. [Participant and Methods] A 27-year-old male with chronic low back pain was treated with a Coflex® intra-spinous instrument, however, it was removed shortly after due to poor outcome including worsening pain and disability. Radiographic assessment revealed significant posterior translation of the thorax complicated by significant loss of the normal lumbar lordosis and a left lateral translated thoracic cage posture. Chiropractic Biophysics® technique was applied over a 5.5-month period leading to structural spine improvements as well as improved pain, Oswestry disability index (ODI) and quality of life (QOL). [Results] There was a 21 mm reduction in posterior thoracic translation, a 6.2° improvement in lumbar lordosis and a 16 mm reduction in lateral thoracic translation corresponding with improved ODI and QOL scores. A 6 year follow-up showed successful outcome despite some degenerative changes in the spine at the prior surgical level. [Conclusion] This case adds to the growing literature showing the efficacy of non-surgical spinal rehabilitative methods in improving outcomes in patients with spinal deformity and associated disabilities. This case also demonstrates necessity of the continued criterion standard of spinal radiography for biomechanical assessment.

2.
J Sport Rehabil ; 32(1): 53-62, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35894888

RESUMO

OBJECTIVE: To evaluate sensorimotor integration and skill-related physical fitness components for participants with forward head posture (FHP) compared with strictly matched controls with normal head alignment. MATERIAL AND METHODS: We measured FHP, sensorimotor processing, and skill-related physical fitness variables in 50 participants with FHP and in 50 participants matched for age, gender, and body mass index with normal FHP, defined as having a craniovertebral angle >55°. Sensorimotor processing and integration variables were: (1) amplitudes of the spinal N13, (2) brainstem P14, (3) parietal N20 and P27, and (4) frontal N30 potentials. The skill-related physical fitness variables selected for the study were (1) T-test agility, (2) leg power, (3) stork static balance test, and (4) Y-balance test. RESULTS: There was a statistically significant difference between the FHP group and control group for the sensorimotor integration variable: frontal N30 potentials (P < .05). Additionally, between-group differences were found for the sensorimotor processing variables: amplitudes of spinal N13, brainstem P14, and parietal N20, and P27 (P < .05). Statistically significant differences between groups for the skill-related physical fitness variables were also identified: T-test agility, leg power, stork static balance test, and Y-balance test (P < .05). The magnitude of the craniovertebral angle showed a correlation with all measured variables (P < .05). CONCLUSION: College athletes with FHP exhibited altered sensorimotor processing and integration measurements and less efficient skill-related physical fitness compared with athletes with normal sagittal head posture alignment.


Assuntos
Aptidão Física , Postura , Humanos , Atletas , Sensação
3.
J Phys Ther Sci ; 35(3): 270-275, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36866005

RESUMO

[Purpose] To document the re-establishment of the cervical lordosis following radiographically verified altered sagittal plane alignment both prior to, and following a motor vehicle collision. [Participant and Methods] A 16-year-old male presented for a non-motor collision complaint of low back pain. Initial lateral cervical radiograph demonstrated cervical hypo-lordosis. The patient was treated with a 6-week plan (18 visits) utilizing Chiropractic BioPhysics® (CBP) methods to increase the cervical lordosis. Eight months later the patient presented with new complaints as a result of a motor collision. The cervical lordosis straightened. The patient received another round of similar treatment to improve the lordosis. There was also a 6.5-month follow-up. [Results] The initial round of treatment achieved a 21° improvement in cervical lordosis. The motor vehicle collision caused a loss of 15° of lordosis. The second round of treatment achieved a 12.5° improvement in lordosis that was demonstrated to be maintained at a 6.5-month follow-up. [Conclusions] This case illustrates how a whiplash event occurring during a motor vehicle collision subluxated the cervical spine. It was also shown that CBP methods reliably corrected the lordosis after two separate treatment programs using specialized methods. Beyond trauma, radiographic screening of specific cervical subluxation is recommended following all motor collisions.

