1. Schroth Method
A 3-D Treatment Approach to Treating Scoliosis According to the Principles of C.L. Schroth
Michelle Dwyer, DPT
Schroth and SEAS Certified for the Treatment of Scoliosis and Spinal Deformities
I use a combination of Methods, SEAS, Soft tissue work, Vestibular work, Sports Integration.
The Schroth Method can also be used with adults with Scoliosis

2. U.S. History- Challenging the Current Model
Parents- Too much “wait and see”
Patients- Lack of knowledge regarding how to help themselves beyond bracing and waiting
Therapists- Inadequately educated and equipped in scoliosis treatment
Orthotists-Traditional bracing lacks 3-D corrections, resulting in flat back and other poor cosmetic changes
Doctors- Is there a way to help patients sooner?
Therapists Training- Needs to be more advanced- Schroth – SEAS’s.

3. Traditional PT Postural Awareness Stretching/ Strengthening Hip ROM
Spinal Stability
Body Mechanics
The problem with traditional PT is we are taught general strengthening and stretching of concave side. We are strengthening the core muscles in the current Curve Pattern. Further reinforcing the neurological imbalance and motor program. In order to be the most effective in the Treatment of Scoli- The PT needs to be Curve Specific to each patient.

4. Challenging the Traditional Model of PT
Schroth Based PT - Barcelona Physical Therapy School
SEAS
- ISICO, Stephano Negrini MD, Milan, Italy
Team Approach
PCP/ Pediatrician, Orthotist, Orthopedic/Neurosurgeon,
Other?
Community Involvement
Curvy Girls, Hope’s Closet, local meeting and support groups.
Team Approach- Coaches, Massage, Gym Teachers, Therapist Word of Mouth
A few methods that are challenging the Traditional Model are Schroth Method and SEAS method. The Schroth is the most specific approach and aggressive approach at this time. The SEAS approach is also Curve Specific, Vestibular and very good for high level athletes and those are not Schroth appropriate. I use a combination of both methods with my patients.
We are also seeing more of a collaborative Team Approach that is patient and family focused on the best outcome possible.
Other- Massage Therapists, Coaches, Websites, Curvy Girls, Hope’s Closet, Community resources

5. Schroth ( BSPTS) Principles
Primarily Adolescent Idiopathic Scoliosis Treatment
Deformities in the Sagittal Plane ( Scheurmann’s, Hyper-Kyphosis and Hyper- Lordosis
Curve Specific
Cognitive, sensory- motor, kinesthetic, neuromuscular
exercises to reduce scoliosis posture

6. History and Goals Germany 1921 Spain 1968 USA 2005
Inpatient
Spain 1968
Outpatient
USA 2005
First certified therapists
2011 First US course held Steven’s Point, WI
Correct scoliosis posture
Reduce risk of progression
Strengthen asymmetrically
Improve respiration
Diminish functional limitations
Reduce pain
Improve body mechanics
Improve self image and quality of life
Germany- Katherina Schroth Started in the 1920’s using breathing and 3D corrections to reshape the body. She
Instructed her daughter Christa lehner-Schroth PT- Then taught her grandson Dr. Weiss – Germany
Elena Salva PT brought the Method to Spain- Her Daughter Gloria Salva, MD. DO. Trained her husband Dr. Manual Rigo in the Method.
Dr. Rigo is the founder of the BSPTS- Dr. Rigo trained Beth Jansen – Beth brought Schroth to US.

7. Treatment Guidelines Precautions: Contraindications: Osteoporosis
Post- Surgery
Juvenile Hypermobility Syndrome (JHS)
Osteogenesis Imperfecta
Spondylolisthesis
Contraindications:
Reactive Scoliosis (tumor, disease, etc)
Inflammatory diseases- during active phase
Psychiatric Issues

8. Treatment Guidelines May be treated but with limitations:
Syndromic and Neuromuscular Scoliosis
Post – Surgery
Adult Degenerative Scoliosis
Infantile (Age 0-3), Juvenile (age 4-9) * * SRS Classification

9. Treatment Guidelines Risk of Progression Factor Patient Age
Risser Score
Cobb Angle
Age patient is first seen
RPF is a calculation based on the following components
Family History
Other things consider are Scoli Score, patient hobby/sports, performing arts etc

10. Assessment Angle of Trunk Rotation- (ATR) Using Scoliometer
Screening- Adam’s Test
Angle of Trunk Rotation- (ATR) Using Scoliometer
>5 ° in sitting = + Screen
Postural- Frontal, Sagittal and Aerial
X- Ray- Cobb, Apex, Rotations, CSL, Risser
Height Measurement – Sitting and Standing
Vital Capacity
Thoracic Function
Pain
Quality of Life – SRS 22, SRS 36, TAPS, QLSPD
Why do we Measure ATR? Because it Correlates directly with Cobb Angle. Because the Pathomechanism of Scoli is Torsion followed by SB. Therefore an increase in Rotation is most likely indicative of increase in Progression/Cobb Angle.
A minimum of 5 degrees Scoliometer= degrees Cobb Angle * Bunnell, Bone and Joint 1984
An increase in 2 degrees is significant for Progression Indication.

12. Semi-Hanging Sagittal Plane
Schroth Exercises
Semi-Hanging Sagittal Plane
Prone on Knees-Transverse Plane Anterior Gravity Assisted

13. Schroth Exercise Standing 3D Correction
Supine Gravity Assisted- Transverse Plane

14. Assessment Photos

15. Assessment Photos

16. In Brace Correction

17. Pre/ Post Brace Comparison
In Brace X- Ray
Pre Brace X-Ray

18. Sagittal Plane Correction
Visit 1
Visit 3
Important to Sagittal Plane Correction first, then Elongation followed Translation moving Rside Thorax to the Left and Deflection. Notice Pre- Post the head is balanced over the thorax, the shoulders are back, the abdominals can now engage do to the decrease in excessive lordosis.

19. Exercises Using Schroth Principles
Traction with AutoCorrection and Elongation- Seated in Corrected Posture

20. Exercises Using Schroth Principles
Visit 1 - Uncorrected
Visit 3 - Corrected Posture
Standing AutoCorrection with Elongation and Deflection- Doing Standing Breathe Work

21. Exercises – Sport Specific and In-Brace
Long Hang Tx, opposite of curve- Elite Gymnast
Standing AutoCorrection –In Brace with RSC

22. Sport Specific Training In Corrected Posture
Right Thoracic Left Lumbar non –corrected.
Doing Sport Specific Training in Over Correction – For Bball and Softball

23. Case Study
Visit 1
Visit 1
JF- 9 y/0 Low Tone, Preemie, with abdominal sx at 2 and 8 months of age

24. Sagittal Visit 1

25. Visit 2 Sagittal Plane Correction
Sagittal Correction
Psoas Stretch

26. Stretching- Stabilization
Supine Hamstring Stretch
Scapular / Core Stability

27. Sagittal Correction
Visit 1
Visit month follow up

28. Patient Follow Up
Visit 1
2 Month follow up

29. PT Treatment Options Local Program Progression Immersion Program
Basic Program 2x wk- 8wks
Progression
Monthly, Quarterly, Bi-Annually
Until Risser 5
Immersion Program
Basic Program for 5 consecutive days
Progression
First yr every 3 months
Bi-Annually to Risser 5
Home Program- 3 exercises 25-30mins Warm up- coordination Exercises in corrected posture 8 mins in each position

31. Assistants