Physiotherapy scoliosis-specific exercises: a comprehensive review of seven major schools

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

Data from: Plum germplasm in Croatia and neighbouring countries assessed by microsatellites and DUS descriptors

At a certain period during the last century, former Yugoslavia (which among others used to include Bosnia and Herzegovina, Croatia, and Serbia) was the biggest producer of plums in the world. Traditional plum cultivars, still grown in this region, represent a mixture of several species including: European plums (Prunus domestica L.), mirabelles (Prunus insititia var. syriaca (Borkh.) Koehne), and damsons (P. insititia L.). The basic problem with the utilization of this plum germplasm, either for cultivation or breeding purposes, is a lack of reliable pomology data or reference repositories that would enable positive identification of cultivars. In this study, 62 plum accessions (42 traditional Croatian accessions, six well-known traditional accessions collected from Serbia and Bosnia, and 14 international, reference cultivars) were assessed using microsatellite markers and distinctness, uniformity, and stability (DUS) plum descriptors. Nine primer pairs amplified 168 distinct alleles, or on average 18.7 alleles per locus. A significant differentiation between the traditional plum cultivars and international reference cultivars, was detected through Fst (Fst = 0.022; P < 0.0001), analyses of molecular variance (AMOVA; f CT = 0.054; P < 0.05) and later confirmed by a factorial correspondence analysis (FCA). Bayesian method enabled the classification of mirabelle, damson, and European plum genotypes. Principal component analyses, based on 22 morphologic traits, managed to separate mirabelle accession from the European plum and damson accessions, but there was a general lack of correlation between the observed morphologic traits and the molecular data. Results of this study indicate that traditional Croatian accessions represent a diverse and underutilized plant genetic material, which should be conserved

SSR profiles and sizes of private alleles of 62 analysed plum accessions

Table1 - SSR profiles (allele sizes expressed in base pairs) of 62 analysed plum accessions (42 traditional accessions from Croatia, 6 traditional, regional cultivars from the neighbouring countries along with 14 international reference cultivars), investigated using 9 SSR markers. Table 2 -Sizes of 52 private alleles registered exclusively among traditional Croatian plum accessions and eight private alleles found only among international reference cultivars