4.
J Phys Ther Sci ; 35(12): 831-837, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38075507

RESUMO

[Purpose] To present the dramatic improvement in posture, radiographic parameters and the alleviation of neck and severe shoulder pain related to shoulder injury associated with vaccine administration (SIRVA) after a COVID-19 injection with a shoulder mobility and posture rehabilitation program. [Participant and Methods] A middle-aged male presented complaining of severe left shoulder pain evolving since receiving a COVID-19 vaccination. The pain was severe and throbbed into the neck. Posture analysis showed a chronic stooped posture with forward head posture and thoracic hyperkyphosis. Treatment included 42 sessions of Chiropractic Biophysics® technique and a shoulder rehabilitation program using three-dimensional vibration. [Results] At 4-months, the patient reported no neck or shoulder pain. There was a 60% decrease in neck disability. The forward head decreased 34 mm, thoracic hyperkyphosis decreased 13°, and T1-T12 forward lean decreased 73 mm, among other radiographic parameters. Re-assessment after 26-months showed maintenance of the treatment induced posture/x-ray corrections and shoulder pain relief. [Conclusion] This case demonstrates immediate and long-term improvement in a patient suffering from COVID-19 vaccine SIRVA, concomitant with neck pain and disability as well as significant radiographic postural/spinal deformity. These conditions all improved and were maintained at a 2 year follow-up without further treatment.

5.
J Phys Ther Sci ; 35(12): 825-830, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38075517

RESUMO

[Purpose] To present the case of a significant reduction in thoraco-lumbar deformity and alleviation of chronic low back pain in an otherwise healthy and active adolescent male basketball player. [Participant and Methods] A 17 year old was assessed with chronic low back pain persisting for 4 years. Radiographic assessment revealed a prominent thoraco-lumbar kyphosis. Chiropractic Biophysics® structural rehabilitation including mirror image® exercise and traction methods as well as spinal manipulative therapy was performed 2-3 times per week. [Results] There was a 12° improvement in the thoraco-lumbar deformity corresponding with the alleviation of chronic low back pains and near complete reduction in disability after 36 treatments over a 4-month period. [Conclusion] This case adds to the growing literature showing the efficacy of the non-surgical spinal rehabilitative methods of Chiropractic Biophysics in improving spine alignment and relieving spinal pain syndromes. This case also demonstrates the importance of the routine screening for spine alignment via radiography in leading to proper biomechanical diagnosis and treatment.

6.
J Phys Ther Sci ; 35(5): 389-394, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37131346

RESUMO

[Purpose] To present a case demonstrating dramatic restoration of the cervical lordosis and reduction of forward head posture by use of Chiropractic BioPhysics® (CBP®) technique. [Participant and Methods] A 24-year-old cervical asymptomatic female presented with poor craniocervical posture. Radiography revealed forward head posture and an exaggerated cervical kyphosis. [Results] The patient received CBP care including mirror image® cervical extension exercises, cervical extension traction and spinal manipulative therapy. After 36 treatments over 17-weeks, repeat radiography demonstrated a dramatic improvement of an alteration of the cervical kyphosis to a lordosis and a reduction of forward head posture. Subsequent treatment increased the lordosis further. Long-term follow-up at 3.5 years showed some loss of original correction, however, a maintenance of the global lordosis. [Conclusion] This case demonstrates that non-surgical reversal of a cervical kyphosis to a lordosis is possible in a short time using CBP cervical extension protocols. It is logical if the kyphosis had not been corrected, over time, osteoarthritis and various craniovertebral symptoms would have evolved as the literature indicates. The diagnosis of gross spinal deformity, we argue, requires its correction prior to the onset of symptoms and permanent degenerative changes.

7.
Eur Spine J ; 31(12): 3452-3461, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36227366

RESUMO

PURPOSE: The current investigation aimed to compare the sensorimotor integration, sensorimotor control, and cost of cognitive-motor dual task during walking, in persons with chronic WAD as compared to matched chronic idiopathic neck pain and normal healthy controls. METHODS: A cross-sectional, case control design comparing 30 participants in each of two study groups (chronic WAD and chronic idiopathic neck pain) to a matched control group was conducted. Measurements included: (1) the cranio-vertebral angle (CVA), (2) left and right rotation head repositioning accuracy (HRA), (3) frontal N30 amplitudes to assess sensorimotor integration, (4) dual cognitive gait cost (DCGC). RESULTS: A statistically significant difference for the CVA was found between groups: WAD 36.8° ± 3.4, chronic pain 44.5° ± 1.5, and controls 47.1° ± 4; p < 0.05. MANOVA revealed significant group differences for the N30 amplitude (p < 0.05), where the WAD group had the greatest amplitude. Statistically significant differences among the three groups were found for HRA left and right where the WAD group had the greatest error, (p < 0.05). Post hoc tests revealed that the WAD group had the highest dual-task cost during walking, (p < 0.05). Significant linear correlations between the CVA and N30 amplitude, HRA, and DCGC were identified in all 3 groups, (p < 0.05). CONCLUSIONS: Compared to both a matched control group and chronic neck pain group, whiplash-injured persons have greater forward head posture, greater error in sensorimotor control, and an altered ability to perform a motor task with a simultaneous cognitive task.


