Changes in Clinical and Radiographic Parameters after a Regimen of Chiropractic Manipulation Combined with Soft Tissue Therapy and Neuromuscular Rehabilitation in 7 Patients with Adolescent Idiopathic Scoliosis
Woggon A*1, Martinez D2
Address: 1Director of Research, CLEAR Institute of Texas; 2618 Electronic Lane, Suite 102; Dallas, Texas 75220; 2 Independent Researcher, Mesquite, Texas.
E-mail: A. Joshua Woggon* – [email protected]; Daniel Martinez – drdmart@[email protected]
* – Corresponding author
Abstract
Background
The causes of idiopathic scoliosis (IS) are likely multifactorial, including genetic and environmental. It is unlikely one therapy addresses all involved factors. Evidence supports a comprehensive approach to evaluation & treatment using a variety of outcome assessments.
Aim
This study presents a review of files of seven adolescent idiopathic scoliosis (AIS) patients treated with a comprehensive two-week treatment protocol including chiropractic manipulative therapy, massage, exercise, and whole-body vibration therapy, followed by a home rehabilitation regimen.
Method
Primary outcome measures reported include Cobb angle, apical vertebral rotation, disc index, apical vertebral deviation, digital spirometry, scoliometry, timed one-legged stability with eyes closed (TOLSWEC), and computerized dual inclinometry, as well as pain drawings and health-related quality of life questionnaires (RAND SF-36 and SRS-22). Data was recorded post-treatment and at follow-up ranging from four to seven months. A Wilcoxon test was performed to assess the statistical significance of the pre and post treatment outcome parameters. Each patient underwent twenty treatment sessions over a two week period (2x day/five days) for an average length of 180 minutes/session. Treatment
sessions were divided into three phases. The first phase of treatment addressed soft tissue deformations and improving spinal flexibility, the second phase influenced spinal biomechanics, and the third impacted neuromuscular function.
Results
The mean and range for the following primary outcome measures were recorded post-treatment: Cobb angle changes: thoracic (8.4°, 6.5° – 11°); lumbar (8°, o° – 12°); apical vertevral rotation : thoracic (5.9%, 1.8% – 19.6%); lumbar (5.4%, 0% – 13.5%); disc index: thoracic (0.18, 0.01 – 0.4); lumbar (0.06, – 0.2 – 0.44); apical vertebral deviation: thoracic (-2.3 mm, -21.5 mm to 13 mm); lumbar (5.6 mm, 4 mm – 7 mm); forced vital capacity: (237 cc, 0-820 cc); forced expiratory volume in 1 second: (212 cc, -50 cc to 520 cc); forced expiratory rate: (5%, -2% to 18%); peak expiratory flow: (420 cc, -960 cc to 1180 cc); scoliometer readings: (3.0°, -1° to 10°); TOLSWEC: left (3 seconds, -3 to 24); pain scales (-1.4, +1 to -4); RAND SF-36: (8%, -21% to 36%). The greatest mean improvements in spinal ranges of motion (ROM) occurred in thoracic rotation, lumbar flexion, and lumbar lateral flexion. At follow-up, Cobb angle progression was prevented in two patients and reversed in two; two patients progressed past pre-treatment levels. Mean SRS score was 3.91.
Conclusion
The applied protocols effected positive functional and/or radiological changes in seven cases of AIS, with two cases demonstrating continued benefit at follow-up.