Articles

Scoliosis Spinal Curvature

    Last week at my daughter's high school I met a young man, about 17 y.o., who had undergone corrective wrist surgery for scoliosis complications and he told me he had an implanted rod for his back curvature.   I told him of a study done 20+ years ago in which a functional electrical stimulation machine was used to strengthen the back muscles to correct some of the excessive curvature of the spine. 

Much of this I write from memory, as the study would take more than 10 years minimal, to ascertain whether the strengthening of the antagonist muscles would bring enough change to counter the agonist muscle groups.  I remember the results were not what was hoped for and to my best knowledge this type study was not tried again.

   Now I've been thinking, "why did this muscle stimulation protocol not work?"  Maybe it's not totally that functional electrical stimulation failed completely but the protocols were inconsistent with what we know now.   Here's my recollection and my reasoning.

  Originally a young patient would have a "Respond II" unit put on the back to stimulate the antagonist mucles.  The purpose was to strengthen them so they could prevent the opposite muscle groups from "turning" the spinal vertebral column.   The unit would be worn by the young patient during the night when sleeping.   It was felt the constant simulation of the muscles would strengthen them.   It apparently did not happen.

  Here's what we know now compared to then.  

• First is we have to distinguish which type muscles would benefit from functional stimulation. 
• Second is to my best knowledge the strengthening of muscles by involuntary electrical stimulation, without the patient also exercising those muscles, will not produce any appreciable muscle strengthening.
• Third is the volitonal movements, until fatigue sets in, is the first step then followed by electrical stimulation, high amplitude, for additional exercise after fatigue had set in.
• Fourth is the width of the pulse signal, as well as the use of negative/positive charges, affect the muscle strengthening outcomes.

   The questions still remain if functional electrical stimulation can help the scolosis patient but if tried again it is important to make sure the patient can do volitional basic muscle strengthening exercises of the antagonist muscle group and has the will to try.   Using advanced functional restoration protocols that question of "will it help" should be decided in a couple of months, not years, by measuring muscle strength, torque, circumference gains.