SCOLIOSIS (1).pptx

what is scoliosis ?
types of scoliosis ?
structural and non structural scoliosis ?
how to check cobbs angle ?
how to Adams forward bend test ?
clinical significance
procedure to assess cobbs angle

1. SCOLIOSIS Presented by -Shadab saba Khan MPT 2 Paediatric Physiotherapy Department

2. INTRODUCTION Scoliosis is an abnormal lateral curvature of the spine. It is most often diagnosed in childhood or early adolescence. It is triplanar deformity of spine which involves the following planes: Coronal plane – LATERAL CURVATURE Sagittal plane – KYPHOSIS , LORDOSIS Axial plane – ROTATION

3. INCIDENCE The primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females are eight times more likely to progress to a curve magnitude that requires treatment. Scoliosis effect about 5 million people in India that is 0.4 % of the population the prevalence among children is much more higher

4. STRUCTURAL NON- STRUCTURAL SCOLIOSIS

5. STRUCTURAL SCOLIOSIS   It is the most common type of scoliosis. This type of scoliosis affects the spine’s structure and is considered permanent it involves a side-to-side curvature of the spine along with rotation of spine

6. It primarily involves bony deformity which may be congenital or acquired may be caused by – Wedge vertebra Hemivertebra Failure of segmentation Excessive muscle weakness

7. Structural scoliosis is further divided into … Idiopathic Neuromuscular

8. IDIOPATHIC SCOLIOSIS Infantile scoliosis : Infantile scoliosis develops at the age of 0–3 years and shows a prevalence of 1 %. Juvenile scoliosis : Juvenile scoliosis develops at the age of 4–10 years, comprises 10–15 % of all idiopathic scoliosis in children Adolescent scoliosis : Adolescent scoliosis develops at the age of 11–18 years, accounts for approximately 90 % of cases of idiopathic scoliosis in children.

9. Neuromuscular scoliosis Encompasses scoliosis that is secondary to neurological or muscular diseases. Includes scoliosis associated with  cerebral palsy , spinal cord trauma,  muscular dystrophy ,  spinal muscular atrophy  and spina bifida. This type of scoliosis generally progresses more rapidly than idiopathic scoliosis and often requires surgical treatment. [1]

10. Non-Structural scoliosis It is also known as functional scoliosis , results from a temporary cause and only involves a side-to-side curvature of the spine (no spinal rotation). scoliosis curve would likely go away on bending forward. It is due to : Postural scoliosis Compensatory scoliosis

11. Postural scoliosis is postural imbalance Ex : limb length discrepancy Pelvic inequality Muscle spasm Abnormal foot arch this causes pelvic drop of one side

12. Assessment Cobbs angle Scoliometer Adam’s Forward bend test

13. COBBS ANGLE The Cobb’s Angle is used as a standard measurement to determine and quantify the magnitude of spinal deformity specially to determine the progression of scoliosis

14. PROCEDURE

15. Locate the most tilted vertebra at the top of the curve and draw a parallel line to the superior vertebral end plate Locate the most tilted vertebra at the bottom of the curve and draw a parallel line to the inferior vertebral end plate Two additional lines are drawn at a 90-degree perpendicular angle to the first lines so they intersect The angle formed between these two intersecting lines is a cobb’s angle

16. CLINICAL SIGNIFICANCE Cobbs Angle 10 degrees Minimum Angulation 10-15 degrees Require regular checkups 20-40 degrees Requires a brace 40-50 degrees Requires surgery

17. SCOLIOMETER It is an inclinometer designed to measure trunk asymmetry, or axial trunk rotation . It’s used at three areas: Upper thoracic (T3-T4) Middle thoracic (T5-T12) Thoraco-lumbar area (T12-L1 or L2-L3) If the sociometer measurement is more than 7 degree it is considered as abnormal

18. Adam’s Forward bend test It can be used to make a distinction between structural scoliosis or non-structural scoliosis of the cervical to lumbar spine The patient needs to bend forward, starting at the waist until the back comes in the horizontal plane, with the feet together, arms hanging and the knees in extension. The examiner stands at the back of the patient and looks along the horizontal plane of the spine searching for abnormality of spine

19. ON OBSERVATION Unequal shoulder levels Unequal scapula levels Rib hump Lateral curvature spine Unequal waist angles Local muscular aches Decreasing pulmonary function

20. Recent advance THE EFFECTIVENESS OF TWO DIFFERENT EXERCISE APPROACHES IN ADOLESCENT IDIOPATHIC SCOLIOSIS: A SINGLE-BLIND, RANDOMIZED-CONTROLLED TRIAL Authors : Hikmet KocamanID , Nilgu¨n Bek , Mehmet Hanifi KayaID , Buket Bu¨ yu¨kturan Received : November 25, 2020 Accepted : March 16, 2021

21. REFERENCES Konieczny MR, Senyurt H, Krauspe R.  Epidemiology of adolescent idiopathic scoliosis . J Child Orthop . 2012;7(1):3–9. Cynthia C Norkin joint structure and function 5 th edition David J Magee orthopedic physical assesment 6 th edition https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis Anwer S, Alghadir A, Shaphe A, Anwar D.  Effects of exercise on spinal deformities and quality of life in patients with adolescent idiopathic scoliosis . BioMed research international. 2015;2015. Hacquebord JH, Leopold SS.  In brief: The Risser classification: a classic tool for the clinician treating adolescent idiopathic scoliosis . Clin Orthop Relat Res. 2012;470(8):2335–2338.

22. Johari J, Sharifudin MA, Ab Rahman A, Omar AS, Abdullah AT, Nor S, Lam WC, Yusof MI.  Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients . Singapore medical journal. 2016 Jan;57(1):33. Balestroni G, Bertolotti G. EuroQol-5D (EQ-5D):  an instrument for measuring quality of life . Monaldi Archives for Chest Disease. 2015 Dec 1;78(3).

23. THANK YOU

24. BRACES BOSTON BRACE Wilmington Brace Milwaukee Brace

25. Milwaukee Brace The Milwaukee brace, which is the original cervico -thoracic-lumbar-sacral orthosis (CTLSO) invented in the 1940s. Due to the effectiveness and relative convenience of today’s more modern braces, the Milwaukee brace is rarely used anymore

26. BOSTON BRACE The Boston brace is made of plastic and shaped to fit the patient.  It is a thoracic-lumbar-sacral orthosis brace, meaning it covers all of those regions of the spine — from armpits to hips. The Boston brace is practically invisible underneath clothing and fits snugly around the body.

27. WILMINGTON BRACE The Wilmington brace is similar in design to the Boston brace except it closes in the front and is made with a mold of the torso