PREFERRED PRACTICE PATTERN
A 16-year-old girl is referred to your outpatient physical therapy clinic. The patient comes with her mom. The patient states she has been going to cheerleading practice and is having back pain. The referring physician told her she had scoliosis with a Cobb angle of 27 degrees. They do a lot of stretching in cheerleading practice, but she is having difficulty with the backward bends. She is starting to have some instability in the thoracic spine with localized pain and erector spinae spasms.
Three-dimensional curvatures of the spine and trunk
Lateral curve is an S- or C-shaped curve in the sagittal plane
Torsional component with vertebrae rotating toward the convexity
Anteroposterior distortion leads to hyperkyphosis and/or hyperlordosis in the coronal plane
Functional lateral curvature of the spine, typically reversible
Structural lateral curvature of the spine, fixed
Infantile onset: Younger than 3 years
Juvenile onset 3 to 9 years old
Adolescent idiopathic scoliosis (AIS) onset 10 to 18 years old
Adult onset: Older than 18 years
AIS is the most common form and occurs in otherwise healthy children during puberty (80%–85% of cases)
Relatively benign condition
Named for the side of the convexity of the lateral curve (right, dextroscoliosis; left, levoscoliosis)
Degree of curvature most commonly defined by the Cobb method, radiographically
Increased risk of curve progression during growth spurts in adolescents
Adam’s forward bending test. (A) No visible rib hump, negative test. (B) Visible rub hump, positive test. (From Lawry GV. Systematic Musculoskeletal Examinations. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
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