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Created with Fabric.js 1.4.5 WHAT IS IT? Scoliosis WHO? TreatmentOptions -Nonstructural scoliosis- caused by another condition and usually improves when that condition is treated -Structural scoliosis-caused by a disease, condition or unknown factor and is more likely to need treatment -Idiopathic-unknown cause, the most common type of scoliosis -Congenital -Neuromuscular -Degenerative -Affects 2-3% of the U.S. population-Can occur in infants, adolescents and adults-Idiopathic is the most common and onset is primarily in adolescents, 10-16 y/o-Occurs equally in male and females but females are morelikely to have a severe curve -Family history, particularly daughters of women who have scoliosis-Being female-Having congenital disorders such as spina bifida or another disorder that affects bone formation -Having nerve or muscle disorders: cerebral palsy or muscular dystrophy -Certain injuries, infections, or tumors-Degenerative changes in the spine with age -As scoliosis progresses, bones of the spine rotate toward the inner part of the curve-Severe curves can change the shape of the ribcage and may reduce lung capacity causing the heart to work harder to pump blood through the lungs and over time lead to heart failure-Curve causes stress and pressure on spinal discs, nerves, muscles, ligaments or facet joints-In advanced cases the vertebral joints may fuse together, locking the spine in a curved position-Bone cartilage may thin causing nerve damage as the vertebrae press on nerves, leading to numbness and tingling down the legs-The imbalance of the curve can cause arthritis of the spine EFFECTS -Depends on the type, cause and severity of the curve-Majority of cases are not expected to require treatment -About 1 in 10 children with scoliosis require treatment-The younger a child is when diagnosed the more likely it is to progress -Curves tend to advance during periods of growth-The more severe a curve is the more likely it is to get worse -Curves in the upper back are more likely to increase -Lateral curvature of the spine-Most cases are mild-Cannot be prevented and treatment is limited to preventing the curve from progressing-Can impact quality of life with: -limited physical activity -pain, usually in older adults -reduced respiratory function -self-esteem issues -Visible curve in the spine -Posture looks unusual -Usually does not cause pain -Uneven waistline -One shoulder higher than the other -Ribs may stick out RISK FACTORS -Observation with physical exams to monitor for progression of the curve, for children every 4-6 months-If exam shows a significant curve, then x-rays are taken to obtain a more precise measurement-Nonsurgical treatment: A brace can be used to stop the curve of the spine-Surgical treatment: Spinal fusion permanently joins the vertebrae together, can sometimes decrease the curve but stabilizes spine to prevent further curvature PRESENTATION TYPES Intervention depends on the age, cause, size of curve and risk of progression: Role of Occupational Therapy Occupational therapy can help those with scoliosis by helping to manage day to day activities or with recovery from surgery. -As the degree of the curve increases the body's posture becomes worse. Muscles in the back, neck, shoulders, hips and legs are stretched or constricted out of alignment leading to pain and fatigue. -Early detection of scoliosis allows for the curve to be monitored for changes and early treatment to prevent the curve from progressing. In areas with limited access to routine health care, scoliosis may go undetected until it is severe and requires more invasive treatment.-Lower self-esteem, particularly in adolescents who wear a brace for 20 or more hours a day for several years-Those with scoliosis may have a poor self-image because they don't like how they look or feel-Activities may be limited due to decreased ROM, pain, the use of a brace or restrictions after surgery PROGNOSIS -Occupational therapists work with clients to help manage physical symptoms and ensure participation in daily activities by: -Postural strategies -Self-care adaptations -Maintaining flexibility -Increase ROM -Activities to maintain the strength of back muscles -Helping to develop customized support cushions -With children recovering from surgery occupational therapists can assist with: -Training parents and others is safe manual handling techniques -Facilitating a smooth discharge from the hospital -Environmental assessments of home and school to develop necessary adaptations -Provide appropriate opportunities for play Other Considerations
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