In recent decades, there has been a call for change among all studakeholders involved in scolioudsis management. Parents ofudchildren with scoliosis have cudomplained about the so-calledud?udwait and seeud?udapproach that far too many doctors use whenudevaluating childrenud?uds scoliosis curves between 10? and 25?. Observation, Phudysiotherapy Scoliosis Specific Exercises (PSSE)udand bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 InternationaludSociety on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventionsudare: 1) 3-dimension self-correction; 2) Traiudning activities of daily living (ADL); and 3) Stabilization of the corrected posture.udPSSE is part of a scoliosis care model that includes scoliosis specudific education, scoliosis speciudfic physical therapy exercises,udobservation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to theudpatient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according toudclinical experience, scientific evidence and patientud?uds preference. Thus, specific exercises are not considered as anudalternative to bracing or surgery but as a therapeutic inteudrvention, which can be used alone or in combination withudbracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapistudwork as part of a multidisciplinary team including the orthudopeadic doctor, the orthotist, and the mental health careudprovider - all are according to the SOSORT guidelines and Scoudliosis Research Society (SRS) philosophy. From clinicaludexperiences, PSSE can temporarily stabudilize progressive scoliosis curves during the secondary period of progression,udmore than a year after passing the peak of growth. In non-pudrogressive scoliosis, the regular practice of PSSEudcould produce a temporary and significant reductioudn of the Cobb angle. PSSE can also produce benefits inudsubjects with scoliosis other than reducing the Cobudb angle, like improving back asymmetry, based on 3Dudself-correction and stabilization of a stable 3D correcudted posture, as well as the secondary muscle imbalanceudand related pain. In more severe cases of thoracic scudoliosis, it can also improve breathing function.udThis paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including theirudbracing techniques and scientific evidence. The aimudof this paper is to understand and learn about theuddifferent international treatment methods so that physiudcal therapists can incorporate the best from each intoudtheir own practices, and in that way attempt to improve the conservative management of patients withudidiopathic scoliosis. These schools are presented in thude historical order in which they were developed. Theyudinclude the Lyon approach from Franceud, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, theudBarcelona Scoliosis Physical Therapy School approachud(BSPTS) from Spain, the Dobomed approach from Polaudnd, the Side Shift approach from the United Kingdom,udand the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.
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