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<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox">
'''Original Editors''' - [[User:Gregory Maes|Gregory Maes]]
'''Original Editors''' - [[User:Gregory Maes|Gregory Maes]]
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Search Strategy ==
== Search Strategy ==
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<u><span style="line-height: 1.5em;">3. Returning to a relaxed position (relaxation) :</span></u><br>It consist out three movements, the patient has to repeat each exercise three times for five minutes.<br>All exercises has to be performed rapidly. The purpose of these exercises are metabolic recovery and relaxation of the used muscles.<br>
<u><span style="line-height: 1.5em;">3. Returning to a relaxed position (relaxation) :</span></u><br>It consist out three movements, the patient has to repeat each exercise three times for five minutes.<br>All exercises has to be performed rapidly. The purpose of these exercises are metabolic recovery and relaxation of the used muscles.<br>
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[[Image:1-s2.0-S1360859211000672-gr4.jpg|250x200px]] .<sup></sup><sup></sup>
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[[Image:1-s2.0-S1360859211000672-gr4.jpg|250x200px]] .<sup></sup><sup></sup>
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== Prognosis ==
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== Prognosis
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'''<u>Surgery</u>'''
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'''<u>Surgery</u>'''
The outcome needs to be age matched since the demands of daily life, professional performance, and leisure activities vary substantially in the different age groups. Most of the patients who are still professionally active do not return to their previous work if it was a physically demanding job, but almost all of those had already stopped working before the surgery, because of pain limitations. When analyzed, regarding their overall daily activity by different questionnaires, most of these patients irrespective of age have improved in almost all categories of quality of life, and the use of regular pain medication is reduced substantially in more than 70% of these patients<sup>[18]</sup>.
The outcome needs to be age matched since the demands of daily life, professional performance, and leisure activities vary substantially in the different age groups. Most of the patients who are still professionally active do not return to their previous work if it was a physically demanding job, but almost all of those had already stopped working before the surgery, because of pain limitations. When analyzed, regarding their overall daily activity by different questionnaires, most of these patients irrespective of age have improved in almost all categories of quality of life, and the use of regular pain medication is reduced substantially in more than 70% of these patients<sup>[18]</sup>.
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However for the elderly the outcome is less positive because of the age. The major problem of these patients after surgery, once surgical complications and implant failures have not occurred, is the residual back pain mostly as an expression of muscular spasms and pain due to unbalanced or chronic contractures of the paravertebral muscles<sup>[19]</sup>.
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However for the elderly the outcome is less positive because of the age. The major problem of these patients after surgery, once surgical complications and implant failures have not occurred, is the residual back pain mostly as an expression of muscular spasms and pain due to unbalanced or chronic contractures of the paravertebral muscles<sup>[19]</sup>.
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<u>'''Bracing'''</u>
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<u>'''Bracing'''</u>
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Whether brace treatment for scoliosis is successful is often described using the curve progression of more than 5° before skeletal maturity as a benchmark for bracing failure rather than spine surgery<sup>[20]</sup>. Some use 10° of curve progression or preventing the curve from reaching 45° at skeletal maturity<sup>[21]</sup>.<sup> </sup>
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Whether brace treatment for scoliosis is successful is often described using the curve progression of more than 5° before skeletal maturity as a benchmark for bracing failure rather than spine surgery<sup>[20]</sup>. Some use 10° of curve progression or preventing the curve from reaching 45° at skeletal maturity<sup>[21]</sup>.<sup> </sup>
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The outcome data should be determined from the percentage of patients with: less than 5° or greater than 6° of progression at maturity, curves exceeding 45° at maturity, and progression resulting in the recommendation for surgery. Bracing studies should have a minimum of 2 years follow up beyond skeletal maturity. The first study to use these criteria determined a brace should prevent progression in 70% of patients to be considered effective]. Regardless of the recommended standardized parameters, the goal of bracing idiopathic curves remains consistent: control the curve, prevent progression, and avoid surgical intervention<sup>[22]</sup>.<br>
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The outcome data should be determined from the percentage of patients with: less than 5° or greater than 6° of progression at maturity, curves exceeding 45° at maturity, and progression resulting in the recommendation for surgery. Bracing studies should have a minimum of 2 years follow up beyond skeletal maturity. The first study to use these criteria determined a brace should prevent progression in 70% of patients to be considered effective]. Regardless of the recommended standardized parameters, the goal of bracing idiopathic curves remains consistent: control the curve, prevent progression, and avoid surgical intervention<sup>[22]</sup>.<br>
== Resources <br> ==
== Resources <br> ==
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#Petros Patias, Theodoros B Grivas, Angelos Kaspiris, Costas Aggouris and Evangelos Drakoutos, ‘A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices.’, Scoliosis, 2010. Level of evidence = 1
#Petros Patias, Theodoros B Grivas, Angelos Kaspiris, Costas Aggouris and Evangelos Drakoutos, ‘A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices.’, Scoliosis, 2010. Level of evidence = 1
# Alves de Arau’jo M.E., Bezerra da Silva E., Bragade Mello D., Ali Cader S., Shiguemi Inoue Salgado A., Henrique Martin Dantas E., ‘The effectiveness of the Pilates method: Reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students’, Journal of Bodywork & Movement Therapies, 2012, 16, 191 -198. Level of evidence = 1
# Alves de Arau’jo M.E., Bezerra da Silva E., Bragade Mello D., Ali Cader S., Shiguemi Inoue Salgado A., Henrique Martin Dantas E., ‘The effectiveness of the Pilates method: Reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students’, Journal of Bodywork & Movement Therapies, 2012, 16, 191 -198. Level of evidence = 1
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#Rinella A, Bridwell K, Kim Y, RudzkiJ, Edwards C, Roh M, Lenke L, Berra. Late complications of adult idiopathic scoliosis primary fusions to L4 and above: the effect of age and distal fusion level. 2004, Spine 29(3):318–325. Level of evidence = 3
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#Rinella A, Bridwell K, Kim Y, RudzkiJ, Edwards C, Roh M, Lenke L, Berra. Late complications of adult idiopathic scoliosis primary fusions to L4 and above: the effect of age and distal fusion level. 2004, Spine 29(3):318–325. Level of evidence = 3
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#M. Aebi. Adult Scoliosis. Eur Spine J (2005) 14: 925–948. Level of evidence = 3
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#M. Aebi. Adult Scoliosis. Eur Spine J (2005) 14: 925–948. Level of evidence = 3
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#Shaughnessy WJ Review Advances in scoliosis brace treatment for adolescent idiopathic scoliosis. Orthop Clin North Am. 2007 Oct; 38(4):469-75, v. Level of Evidence = 1
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#Shaughnessy WJ Review Advances in scoliosis brace treatment for adolescent idiopathic scoliosis. Orthop Clin North Am. 2007 Oct; 38(4):469-75, v. Level of Evidence = 1
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#Richards BS, Bernstein RM, D'Amato CR, Thompson GH Spine Review Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. 2005 Sep 15; 30(18):2068-75; discussion 2076-7. Level of evidence: 1
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#Richards BS, Bernstein RM, D'Amato CR, Thompson GH Spine Review Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. 2005 Sep 15; 30(18):2068-75; discussion 2076-7. Level of evidence: 1
#Weinstein SL. Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST). University of Iowa, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 2008. Level of Evidence: 1<br><br>
#Weinstein SL. Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST). University of Iowa, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 2008. Level of Evidence: 1<br><br>