Dynamic Electroneurostimulation and corrective therapeutic gymnastics in medical rehabilitation programs for children with scoliosis

BACKGROUND: The high prevalence of scoliosis within pediatric orthopedic condition (up to 27.6%), the significant progression of the pathological process in adolescents (50%), and the risk of early disability in children (8%–9%) necessitate the development of innovative medical rehabilitation programs.

AIM: This study aimed to provide a scientific rationale for the combined use of dynamic electroneurostimulation and corrective therapeutic gymnastics with elements of the Katharina Schroth method in the medical rehabilitation of children with scoliosis.

METHODS: A randomized prospective study included 60 children aged 5–18 years with grade II scoliosis (36.7% boys and 63.3% girls). All patients were randomized into three equal groups. The main group received a combined program of dynamic electroneurostimulation and corrective therapeutic gymnastics with elements of the Schroth method. The first reference group received dynamic electroneurostimulation only, whereas the second reference group received corrective therapeutic gymnastics with elements of the Schroth method only.

RESULTS: The study demonstrated that only the main group, which received combined dynamic electroneurostimulation and therapeutic gymnastics with elements of the Schroth method, showed reductions in back muscle fatigue and dorsal pain under static and dynamic loads compared with children who received dynamic electroneurostimulation or therapeutic gymnastics alone (p <0.05). Regression of pathological changes in clinical and orthopedic status was recorded in the main group and the second reference group (p <0.05). The most significant increase in median strength endurance of the back and abdominal muscles was observed in the main group patients. In the longitudinal analysis of scoliometry parameters, only children in the main group showed an increase in the medians of thoracic spine parameters (p <0.05). Longitudinal laser Doppler flowmetry analysis of the thoracic spine revealed an increase in the mean values of microcirculation (M) and perfusion variability (σ), more pronounced in children receiving combined dynamic electroneurostimulation and therapeutic gymnastics or therapeutic gymnastics alone.

CONCLUSION: The study confirmed the feasibility of applying dynamic electroneurostimulation both alone and in combination with therapeutic gymnastics incorporating elements of the Schroth method in children with grade II scoliosis. The therapeutic efficacy of the combined use of dynamic electroneurostimulation and therapeutic gymnastics in children was statistically significant (p <0.05) and amounted to 75.0% compared with therapeutic gymnastics incorporating elements of the Schroth method alone (68.8%) and dynamic electroneurostimulation alone (53.8%). Follow-up in 41.6% of children from all groups at 3 and 6 months after treatment completion confirmed the persistence of achieved results.