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Therapy with corset in patients with scoliosis
ČERMÁKOVÁ, Michaela
For my bachelor thesis I selected the topic "Brace Treatment for Scoliosis Patients". Scoliosis is defined as a three-dimensional deformity of the spine with side curvatures in the frontal, sagittal and transverse planes at the same time. A scoliotic curvature is accompanied by deformations of vertebras, changes in ribs and spatulas and changes in the position of crista iliaca. One of the conservative scoliosis treatment options is brace treatment. Brace treatment aims at generating a positive effect on the curvature and, most of all, at preventing its further development in the period of an individual's growth. Brace treatment is a controversial method to a certain extent, considering a large number of diverse opinions of doctors, orthopaedists and physiotherapists concerning the treatment with torso orthoses. The theoretical part summarizes the findings relating to scoliosis, including anatomical structures influenced in scoliosis. It contains information on basic terminology, scoliosis classification, diagnostics and treatment options. The thesis is focused particularly on conservative treatments but also provides information on possible surgical treatments. Introduction into the issue of brace treatment is addressed in more detail. The history, kinds of braces, manufacture, and the principles of the effect of torso orthoses are outlined there. The practical part of the thesis includes objectives, description of the method, characteristics of the set and particularly the processed results presented in the form of case histories. The data were obtained in a qualitative research. The research involved two patients suffering from idiopathic scoliosis with indicated brace treatment in the Rehabilitation Department of the Hospital of České Budějovice. The girls were selected on the basis of their diagnosis and brace indication. The medical history of the probands was gained and the initial and final kinesiological analyses were performed. The analyses consisted of a visual static and dynamical examination, palpation examination, evaluation with a plumb line, and examination of hypermobility, gait and breathing mechanism. Both patients had the length of their lower limbs measured. The three-month research was aimed at creating a physiotherapeutic procedure for individual patients and outlining the effect of brace treatment on the overall effectiveness of the treatment. The research has confirmed the necessity of an individual approach to each patient suffering from scoliosis. Seemingly similar curvatures may show a completely different development and require a different therapeutic approach. It follows from the research that the best results may be achieved in patients if a combination of several various methods is used. Particularly auto-correction in front of a mirror, Vojta's reflex locomotion and de-rotational breathing proved successful in my research. Auto-correction in front of a mirror before and after the treatment was found particularly beneficial because the patients themselves could observe the changes of their posture during the treatment. In my experience, the use of Vojta's reflex locomotion always served as an excellent preparation for the following exercises because the abdominal wall, autochthonous muscles and ribs become activated and the breath wave is rearranged. Since both patients suffer from scoliosis with a considerable rotation element, the application of de-rotational breathing showed to be suitable because it brought visible results in each treatment for each patient. The brace treatment influences the effectiveness of the entire treatment particularly by not allowing the patient to keep a pathological posture all day long. This fact makes the work with a patient easier and has an effect on the patient's auto-correction. The bachelor thesis may be used in clinical practice of physiotherapists. The thesis may also be used as an educational material for patients.

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