Assuntos
Dor Crônica , Traumatismos em Chicotada , Humanos , Cervicalgia/complicações , Dor Crônica/complicações , Estudos Transversais , Traumatismos em Chicotada/complicações , Doença Crônica , Cognição
8.
J Phys Ther Sci ; 34(6): 467-472, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35698559

RESUMO

[Purpose] A case series is featured demonstrating reduction of curvature in three adult patients who presented with a mild to moderate severity of a uniquely high thoracic curvature clinical presentation. [Participants and Methods] Three adult patients who presented with an upper thoracic scoliosis deformity of mild to moderate severity underwent Chiropractic BioPhysics® treatment protocols to treat their deformity. Radiographic stress imaging was performed to correctly position and ascertain potential treatment effect of the Denneroll spinal orthotic device. Patients performed spinal traction for 10-20 minutes daily with intermittent spinal manipulative therapy. [Results] There was a 4.5° average reduction in computerized Cobb angle measurement after treatment. All patients reported reductions in spinal pain and also reported subjective improvements in sleep quality and quality of life. [Conclusion] Mild reductions in uniquely high thoracic curves can be reduced in adult scoliosis patients with mild to moderate (17°-26°) curve magnitudes by CBP treatment protocols. Stress X-ray images are recommended to properly place the fulcrum and assess correction potential.

9.
J Phys Ther Sci ; 34(2): 167-171, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35221522

RESUMO

[Purpose] To present the successful structural improvement in cervical lordosis in a patient suffering from cervicogenic headache having cervical kyphosis. [Participant and Methods] A 26 year old female presented with the primary complaint of headache. Radiography demonstrated a cervical kyphosis. Chiropractic BioPhysics® methods were used to restore the cervical spine alignment. Twenty-five treatments were given over 8 weeks. A 2.5 year follow-up was also reported. [Results] Radiography showed a dramatic increase in cervical lordosis following initial treatment. The patient also reported substantial reductions in headache frequency and severity as well as other bodily improvements, reduced disability and improved quality of life. The long-term follow-up showed a maintenance of lordosis correction and patient wellness. [Conclusion] A cervical kyphosis was reversed back to a normal lordosis in 8 weeks and coincided with dramatic resolution of cervicogenic headache in a young female. The cervical lordosis may be a key biomechanical biomarker in cervicogenic headache.

10.
J Phys Ther Sci ; 34(1): 71-75, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35035083

RESUMO

[Purpose] To present the case of a dramatic improvement in the cervical lordosis and relief from chronic headaches and neck pain in a pediatric having a recent neck trauma. [Participant and Methods] A 10 year old male presented with recent neck trauma, neck pain and pre-existing chronic headaches. Cervical range of motion was limited with pain. X-ray analysis showed dramatic loss of cervical lordosis and an acute atlantoaxial rotatory fixation. Chiropractic Biophysics technique methods incorporating spinal manual adjustments, cervical extension traction and corrective exercises were used to restore normal cervical lordosis. Treatments were performed intensively over 6.5-weeks, with a 17-month long-term follow-up. [Results] The pediatric patient responded well to treatment with near complete resolution of cranio-cervical complaints. The cervical lordosis was corrected to age-appropriate magnitude, the coronal symmetry was restored, and both were maintained after nearly 1.5 years. [Conclusion] Chiropractic Biophysics technique which includes the cervical extension traction using the pediatric Denneroll orthotic was effective in restoring lordosis in a pediatric patient with cervical kyphosis and chronic headaches presenting with recent neck pains from a traumatic origin. Routine X-ray of the cervical spine is recommended for patients presenting with craniocervical symptoms as spine alignment is often overlooked as pathognomonic for these conditions.

