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Scoliosis bracing
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Scoliosis bracing - July 8, 2008 8:47:06 AM
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PTupdate.com
Posts: 1478
Joined: October 8, 2001
From: Pittsburgh, PA USA
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I am treatinga thin, 66 year old female with fairly severe scoliosis. Primary phsyician inquired about bracing, but spine ortho and myself are not sure of anything that could help. The obvious deformity is a lateral shift, putting her body weight wayyyy past her COG, and thus creating some balance issues. My primary concern is the pain she has where the inferior right rib cage pretty much mashes against her iliac crest, irritating the soft tissue in that region. I have relieved her of much of her pain utilizine stretching, strengthening and mobilization, but I'd like to see if anybody has had any luck with any specific brace, mainly to unload that compresssed area....even just a little. At times, wish I could tilt her the other way and stuff in a stiff foam bolster.
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John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Scoliosis bracing - July 8, 2008 8:58:26 AM
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gerry
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From: Montgomery, AL, USA
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No experience with this age and scoliosis, but I do work with children, teens, and young adults. I wanted to respond to your last suggestion about the stiff foam bolster. There are times when clients do not tolerate the usual plastic brace for scoliosis, the orthotist will make the same brace out of a stiff foam. There is usually a thin layer of plastic between layers of foam to give it a little extra stiffness. It is worn over a T-shirt and under clothes.
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RE: Scoliosis bracing - July 8, 2008 9:34:21 AM
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PTupdate.com
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Joined: October 8, 2001
From: Pittsburgh, PA USA
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Thanks Gerry. I was actually joking a bit about the foam bolster. When she stands, her inferior rib cage actually touches the iliac crest, if she tilts away, and you stick your hand in there, it actually gets mashed when she goes back to resting position, and thus the tissue compression and pain. That's what I meant about stuffing in some foam padding. Even asked the ortho if they remove the inferior ribs, and he indicated no
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Scoliosis bracing - July 8, 2008 2:09:31 PM
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bonez
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I suspect that the patients structural system will not tolerate a brace very well. I also get the bolster joke. What would happen if a firm foam cushion could be tapered in such a way that when she lays on the non shifted side the rib shift and affected soft tissues would be under gentle elongation stretch? I suspect that if it were shaped right and she had a little instruction there could be some self contro of symptoms.
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RE: Scoliosis bracing - July 8, 2008 2:12:58 PM
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SJBird55
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Joined: May 10, 2004
From: Michigan
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I had a lady who was older with post-polio. She had severe scoliosis also - lower ribs approximating the iliac crest. Bracing generally doesn't have great outcomes with the older adults - their skin doesn't tolerate it and their posturing is secondary to changes in the bones themselves - degenerative changes, osteoporetic changes... The lady I treated had changes also because of the neuromuscular component - which wasn't going to change.
There are some considerations to think about - her risk of falling and her lung function.
I'd probably do what I could, but recommend a consult with a spine surgeon so she would know her options.
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RE: Scoliosis bracing - July 10, 2008 8:02:23 AM
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rwillcott
Posts: 436
Joined: March 20, 2006
From: Canada
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Does anyone have copies of scolosis exercise programs? I have a 13 year old coming to see me next week. I once had a really nice exercise program for scolosis that I can't find. Anyone have a copy?
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