The Spinal Engine
Recent scientific articles have begun to explore the role of gait (walking), and how the body balances itself while it is moving, in patients with scoliosis (1,2). These studies have proven that there are differences in how people with scoliosis walk and move, compared to people without scoliosis. After a while, the brain develops a pattern to help the body balance.
Scoliosis is 3-dimensional. If you only look at the sideways curvature, you are missing the big picture, because compression and rotation of the spinal column are also involved. Similarly, walking is a 3-dimensional process – it is not simply moving forward. In the normal pattern of walking, there is a twisting of the shoulders and a simultaneous counter rotation in the hips (3,4). The head must yaw (bend slightly to the left and right) to compensate for this motion and keep the eyes level (5).
In patients with scoliosis, this normal pattern is often absent. The hips and shoulders do not rotate opposite each other, and the head does not move. The main righting reflex of the body is the eyes; if the head is not moving to keep the eyes level, it suggests that scoliosis may create problems with balancing.
Further research supports this conclusion; scoliosis patients tend to have a more difficult time balancing, on average, than non-scoliosis patients (6). Typically, scoliosis patients must slow down their walking speed, and stiffen their upper spine significantly, to maintain their balance when walking.
Restoring normal patterns of movement in scoliosis patients is more difficult than one might suspect. You cannot simply tell someone to walk differently; the brain creates a pattern, and it falls into this pattern automatically, even when the biomechanics of the spine are altered. When the body falls into this old pattern, it can re-enforce imbalances in the muscles, and cause the spine to shift back to its old position.
To prevent this, CLEAR Institute teaches methods of rehabilitating the spine in both static (standing) and dynamic (walking) environments. One such method, pictured above, is referred to as the "Tightrope" Exercise. Scientifically-applied spinal weights are used to create a "mirror-image" of the patient's scoliotic posture, and the eyes are blocked to remove the primary optical righting reflex; this enhances the communication between the body & the brain. In order to balance, the brain must receive sensory input from the body and reply with appropriate motor feedback to the postural muscles. In this manner, the neuromuscular pathways can be re-trained, and new patterns of walking established that will "re-program" the brain to better maintain & improve upon the non-surgical reductions to the scoliosis that were achieved.
1) Gait analysis in patients with idiopathic scoliosis. Kramers et al, Eur Spine J 2004; 13:449-56
2) Locomotor skills and Balance Strategies in Adolescent Idiopathic Scoliosis. Mallau et al, Spine 2007; 32(1):E14-E22
3) Patterns of spinal motion during walking. Crosbie et al, Gait Posture 1997;5:6-12
4) Head and trunk stabilization strategies during forward and backward walking in healthy adults. Nadeau et al, Gait Posture 2003;18:134-42
5) Head stabilization during various locomotor tasks in humans. Pozzo et al, Exp Brain Res 1990;82:97-106
6) Influence of different types of progressive idiopathic scoliosis on static and dynamic postural control. Gauchard et al, Spine 2001;26:1052-8.
PneuMex: a "Pneu" Approach to Spinal Therapy!
While CLEAR Institute has made significant progress in the field of scoliosis rehabilitation, it is our sincere belief that it will require the cooperative efforts of every member of the healthcare profession to truly eradicate this spinal condition. For this reason, we have always been more than happy to share our clinical observations & experiences with other organizations, and learn from them in turn. In the words of Sir Isaac Newton, "If I have seen farther than others, it is because I have stood on the shoulders of giants."
One such company that CLEAR Institute has held a long-standing symbiotic relationship with is PneuMex (www.pneumex.com). The President of PneuMex, Gerry Cook, is recognized as a pioneer in the field of spinal rehabilitation for his efforts in non-surgical scoliosis treatment. Although the primary focus of PneuMex is sports rehabilitation & strength training, they are able to apply their extensive knowledge of muscle physiology & spinal biomechanics to achieve dramatic results with scoliosis patients as well. Using a revolutionary system of spinal unweighting, PneuMex has achieved remarkable success in this endeavor. Typical decompression operates in a static, non-weightbearing position; PneuMex's unweighting system is performed while the patient is moving and relating to gravity. Two complete PneuMex Spinal UnWeighting systems are currently in use at the CLEAR Scoliosis Treatment and Research Center in Dallas, Texas.
