September 18, 2019
What Happened to Scoliosis School Screening?
Parents of children with Idiopathic Scoliosis often have great intentions when instructing them to ‘straighten their back’. Parents are naturally concerned about the progression of the scoliosis. They can often be thinking about the condition even more than the child does. However, what actually happens to a child’s posture when we give them quick posture instructions? At the recent SOSORT* Conference in San Francisco 2019, I was fortunate enough to hear the results of a study by Kozinoga and his team in Poland.
The research team investigated what happens to body posture of children who are given the instruction to ‘straighten your back’. The aim of the study was to detect differences between the spontaneous and actively corrected body posture after ‘straighten your back’ command in a group of previously non-instructed children. The results showed that when you give this instruction to the children they do in fact change their body posture instantly. However, what I thought was note-worthy was that the children actively extended their thoracic spine (upper back). Why?
Children with scoliosis often, but not always, have a flattened upper back. We call this hypokyphosis or flat back. This flatness increases the risk of progression of the scoliosis spine. These children often already have their upper back in too much extension. This leads me to ask: what is the more appropriate instruction?
I believe this is patient specific, and further studies in this area would be useful. I don’t have the exact answer for all children in a broad setting. In my clinic we teach children to improve their posture and it is patient specific. I find you have to find the ‘right cues’ for each patient to achieve the best auto-correction or active self-correction of their posture.
The authors quoted that ‘Active self correction comprises an active movement performed by the child presumably aiming to achieve the best possible position of the body’. “Straighten your back” reveals a common command used by the parents to their children in daily living.’ However, if the child is already in too much hypokyphosis, then this instruction might exaggerate the problem. If you’re unsure how to guide your child, speak to your physiotherapist trained in the treatment of scoliosis.
*SOSORT is the Society of Scoliosis Orthopaedic and Rehabilitation Treatment.