11.
J Phys Ther Sci ; 34(11): 759-771, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36337218

RESUMO

[Purpose] To characterize the case report evidence of Chiropractic BioPhysics® (CBP®) technique methods applied to increase cervical lordosis and improve forward head posture. [Methods] The CBP Non-profit website as well as PubMed and Index to Chiropractic literature were searched for case reports/series documenting the increase of cervical lordosis and improvement of forward head posture in the treatment of various craniocervical spinal disorders by CBP technique methods. [Results] Sixty patients were reported in 41 unique manuscripts detailing the improvement in cervical spine alignment by CBP technique methods. On average, there was a 14° improvement in cervical lordosis and a 12 mm reduction in forward head position after 40 treatments over 16 weeks with a 5-point reduction in pain rating scores. Thirty-eight percent of cases included follow-up showing only slight loss of lordosis, but maintenance of pain and disability improvements after an average of 1.5 treatments per month for 1.8 years. [Conclusion] An abundance of reports document improvement in craniocervical and other ailments by CBP methods that increase cervical lordosis. Routine radiographic imaging of the spine is recommended as it is safe and the only current practical method of screening for critical biomechanical biomarkers of sagittal spine alignment.

12.
J Phys Ther Sci ; 34(9): 646-650, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36118660

RESUMO

[Purpose] To demonstrate the reduction of lumbar hyperlordosis, sacral base angle and anterior thoracic translation posture in an 11-year-old female. [Participant and Methods] A pediatric patient presented with lumbar hyperlordosis and underwent Chiropractic BioPhysics® treatment protocols to reduce her spinal deformity and correlated symptoms. Symptoms included thoracolumbar, hip, knee and ankle pains and lower extremity weakness. Radiographs confirmed lumbar hyperlordosis, increased sacral base angle and a forward translated thoracic posture. Spinal traction as well as corrective exercises and spinal manipulative therapy was performed over an 11-month period. [Results] After 57 treatments, there was a 13.4° reduction in L1-L5 lordosis, an 11.8° reduction in sacral base angle and a 13.8 mm reduction in anterior thoracic translation. The improved structural changes correlated with improved symptoms. [Conclusion] Lumbar hyperlordosis can be reduced in pediatric patients presenting with hyperlordosis and associated symptomatology. Routine radiography may be warranted in the diagnosis of lumbar spine deformities in pediatrics. Further research into the non-surgical reduction of lumbar spine hyperlordosis is needed.

13.
J Phys Ther Sci ; 33(10): 784-794, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34658525

RESUMO

[Purpose] To systematically review the literature on the use of cervical extension traction methods for increasing cervical lordosis in those with hypolordosis and cervical spine disorders. [Methods] Literature searches for controlled clinical trials were performed in Pubmed, PEDro, Cochrane, and ICL databases. Search terms included iterations related to the cervical spine, neck pain and disorders, and extension traction rehabilitation. [Results] Of 1,001 initially located articles, 9 met the inclusion/exclusion criteria. The trials demonstrated increases in radiographically measured lordosis of 12-18°, over 5-15 weeks, after 15-60 treatment sessions. Untreated controls/comparison groups not receiving extension traction showed no increase in cervical lordosis. Several trials demonstrated that both traction and comparison treatment groups experienced immediate pain relief. Traction treatment groups maintained their pain and disability improvements up to 1.5 years later. Comparative groups not receiving lordosis improvement experienced regression of symptoms towards pre-treatment values by 1 years' follow-up. [Conclusion] There are several high-quality controlled clinical trials substantiating that increasing cervical lordosis by extension traction as part of a spinal rehabilitation program reduces pain and disability and improves functional measures, and that these improvements are maintained long-term. Comparative groups who receive multimodal rehabilitation but not extension traction experience temporary relief that regresses after treatment cessation.

14.
J Phys Ther Sci ; 33(1): 89-93, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33519081

RESUMO

[Purpose] To report on the reduction of a double lumbar spine spondylolisthesis by use of Chiropractic BioPhysics® technique. [Participant and Methods] A 57 year-old male presented with severe chronic low back pains and sciatica. After playing hockey for 50 years, he was unable to continue and was forced to retire. Lumbar radiography showed an L3 retrolisthesis of -5.3 mm and an L4 anterolisthesis of 5.4 mm. Chiropractic BioPhysics technique including mirror image lumbar spine drop-table adjustments, corrective exercises and a unique pelvic extension traction was performed 50 times over 7-months. [Results] A radiograph after 3-months showed full reduction of the L3 retrolisthesis. A radiograph after 7-months showed full reduction of the L4 anterolisthesis. The patient reported full resolution of chronic back pains and was able to return to play hockey; a 1.75 year follow-up showed maintenance of the corrections and the patient remained injury-free while returning to play hockey. [Conclusion] A customized treatment program including Chiropractic BioPhysics lumbar spine traction, corrective exercises and drop-table spine manipulation resolved chronic back pains and fully reduced an L3 and L4 retro- and antero-listhesis, respectively. Further research may substantiate this treatment approach for reducing translational displacements in the lumbar spine. Routine upright radiography is required to diagnose spondylolisthesis.

