Outcome of intensive outpatient rehabilitation and bracing in an adult patient with Scheuermann's disease evaluated by radiologic imaging-a case report

Abstract

Background: No studies examine the efficacy of intensive specific physical therapy (PT) exercises along with brace for the adult with Scheuermann's kyphosis (SK). The aim of this study was to examine the effects of intensive PT based on the Barcelona Scoliosis Physical Therapy School (BSPTS) and SpinoMed brace on a 76-year-old female with SK. Case Description: A 76-year-old female, diagnosed with SK as an adolescent, presented in October 2014 with thoracic hyperkyphosis T1 to T12 Cobb angle of 85° and lumbar hyper lordosis L1 to L5 Cobb angle of 70°. Lumbar scoliosis T12-L5 with 21° Cobb and vertebral rotation 2. Trunk translation in the sagittal plan was 4.5 cm. Intermittent low back pain 6/10 at worst. Quality-of-life score was 3.8 (SRS 22 questionnaire). Method: The PT regimen included one-hour Schroth exercise sessions three times per week for 6 months. In addition, a home exercise program (HEP) was recommended. Patient also wore a SpinoMed brace for 2 h per day. All tests and measurements were recorded before and after treatment. Results: After a six-month treatment period the kyphosis Cobb angle was reduced to 70° and the lordosis Cobb angle improved to 57°. A recent x-ray (October 2015) showed another improvement in the sagittal plane with thoracic kyphosis measuring 64° and lumbar lordosis 55°. Lumbar curvature decreased to 12° and vertebral rotation to 1. The quality-of-life score showed improvement with a score of 4.5 on the SRS 22. Pain score diminished to 2. Trunk deviation improved by 2.2 cm. Conclusion: These findings suggest that intensive and specific PT and bracing were successful for the treatment of this adult patient with SK.