The role of measured resistance exercises in adolescent scoliosis

Abstract

Vert Mooney, MD, Allison Brigham, BS, San Diego, CA, USA

Purpose: To document the effect of progressive strength training in torso rotation in individuals with adolescent scoliosis. Preliminary work at our center has demonstrated that all scoliotic adolescents had an asymmetry of rotation strength measured on specialized equipment, which isolates the torso rotation strength. In addition, surface electrode electromyograms had demonstrated inhibition of lumbar paraspinal muscles. The inhibition and strength corrected after several sessions of isolated progressive exercise training.

Methods: Twenty-five adolescents (23 females, 2 males) with scoliosis ranging from 15 to 41 in their major curve were treated with a progressive resistive training program for torso rotation. They were treated twice a week until skeletal maturity or documented reduction of curve. None were braced during the period of treatment. Starting resistance was one third of body weight. Equal resistance was used for both left and right rotation, although initially rotation was weaker in one direction compared with the other. Once able to carry out 20 repetitions, the resistance was increased about 5%. Rotation range was increased as tolerated. Patients with surgical level of curves did not respond and were not followed.

Results: Eighteen of 25 demonstrated curve reduction. Although there was some fluctuation, none of the rest had a persistent increase in curve. Pretraining average range was 28.2 ± 13.2. Posttraining range was 23.0 ± 14.1. The percentage improvement was 20% ± 23.3%. There was a 132.5% (±61.4%) increase in dynamic strength. None went on to surgery or bracing.

Discussion: Based on the demonstration of strength and asymmetry in rotation and inhibited lumbar extensor muscle activity, it is rational to place adolescents with scoliosis into a progressive resistance training program. In this small series, it offered notable benefit with documented control of curve progression. Parents were pleased that an active intervention was provided rather than “watch and wait” typical of presurgical adolescent scoliotic care. Lack of efficacy of exercise in previous studies may be because there was a lack of specific muscle training and measurement. No exercise program using equipment has previously been reported.