NON-OPERATIVE APPROACHES IN SCOLIOSIS TREATMENT

Skolioza je trodimenzionalno krivljenje kralježnice koje uzrokuje brojne probleme kao što su bol, teškoća disanja, smanjenje mogućnosti u aktivnostima svakodnevnog života i sl. Skolioze se razlikuju po dobi u kojoj se javljaju, etiologiji nastanka, te dva glavna tipa po kojima se iste razlikuju su strukturalne i nestrukturalne. Najčešći oblik skolioze je idiopatski, te se javlja u adolescentnoj dobi. Rana intervencija od velike je važnosti, kako bi se konzervativnim (neoperativnim) pristupom što prije započela prilagođena rehabilitacija. Procjena je glavni dio rehabilitacije, te sam sustav praćenja napretka/nazadovanja u rehabilitaciji. Na temelju procjene stvara se plan terapije i postavljaju se ciljevi za pacijenta i fizioterapeuta. Fizioterapeut pristupa pacijentu individualno pa je i pristup koji odabire strogo individualan za svakog pacijenta. Danas postoji mnogo različitih neoperativnih pristupa u tretmanu skolioza kao što su Bobath koncept, Vojta, Proprioceptivna neuromuskularna facilitacija (PNF), Schroth metoda, Biofeedback, manipulativne tehnike, masaža, akupunktura, kinesio taping i terapijsko jahanje. Često se među navedenim pristupima izabire onaj standardni, kojeg čine izometričke vježbe, no zanemaruje se sama vestibularna rehabilitacija koja je ključna za balans i ravnotežu svakoga pacijenta. Sve metode mogu se koristiti zajedno pa čak i uz najstarije rješenje ispravljanja skolioza, a to su ortoze. Osim navedenog postoje i alternativne metode koje ne liječe skoliozu, ali olakšavaju i ublažuju neke od njezinih simptoma. To su primjerice i yoga, pilates, tai chi. Svrha ovoga rad je prikazati funkciju i uspješnost neoperativnih pristupa. Cilj je rana intervencija kako bi se rehabilitacija započela i bila što uspješnija. Važno je biti upoznat različitim pristupima kao što su alternativni kako bi sam fizioterapeut mogao izabrati odgovarajući i primijeniti isti.Scoliosis is a three-dimensional curvature of the spine that causes a number of problems such as pain, difficulty breathing, reducing opportunities in activities of daily living and so on. Scoliosis vary by age at which they occur, the etiology of origin, and two main types by which they are different structural and nonstructural. The most common form of scoliosis is idiopathic, and occurs in adolescence. Early intervention is of great importance, so that conservative (non-operative) approach as soon as possible began adapted rehabilitation. The assessment is a major part of rehabilitation, and is a system for monitoring progress / reversion in rehabilitation. Based on the assessment, the plan of therapy is created and set of goals for the patient and physiotherapist. The physical therapist approaches the patient individually so the approach chosen strictly individual for each patient. Today there are many different non-operative approaches to scoliosis treatment such as Bobath Concept, Vojta, Proprioceptive Neuromuscular Facilitation (PNF), Schroth Method, Biofeedback, Manipulative Techniques, Massage, Acupuncture, Kinesium Taping and Therapeutic Riding. Often, among the aforementioned approaches, the standard is chosen, which is an isometric exercise, but the vestibular rehabilitation itself is neglected, which is crucial for the balance and balance of each patient. All methods can be used together even with the oldest solution to correct scoliosis, namely orthotics. In addition to this, there are alternative methods that do not cure scoliosis but alleviate and relieve some of its symptoms. These are for example yoga, pilates, tai chi . The purpose of this paper is to show the function and performance of nonoperative approaches. The goal of early intervention i so the rehabilitation could begin make it more successful. It is important to be aware of different approaches such as alternative ones, so that the physiotherapist himself can choose the appropriate one and apply it