The Schroth Method is a specialized physical therapy approach designed to address the three-dimensional spinal curvature associated with scoliosis. This non-surgical treatment uses targeted exercises to improve posture and stabilize the spine. While often associated with adolescents, the technique is also applied to and shows effectiveness for adult patients, though the goals of treatment shift significantly once skeletal maturity is reached. This article focuses on how the Schroth Method works and what adults can expect from this therapy.
Understanding Adult Scoliosis
Scoliosis in adults is distinct from Adolescent Idiopathic Scoliosis (AIS) because the spine is skeletally mature. Adult scoliosis can be a progression of previously diagnosed AIS, or it can be de novo, developing in adulthood due to degenerative changes like disc degeneration and asymmetrical facet joint arthritis. Degenerative scoliosis most often affects the lumbar or thoracolumbar spine and is common in the elderly population.
Curve reduction is rarely the goal for adults since the spine is mature and stiffened. Instead, treatment focuses on managing symptoms that affect daily life. These goals include reducing chronic back and leg pain, improving postural stability, and enhancing overall quality of life. Preventing further curve progression, which can occur at a rate of about 0.5 to 1 degree per year in degenerative curves, is also a major objective.
Core Principles of the Schroth Method
The Schroth Method is a scoliosis-specific exercise approach that addresses the spine in the frontal, sagittal, and transverse planes, making it a three-dimensional treatment. Every exercise is tailored to the individual patient’s specific curve pattern. The technique relies on three fundamental components that patients must master.
The first principle is auto-elongation, which involves actively lengthening the spine upward against gravity to decompress the vertebrae. This self-correction creates space within the spinal column before specific strengthening begins.
The second component is Rotational Angular Breathing (RAB), a unique breathing technique that uses the breath to expand the collapsed, concave side of the ribcage. Breathing into compressed areas helps de-rotate the spine and mobilize the ribcage, addressing the rotational aspect of the curve.
The final step involves stabilization in the newly corrected posture. Patients use isometric muscle contractions to strengthen specific trunk muscles and hold the spine in the best possible alignment. This process is repeated to create new muscle memory and postural awareness, helping the patient integrate the corrected posture into their daily activities.
Efficacy and Research for Adult Patients
The Schroth Method has demonstrated effectiveness for adults, particularly in addressing the symptoms that drive them to seek treatment. Multiple studies indicate that the therapy can significantly reduce patient-reported pain severity and improve functional ability. One study showed an average pain score improvement of 2.05 points for adults, which was a greater improvement than seen in adolescent subjects.
Schroth therapy has a positive impact on disability scores and overall health-related quality of life. Improvements in the Modified Oswestry Disability Index (m-ODI) for adults suggest reduced functional limitations, with some adult groups showing average improvements of over 20 points. While major structural curve reduction is not a realistic goal for adults with mature spines, the exercises are effective in improving postural alignment and muscular symmetry.
The exercises also aim to halt curve progression, which is a major concern for both de novo and pre-existing adult scoliosis. By strengthening the core muscles and improving spinal stability, the treatment provides tools for patients to manage their condition proactively. The positive outcomes extend to functional measures, including improved respiratory function and increased strength and endurance.
Implementation and Commitment Required
Initiating Schroth therapy requires finding a certified physical therapist, as specialized training is needed to tailor the three-dimensional exercises to the patient’s curve pattern. The initial in-clinic training is intensive, with individual treatment sessions typically lasting 40 to 45 minutes. Adults generally require a shorter course of supervised sessions compared to adolescents, often ranging from four to eight sessions.
The success of the therapy depends heavily on the patient’s commitment to the long-term program. After the initial training phase, the therapist prescribes a personalized home exercise program (HEP) that must be performed consistently. Integrating the exercises and postural awareness into daily life is necessary to maintain improvements and prevent regression. The ultimate goal is to empower the patient with the tools to manage their spine health independently over time.