15.
J Phys Ther Sci ; 32(9): 601-610, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32982058

RESUMO

[Purpose] To systematically review controlled trial evidence for the use of lumbar extension traction by Chiropractic BioPhysics® methods for the purpose of increasing lumbar lordosis in those with hypolordosis and low back disorders. [Methods] Literature searches were performed in Pubmed, PEDro, CINAHL, Cochrane, and ICL databases. Search terms included iterations related to the lumbar spine, low back pain and extension traction rehabilitation. [Results] Four articles detailing 2 randomized and 1 non-randomized trial were located. Trials demonstrated increases in radiographic measured lordosis of 7-11°, over 10-12 weeks, after 30-36 treatment sessions. Randomized trials demonstrated traction treated groups mostly maintained lordosis correction, pain relief, and disability after 6-months follow-up. The non-randomized trial showed lordosis and pain intensity were maintained with periodic maintenance care for 1.5 years. Importantly, control/comparison groups had no increase in lumbar lordosis. Randomized trials showed comparison groups receiving physiotherapy-less the traction, had temporary pain reduction during treatment that regressed towards baseline levels as early as 3-months after treatment. [Conclusion] Limited but good quality evidence substantiates that the use of extension traction methods in rehabilitation programs definitively increases lumbar hypolordosis. Preliminarily, these studies indicate these methods provide longer-term relief to patients with low back disorders versus conventional rehabilitation approaches tested.

16.
J Phys Ther Sci ; 32(12): 864-868, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33362360

RESUMO

[Purpose] To present the case of the relief of idiopathic dizziness and the reduction of neck pains and headache by the improvement in cervical alignment using Chiropractic BioPhysics® technique. [Participant and Methods] A 57 year old female presented with 30 years of chronic dizziness, neck pains and headache. Multiple testing ruled out known causes of vertigo. The patient was diagnosed with idiopathic dizziness. The patient scored 56 points on the dizziness handicap inventory. The patient showed a cervical hypolordosis of -13.7° and anterior head translation of 27 mm. The patient underwent a multimodal treatment of spinal manipulation, cervical extension traction, neck exercises as well as initial electrical stimulation. Traction procedures were slowly progressive due to the severity of the dizziness symptoms. [Results] Over a period of 12-months and 115 treatments there was a 20° increase in cervical lordosis. The patient reported significant reduction in neck pains, headache and dizziness frequency and severity. The patient had a 44-point drop on the dizziness handicap inventory; dizziness symptoms were reported to be very rare. A 1.5 year follow-up showed stability of the symptom relief and a negligible score on the dizziness handicap inventory. [Conclusion] Cervical hypolordosis may be an under-diagnosed cause of idiopathic dizziness in some patients.

17.
J Phys Ther Sci ; 31(11): 965-970, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31871386

RESUMO

[Purpose] To present the dramatic improvement of sagittal posture in a young male with Scheuermann's disease suffering from pain ailments as treated by Chiropractic BioPhysics® technique. [Participant and Methods] An 18 year old reported low back pain and headaches for several years. Full spine radiographic assessment revealed pronounced thoracic hyperkyphosis, anterior head translation, posterior thoracolumbar sagittal balance, and a reduced sacral base orientation. The patient was treated by Chiropractic BioPhysics methods incorporating mirror image® exercises, traction, as well as spinal manipulation. [Results] Assessment after 35 treatment sessions over 14-weeks revealed a dramatic improvement in postural parameters. The thoracic kyphosis reduced by 13°, and was accompanied by a reduction in forward head posture, reduction in posterior sagittal balance, and an increase in sacral base angle to normal. The low back pain and headaches were alleviated. [Conclusion] This case adds to the accumulating evidence demonstrating CBP methods offers an effective approach to reduce the burden of postural disorders including those with Scheuermann's disease. Since thoracic hyperkyphosis is a serious disorder, the routine comprehensive assessment via full-spine radiography is essential for the quantification of relevant postural parameters.

