CLINICAL-BIOMECHANICAL AND PHYSIOLOGICAL RESULTS OF MULTIMODAL CONSERVATIVE TREATMENT OF PATIENTS WITH GRADE II—III IDIOPATHIC SCOLIOSIS

Abstract

Objective. To analyze the efficacy of multimodal treatment of patients with grade II—III idiopathic scoliosis comprising artificial correction of movements (ACM) by means of functional electric stimulation (FES) of muscles during walking in a correcting brace. Material and Methods. The subjects of examination and treatment were 50 patients with idiopathic scoliosis, among them 20 patients with grade II spinal curvature, and 30 — with grade III. Brace therapy was performed with a functional frame-type brace modified by adding lateral pelottes attached with springs. All patients received 15‑day course of FES during walking in a functional correcting brace. Electric stimulation was applied to trunk muscles of both sides: sacrospinous, intercostal, rhomboidal, trapezius, as well as greatest and medium gluteal muscles at the concave side of the curvature. Results. The study showed that multimodal treatment facilitates significant correction of different types of spinal deformity and normalization of biomechanical and innervation structure of walking. Long-term outcomes were evaluated in 36 patients during a 3‑year follow-up period. With the adherence to a prescribed orthopedic treatment regimen and repeated FES courses each 8—10 months the long-term outcome was good in 29 cases and satisfactory in 8 cases. Conclusion. The effect was achieved by reduction of scoliosis, essential intensification of the activity of symmetric trunk and leg muscles, and improvement of their functioning during walking.