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Adolescent Idiopathic Scoliosis Part 2: Clinical & Radiological Evaluation

presented by Cindy Marti, PT

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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This course will provide an overview of clinical and radiological evaluation of AIS. Different curve pattern examples will be given using the Rigo Classification System as a foundation. Clinical evaluation tools will include postural assessment, use of Bunnell Scoliometer for measurement of angle of trunk rotation, and suggested respiratory assessments. Radiological evaluation will include education on Cobb angle and other spinal parameters.

Meet Your Instructor

Cindy Marti, PT

Cindy Marti began her career at St. Elizabeth Hospital in Appleton in 1986. In 1989 she joined Milwaukee-based Competitive Edge Sports Medicine and became part of the management team in 1991. In 1994, after Competitive Edge became part of NovaCare, Cindy became General Manager of the Wisconsin region. In 1996, Cindy stepped down from upper…

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Chapters & Learning Objectives

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1. Clinical Screening and Leg Length Discrepancy

This chapter will educate on screening for scoliosis using the Bunnell scoliometer and how the clinician should coordinate care in the event of a positive scoliosis screening. There will be examples of postural asymmetry seen in scoliosis. In addition, the learner will be introduced to research supporting the most valid and reliable methods for detecting leg length discrepancy and understand importance of correctly detecting and treating leg length discrepancy in scoliosis. Case examples of leg length discrepancy will be given.

2. Clinical Examination

This chapter will introduce the reader to scoliosis curve patterns and educate the learner on the fundamentals of how to clinically examine scoliosis using various objective measures such as photography, inclinometer, and respiratory measures. There will be an introduction to the use of surface topography for clinical tracking of scoliosis. There will be a video of a scoliosis patient examination.

3. Radiological Examination

This chapter will introduce the reader to how scoliosis is evaluated radiologically using standing x-ray. The learner will understand the Cobb angle as the key radiological measurement of scoliosis, and also be introduced to additional radiological measures such as vertebral rotation, sagittal and coronal imbalance, and Risser score for skeletal maturity.

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The course will focus on published literature for appropriate decision making in treatment of AIS - including references from SOSORT (Society of Scoliosis Orthopedic Rehabilitation and Treatment), SRS (Scoliosis Research Society), and additional literature. The course will provide information on treatment recommendations based upon risk of curve progression and other variables, and outline goals of therapy based upon individual needs.

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This course will provide entry level information about Adolescent Idiopathic Scoliosis (AIS). The course will define AIS, provide a basic understanding of the scientific theory of the etiology and pathomechanism of AIS, explain the differential diagnosis of AIS, and provide tools for predicting progression of deformity in order to prioritize care.

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The course will define PSSE (Physiotherapeutic Scoliosis Specific Exercise) based upon accepted international standards in conservative management of scoliosis. Various schools of PSSE will be reviewed with an emphasis on the Schroth-Barcelona method. Exercise examples will be shown. PSSE will be contrasted to general physical therapy. Precautions for and modifications of general physical therapy and exercises will be given. The course is not intended for the application of PSSE by the clinician (advanced PSSE training is needed), but some simple scoliosis intervention suggestions will be given.

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The course will provide entry level information about Scheuermann’s disease and postural hyperkyphosis. Clinical evaluation and radiologic diagnostic criteria will be described. Treatment indications and goals for physical therapy will be explained. An overview of physical therapy concepts for Scheuermann’s Disease will be provided and in addition, example exercises will be shown. The course is not intended for full competency in treating Scheuermann’s Disease, (advanced training is needed), but some simple intervention suggestions will be given.

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The course will give an overview of scoliosis seen in adults. Differential diagnosis of adult onset degenerative scoliosis will be discussed. Key radiological characteristics related to quality of life for adults with scoliosis will be reviewed based upon published literature.Complexities of symptom presentations will be shared, including case examples Suggestions will be provided for clinical precautions and coordination of care with other scoliosis professionals. The course is not intended for the application of PSSE by the clinician (advanced PSSE training is needed), but some simple scoliosis intervention suggestions will be given.

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