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Week 2

The document discusses assessment and treatment of scoliosis. It provides a case study describing assessment of a patient with a single thoracic curve measuring 28 degrees. It also includes true/false questions and multiple choice questions testing knowledge of scoliosis, including types, predictors of progression, management approaches, and criteria for orthopedic referral. Assessment involves measuring the curve size and rotation using a scoliometer. Management depends on factors like curve size, progression risk, and effectiveness of non-surgical options. Surgery is considered for curves over 45-50 degrees.

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87 views4 pages

Week 2

The document discusses assessment and treatment of scoliosis. It provides a case study describing assessment of a patient with a single thoracic curve measuring 28 degrees. It also includes true/false questions and multiple choice questions testing knowledge of scoliosis, including types, predictors of progression, management approaches, and criteria for orthopedic referral. Assessment involves measuring the curve size and rotation using a scoliometer. Management depends on factors like curve size, progression risk, and effectiveness of non-surgical options. Surgery is considered for curves over 45-50 degrees.

Uploaded by

api-479499469
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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The questions for this week will focus on the assessment and treatment

of scoliosis.

Case Study Question1:


Tammy is a 23-year-old woman who has a structural scoliosis with a
single C curve having an apex at T7. Describe your assessment plan
before beginning treatment. How would you measure the curve which is
28 degrees and the amount of rotation?

True/ False Questions


Q1. Functional scoliosis involves rotation and malformation of
vertebra?
False

Q2. The majority of idiopathic scoliosis’s will be progressive?


False

Q3. When assessing for scoliosis it is important to view the patient


doing a forward bending movement in all three planes?
True

Q4. A scoliometer is an instrument used to measure trunk inclination?


True

Q5. There is a correlation between nursing posture of an infant and


the development of a scoliosis curve?
True

Q6. Patients with idiopathic scoliosis may initially report fatigue in the
lumbar region after prolonged sitting or standing
True

Q7. Most idiopathic scoliosis curves are convex to the right in the
thoracic spine and to the left in the lumbar spine, so that the right
shoulder is higher than the left.?
True

Q8. A subtle scoliosis (less than 10-15 degrees) in the lower thoracic
and lumbar spine are easily missed on postural exam due to coupled
motion?
True
Q9. Adolescent scoliosis rarely improves spontaneously and typically
halt only one skeletal maturity has been reached (17- 19 years)
True

Q10. Name 4 predictors of progression for idiopathic scoliosis


Risser sign (0-5)
Gender (female > male)
Age at diagnosis
Menarche -increased progression pre-menarche (usually 12-14
years)

Q11. Complete the table below

Infantile Juvenil Adolesce


e nt
Ages 0-3 3- Puberty -
pubert adulthoo
y d
Sex Male>fema Femal Male =
le e female
>male
Progressiv 90% remit Most – Yes
e detect beyond
early 20
degrees
Radiograph If less
ic follow up than
needed 20
when degree
s – no
6mnth
s.

Q12. Name (3) three orthopedic tests that would be considered when
assessing a patient with a scoliosis?
Adam’s forward bend
Schepelmann’s sign
Alli’s test

Q13. When measuring the severity of a scoliosis which (3) three


radiographic evaluations would be undertaken or referred for to be taken?
Cobb angle
Risser sign
Nash-Moe method

Q14. Do primary or double curves form more deformity? Primary single


curve cause more deformity but double patterns progress more.

Q15. According to the literature what (3) three factors exist that may lead
to a greater chance of progression?
Greater the curve at detection
Onset before menarche
The lower the Risser sign at detection

Q16. What should the clinician be asking when considering the correct
management approach to an idiopathic scoliosis?
Risk of progression
Effectiveness of care
Risk of using chiropractic
Criteria for referral
Risks of surgery
Outcome desired

Q17. Would girls who are at pre-menarche or menarche with curves in the 20° to
40° range have the greatest chance of success with bracing. Yes/No
Yes

Q18. According to the literature how long should bracing be required for during the
day to have the best outcome and what factors may contribute to this success.
23 hours/day

Q19. What management approaches have been shown to be effective in the


management of compensatory scoliosis
• Soft tissue techniques
• Exercises: stretching
• Flexion distraction
• Gonstead states that a heel lift should only be used when the patient does not
hold the adjustment.
• Discrepency less than 6 mm – well tolerated.

Q20. When should a patient be referred for orthopedic surgery with an idiopathic
scoliosis?
45-50 degrees

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