In addition, PneuMex utilizes Whole-Body Vibration therapy in much the same manner as CLEAR Institute, and, independently of each other, the two companies have drawn very similar conclusions, and observed similar clinical results. For example, PneuMex has observed increases in bone density in patients using their WBV platform, the Pro Vibe, as CLEAR Institute has noticed in patients with the Vibe Pro (yes, these really are their names, and no, neither company was aware of the other's existence when they were named!). Also, PneuMex uses the same frequency as CLEAR Institute to stimulate & re-train the postural muscles. Both the frequency & the amplitude of PneuMex's platform are adjustable; at the "low" setting, the amplitude (intensity) of vibration is approximately equal to the Vibe Pro. The frequency of the PneuMex platform can also be increased to higher levels, which will stimulate the fast-twitch muscles more than the postural muscles; this is generally more useful in strength training & fitness programs, but may have applications in the realm of spinal rehabilitation as well, and we will most definitely continue to explore this possibility as we make every effort to improve our understanding of the enigmas of scoliosis. We at CLEAR Institute would like to extend a very sincere "Thank You" to Gerry Cook and his family at PneuMex, and we look forward to continuing to work side-by-side in the fight against scoliosis!
Please take a moment to explore PneuMex's website, www.pneumex.com, to learn more about their products & seminars.
The Emotional Impact of Scoliosis
It is a common & long-established phenomenon that there often exists a disconnect between most scoliosis patients and their treating doctors. One study found that while 90% of scoliosis patients would like more time to discuss their condition with their doctor, only 5% actually had the opportunity to do so. It is also well-known that traditional methods of scoliosis treatment, such as bracing & surgery, have long-term psychological ramifications that are poorly understood at best, and outright ignored at worst. CLEAR Institute is aware of this unfortunate fact, and we feel that the responsibility of a doctor should not merely be limited to the physical status of his or her patient. This is one of the reasons why we are fervent supporters of the Scoliosis Mentorship Program (www.scoliosismentors.org).
Studies published in various scientific journals regarding the experience of adolescents treated with orthopedic bracing to halt the progression of their scoliosis come to heartbreaking conclusions that barely hide the underlying emotional anguish beneath a veneer of academic jargon:
"Girls with scoliosis had a statistically significant difference in perception of happiness and satisfaction."
J Adv Nursing, 2001 Sep; 35(5):683-90
"Almost all of the participants reported having to deal with stress, denial, fear, anger, and shame."
Scoliosis, 2006 May 22;1:8.
"As they grow older, patients feel increasingly ashamed of their body, as they are more concerned about the future effect of the deformity on their body."
Eur Spine J, 2007; 16(4):537-46
Patients undergoing surgical treatment often fare little better, according to research:
"There was no change in body image, Visual Analogue Scales, Oswestry Disability Index, or short-term McGill Pain Questionnaire scores by 2 years follow-up."
Spine, 2002; 27(14):1543-50
"49% of surgically-treated patients admitted limitations of social activities due to their back."
Eur Spine J, 2001 Aug; 10(4):278-88
"The study group [of 103 idiopathic scoliosis patients fused with Harrington rods] had a higher rate of secondary surgeries for complications or late disc disease below the fusion, a higher back pain score, more difficulties with normal daily activities, needed more regular pain medications, and had more episodes of back pain."
Spine, 1992 Aug;17(8 Suppl):S249-53
These facts are not meant to disparage the orthopedic surgeons who prescibe braces & perform surgeries for their patients, nor are we stating that every surgically-treated patient will have a negative experience. However, the emotional impact of these procedures should not be swept under the rug, and should be considered, along with the physical risks, before they are undertaken. To do otherwise is a grave disservice to the patient, for it is often the invisible scars that take the longest to heal.
Scoliosis Artwork
Laura Ferguson is an exceptionally talented artist who lives with scoliosis. She has created a series of evocative and powerful works of art, entitled The Visible Skeleton Series, which illustrate the haunting beauty to be found in the scoliotic spine. Each one is based upon a 3-dimensional scan of Laura Ferguson's own spine.
If one views scoliosis not as a deformity, but as an incredible adaptation to the never-ceasing pressure of gravity that occurs when the normal curves of the spine are lost, a sense of wonder can be felt over the fact that our bodies have the inborn power to compensate and maintain life, even under these dire circumstances.
Updates on the Connecticut Scoliosis Correction Seminar Series
The dates & location of the Scoliosis Correction Seminar, sponsored by the Connecticut Chiropractic Association, are now available on the CLEAR Institute website. This information is also reprinted below, for your convenience. We hope to see you there!
Connecticut Scoliosis Seminar Dates
Part 1 - January 12 & 13, 2008
Part 2 - February 2 & 3, 2008
Workshop - March 8, 2008
Location: Rocky Hill, CT
(15 minutes south of Hartford)
For information, contact the
Connecticut Chiropractic Association:
http://www.ctchiro.com/
2257 Silas Deane Highway
Rocky Hill, Connecticut 06067
Tel: (860) 257-0404
Toll Free: (800) 966-2225
FAX: (860) 257-0406
Email: Info@ctchiro.com
"One's own philosophy is not best expressed in words; it is expressed in the choices one makes. In the long run, we shape our lives and we shape ourselves. The process never ends until we die. And the choices we make are ultimately our own responsibility."
- Eleanor Roosevelt