Proposal of a New Exercise Protocol for Scoliosis

In the December issue of Medicine, Jin Young Ko, MD describes a new exercise protocol that is designed to help scoliosis. If I have ever prescribed spinal stabilization exercises for your back pain or sciatica, you will notice that these exercises are very familiar, but Dr. Ko uses just one side only.  He refers to the exercises as asymmetric spinal stabilizing exercise (ASSE). ~ Dr. Broussard

Medicine (Baltimore). 2018 Dec; 97(49): e13336.
Published online 2018 Dec 10. doi: 10.1097/MD.0000000000013336
PMCID: PMC6310602
PMID: 30544395
Jin Young Ko, MD

Abstract
In clinical practice, we found a unilateral instability in patients with right thoracic scoliosis during asymmetric spinal stabilization exercise (ASSE), which can be an important clue to identify the pathophysiology of idiopathic scoliosis (IS).

We investigated the relationship between unilateral postural instability and weakness of paraspinal muscles according to curve pattern. And finally, we propose the new exercise method based on the curve pattern.

Combined use of prospective and retrospective clinical trials.

Fifteen participants without IS and 10 patients with IS in 1 tertiary referral hospital.

In 15 participants without IS, surface electromyography (sEMG) was used to evaluate the muscular activation patterns in the bilateral erector spinae (ES), rectus abdominis (RA), and external oblique (EO) muscles during ASSE. In addition, to assess the clinical effect of ASSE, Cobb angle and rotation grade were measured from 10 patients with IS.

The most significant findings from the sEMG data were the increased activities of ipsilateral 7th thoracic ES during hand-up motion, ipsilateral 3rd lumbar ES during leg-up motion, and 12th thoracic and 3rd lumbar ES during side-bridging. In a radiographic analysis, specific components of ASSE that activates the concave side muscles were found to be effective for IS.

The paraspinal muscle strengthening of the concave side using ASSE can improve the severity of scoliosis. Based on this research, we could propose a new exercise protocol that can be personalized according to the curve pattern.

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