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Orthotics in rehabilitation. Secondary scoliosis. Scoliosis is a more complex, helical deformity in which a curve in the coronal plane is combined with abnormal rotation of the vertebrae in the transverse plane.

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Orthotics in rehabilitation

Orthotics in rehabilitation

Secondary scoliosis


  • Scoliosis is a more complex, helical deformity in which a curve in the coronal plane is combined with abnormal rotation of the vertebrae in the transverse plane.


The definition and classification of the causes of scoliosis made more than two millennia ago by Hippocrates still stands true today. He stated that:‘There are many variations of curvatures of the spine, even in persons who are in good health, for it takes place from natural conformations (congenital and idiopathic) and from habit (functional) and the spine is liable to be bent from old age (degenerative) and pains (acquired).’


The hippocrates solution
The Hippocrates solution made more than two millennia ago by


Physical exam
Physical Exam made more than two millennia ago by

  • Iliac crest height

    • Leg length discrepancy

  • Shoulder height

  • Arm trunk space

  • Scapular position

  • Trunk shift

  • Inspection of skin

    • Café au lait spots


Forward bend test adam s sign
Forward made more than two millennia ago by Bend TestAdam’s sign


Rib hump made more than two millennia ago by


Scoliometer
scoliometer made more than two millennia ago by


Clinical presentation
Clinical presentation made more than two millennia ago by


Rotation
Rotation made more than two millennia ago by

  • Spinous process rotates into concavity

  • Pedicle position


COBB’S ANGLE made more than two millennia ago by

Measures severity

Intersecting angle between lines drawn from upper and lower surfaces of vertebrae at the end of the curve.


100 made more than two millennia ago by


Skeletal maturity
Skeletal Maturity made more than two millennia ago by

  • Gruelich & Pyle atlas

  • Triradiate cartilage fusion

  • Risser sign


The Scoliosis Research Society: made more than two millennia ago by has defined a medically significant scoliosis as any curve that is 10 degrees or more with or without a rotatorycomponent.


  • Scoliosis secondary made more than two millennia ago by to congenital or acquired neurological disorders usually results from paraspinal muscle weakness in conditions leading to lower motor neurone muscle weakness.


  • contribute to the development of scoliosis made more than two millennia ago by

  • muscle weakness

  • poor central balance control

  • impaired sensory feedback

  • Pelvic obliquity and hip joint dislocation are also common complications of cerebral Palsy


  • Patients with made more than two millennia ago by secondary scoliosis provide a unique challenge, as the standardways to manage scoliosis often fail to correct or stop the progression of the scoliosis.

  • Problems such as hip joint dislocation, poor sitting balance, or movement disorders such as athetosiswill all have an impact on the scoliosis.


A standard physiotherapy made more than two millennia ago by programme is essential to

  • maintain the range of movement(ROM) of joints

  • reduce muscle spasticity

  • improve sitting balance.


  • Appropriate made more than two millennia ago by seating and sleeping systems are essential in the management of severe scoliosis in both children and adults.

  • A balance needs to be struck between comfort and functionon one side and support and stabilisation on the othe.


  • Most patients with severe scoliosis will need made more than two millennia ago by foam carved or moulded seats.

  • Appropriate seating can improve posture and facilitate care with activities such as feeding but it will not stop progression of the scoliosis.


  • moulded made more than two millennia ago by seats


  • Orthotic management: made more than two millennia ago by

  • valuable for patients with idiopathic scoliosis as it can correct and stop its progression.

  • limited role to play in the management of secondary scoliosis, as they are unable to stop its progression.




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