In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called “wait and see” approach that far too many doctors use when evaluating children’s scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient’s preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also produce benefits in subjects with scoliosis other than reducing the Cobb angle, like improving back asymmetry, based on 3D self-correction and stabilization of a stable 3D corrected posture, as well as the secondary muscle imbalance and related pain. In more severe cases of thoracic scoliosis, it can also improve breathing function. This paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including their bracing techniques and scientific evidence. The aim of this paper is to understand and learn about the different international treatment methods so that physical therapists can incorporate the best from each into their own practices, and in that way attempt to improve the conservative management of patients with idiopathic scoliosis. These schools are presented in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.

Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients.

Purpose The aim of the study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into Polish. Methods The BrQ is an instrument for measuring the quality of life of scoliotic adolescents who are being treated conservatively with wearing a corrective brace. The BrQ consists of 34 Likert-scale items related to eight domains. The translation from the original Greek into Polish was performed. The process of cultural adaptation of the questionnaire was in accordance with the guidelines of the International Quality of Life Assessment Project. It involved 35 adolescents, aged between 10.0 and 16.0 years, all with adolescent idiopathic scoliosis with mean Cobb angle of 35.1 ± 10.6 degrees, and all wearing the same kind of brace (Chêneau orthosis) for more than 3 months. Statistical analysis calculated the reliability (internal consistency), floor and ceiling effects of the BrQ. Results The internal consistency was satisfactory; Cronbach’s alpha coefficient was 0.94. There was no floor or ceiling effects. Conclusions Polish version of the BrQ is reliable and can be used in adolescents with idiopathic scoliosis wearing the brace to assess their quality of life.

Physiotherapy for stabilization of idiopathic scoliosis angle in growing children remains controversial. Notably, little data on effectiveness of physiotherapy in children with Early Onset Idiopathic Scoliosis (EOIS) has been published. The aim of this study was to check results of FITS physiotherapy in a group of children with EOIS. The charts of the patients archived in a prospectively collected database were retrospectively reviewed. The inclusion criteria were: diagnosis of EOIS based on spine radiography, age below 10 years, both girls and boys, Cobb angle between 11° and 30°, Risser zero, FITS therapy, no other treatment (bracing), and a follow-up at least 2 years from the initiation of the treatment. The criterion for curve progression were as follows: the Cobb angle increase of 6° or more, for curve stabilization; the Cobb angle was ± 5° comparing to the initial radiograph, for curve correction; and the Cobb angle decrease of 6° or more at the final follow-up radiograph. There were 41 children with EOIS, 36 girls and 5 boys, mean age 7.7 ± 1.3 years (range 4 to 9 years) who started FITS therapy. The curve pattern was single thoracic (5 children), single thoracolumbar (22 children) or double thoracic/thoracolumbar (14 children), totally 55 structural curvatures. The minimum follow-up was 2 years after initiation of the FITS treatment, maximum was 16 years, mean 4.8 years). At follow-up the mean age was 12.5 ± 3.4 years. Out of 41 children, 10 passed pubertal growth spurt at the final follow-up and 31 were still immature and continued FITS therapy. Out of 41 children, 27 improved, 13 were stable, and one progressed. Out of 55 structural curves, 32 improved, 22 were stable and one progressed. For the 55 structural curves, the Cobb angle significantly decreased from 18.0° ± 5.4° at first assessment to 12.5° ± 6.3° at last evaluation, p < 0.0001, paired t-test. The angle of trunk rotation decreased significantly from 4.7° ± 2.9° to 3.2° ± 2.5° at last evaluation, p < 0.0001, paired t-test. FITS physiotherapy was effective in preventing curve progression in children with EOIS. Final postpubertal follow-up data is needed.

Background and Objectives: Physiotherapeutic Scoliosis-Specific Exercises (PSSE) are recognized treatment methods for idiopathic scoliosis, focused on correcting three-dimensional postural abnormalities. Objective indices such as Angle of Trunk Rotation (ATR), Anterior Trunk Symmetry Index (ATSI), and Posterior Trunk Symmetry Index (POTSI) enable precise assessment of clinical changes, while the Trunk Appearance Perception Scale (TAPS) reflects the patient’s subjective perception of their posture. Combining these data allows for a comprehensive assessment of the effects of therapy after intensive 5-day inpatient rehabilitation. We aimed to assess the improvement in the patients’ clinical appearance and compare objective and subjective trunk assessment indicators after intensive 5-day inpatient rehabilitation, treated by PSSE, according to the Functional Individual Therapy of Scoliosis (FITS) Method. Materials and Methods: This retrospective study included 75 patients with idiopathic scoliosis who participated in a 5-day inpatient rehabilitation, treated by FITS Method. The average age was 13.5 years, and 63% of the girls were after menarche. The mean Cobb angle was 27.41° in single-curve scoliosis and 31.03° in double-curve scoliosis (31.24° in the thoracic spine, 30.82° in the lumbar spine), Risser test 2, and ATR was 7.1° in the thoracic spine and 4.6° in the lumbar spine. Forty-nine patients wore a brace. At the beginning and end of inpatient care, objective assessments were performed, including ATR at the peak of the scoliosis using the Adams test and photoregistration of the trunk in the front and back standing positions—ATSI and POTSI. A subjective assessment was also performed using the TAPS. Results: A statistically significant difference was demonstrated after therapy in the ATSI (p < 0.001) and POTSI (p = 0.008) values. A reduction in the ATR in the thoracic spine was observed (p < 0.001). The TAPS questionnaire demonstrated a statistically significant difference in the values of all indicators measured before and after therapy: in the frontal plane SET 1 (p = 0.002), in the transverse plane SET 2 (p = 0.042), and in the frontal plane SET 3 (p = 0.028). A statistically significant negative correlation was demonstrated between objective and subjective indicators after therapy: ATR Th vs. TAPS-SET 2 (−0.45) (p < 0.001) and ATSI vs. SET 3 (−0.29) (p = 0.011). Conclusions: The subjective assessment of trunk appearance correlates with the objective assessment, except for SET 1 vs. POTSI. Patients who noticed a change in their posture can expect confirmation in objective clinical tests. FITS Method positively influences the improvement of subjective and objective assessments of idiopathic scoliosis patients during the short term of intensive care.

Background/Objectives: This is a study of adolescents with idiopathic scoliosis (IS), treated by the Functional Individual Therapy of Scoliosis (FITS) method. The hypothesis was that active parental involvement in the treatment process enhances the outcomes of therapy. Materials and Methods: A total of 208 adolescent girls with IS were examined and divided into two groups. Only in Group I were the parents present. Trunk morphology before and after was evaluated by measuring change of the Anterior Trunk Symmetry Index (ATSI), Posterior Trunk Symmetry Index (POTSI), Posterior Trunk Symmetry Index in Correction (POTSI COR), and the angle of trunk rotation (ATR). Results: Statistically significant improvements in ATSI values were observed in both groups (Group I: p < 0.001; Group II: p = 0.001). POTSI values showed improvement only in Group I (p < 0.001). Similarly, POTSI COR values improved significantly in Group I (p < 0.001). ATR improved significantly better in Group I. Conclusion and Significance: Children with IS who underwent specific physiotherapy demonstrated better outcomes when their parents actively participated in the therapy.