18.
J Phys Ther Sci ; 31(2): 153-158, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30858655

RESUMO

[Purpose] To demonstrate the reduction of symptoms related to Parkinson's disease by improvement in posture. [Participant and Methods] A 59-year-old male patient presented with a prior diagnosis of Parkinson's. Symptoms included a resting right hand tremor, intermittent 'freezing episodes' with gait, mild ataxia with shuffling on toes and bradykinesia assisted with a cane, as well as low back pain and right knee pain. Radiography revealed gross postural and spine deformity. The patient received Chiropractic BioPhysics care including mirror image exercises, spinal traction, spinal adjustments as well as gait rehabilitation. [Results] After 38 treatments over 5 months, the patient had significant improvements in posture alignment as well as gait, balance, hand tremors, low back and knee pains and SF-36 values. A 21 month follow-up revealed the patient had remained essentially well and the initial postural improvements were maintained. [Conclusion] This case demonstrates improvement of various symptoms in a patient with Parkinson's disease. Since poor posture is a long known clinical manifestation of this disorder, it is proposed that the improvement of posture in these patients may lead to improved outcomes. X-ray use in the diagnosis and management in those with spine deformity is safe and not carcinogenic.

19.
J Phys Ther Sci ; 31(10): 860-864, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31645820

RESUMO

[Purpose] To present the reduction of both lumbar spine hyperlordosis and anterior sagittal balance in a symptomatic patient as treated by Chiropractic BioPhysics® technique. [Participant and Methods] A 46 year old reported with low back and hip pains for six years. Oswestry disability index scored 28%. Radiographic assessment revealed pronounced anterior sagittal balance with lumbar hyperlordosis. The patient was treated by Chiropractic BioPhysics technique to reverse the spinal deformity subluxation via mirror image corrective exercises and spinal traction, as well as spinal manipulative therapy. [Results] Assessments after 36 and 74 treatments corresponding to the 4-month and 13-month check-ups demonstrated a continuous structural improvement in lumbar spine biomechanical parameters. There was a near complete resolution in low back and hip pains with an Oswestry score of 4%. [Conclusion] This case documents the reduction of lumbar spine hyperlordosis and forward sagittal balance by contemporary spine rehabilitation methods. It is essential to screen spinal subluxation patterns via standing radiography which obviously, as demonstrated in this case determines treatment approach as most low back pain patients present with lumbar hypolordosis. Routine initial and repeat radiography is safe in the screening and monitoring of treatment efficacy and is the standard for evidence-based, patient-centred structural rehabilitation.

20.
J Phys Ther Sci ; 31(2): 159-165, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30858656

RESUMO

[Purpose] There is a paucity of high-quality data pertaining to the conservative management of adult spinal deformity, particularly Scheuermann's kyphosis. Long-term follow-up data for both treated and untreated Scheuermann's patients is also lacking. Given that changes in sagittal balance are associated with increased morbidity, and that these changes are increasingly prevalent in the spines of ageing populations, it is imperative that potential strategies aimed at reversing or minimizing this type of deformity are explored. As the number of elderly patients in developed countries increases, so does the need for a safe and effective non-surgical management option for patients with spinal deformity/sagittal imbalance. This case study details the influence of ScoliBrace rigid TSLO bracing in combination with a specific rehabilitation program in an adult patient with Kypho-scoliosis. [Participant and Methods] The authors describe a case involving the treatment of a 26-year-old male with Scheuermann's kyphosis and a lumbar scoliosis. The patient received 12 months of bracing with a supplemental exercise program. The patient was followed for a period of approximately 12 months. Patient progress was assessed using ODI, SRS-22r, NPRS, and radiographic Cobb angle measurements throughout treatment. [Results] The patient presented with an initial ODI score of 18/100, a SRS-22r score of 3.0, and an average NPRS score of 4/10. Initial Cobb angle measurements demonstrated a 79° thoracic kyphosis and a 30° (coronal plane) lumbar scoliosis. At the final assessment, the patient reported an ODI score of 6/100, an SRS-22r score of 3.91, and an average NPRS score of 0/10. The coronal plane Cobb angle measured 63°, and the thoracolumbar scoliosis had reduced to 25°. [Conclusion] The findings from this case study highlight that this type of brace in combination with exercise rehabilitation may be useful for reducing the magnitude of curves and reducing symptoms in patients presenting with adult kypho-scoliosis. Further investigation of this style of treatment is warranted in patients with sagittal plane imbalance.

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