Co-Chair: Manuel Rigo
A group of SOSORT members, approved by the SOSORT board, to work on this particular subject of ‘education’.
Any member of the SOSORT is welcome to collaborate in this committee.
Current Members are:
Josette Bettany-Saltikov PT, PhD (UK)
Manuel Rigo MD, PhD (SPN)
Hagit Berdishevsky PT (USA)
Garikoitz Aristegui PT (SPN)
Cindy Marti PT (USA)
Czaprowski Dariusz PT,PhD (POL)
Sabrina Donzelli MD (ITA)
Eric Parent PT,PhD (CAN)
Lukasz Stolinski PT (POL)
The objectives of this committee are clearly defined in the SOSORT statute. The statute of SOSORT declares in article 4:
‘- The general aim of the society is:
First, to foster the best conservative management – early detection, prevention, care, education and information - of scoliosis and other spinal deformities.’
Later, in point 4.5 it specifies that one of the aims of the society is:
‘To promote specific education and training among professionals creating a body of specialists in this particular area, able to care efficiently for scoliosis patients.’
1) the SOSORT EC is currently working in the definition and description of a specific educational plan which includes a general SOSORT instructional course (three days: one for general aspects, one for physiotherapy methods and one for bracing) and a series of instructional courses on any specific physiotherapy method or bracing technique supported by the SOSORT. This project has to be presented to the SOSORT board for its final discussion and aproval.
2) The coordination of a series describing the physical therapy methods represented in SOSORT to be published in Scoliosis, the journal.
3) Compilation of a comprehensive list of current training programs and abstracts summarizing the principles of the different methods represented in SOSORT. Information about International courses with programs and contents approved by the Committee and the SOSORT board.
4) Promotion of SOSORT among the different scientific societies with interest in this field as well as the patient’s societies, groups, foundations, etc
5) The most ambitious project is the elaboration of a ‘Scoliosis International White Book’.
To any further information please contact with the provisional coordinator:
Manuel Rigo MD, PhD
Vía Augusta 185, 08021 Barcelona, Spain
T 00 34 93 2091330
First submission of the ‘Educational Project’ to the SOSORT board.
A SOSORT Instructional Course will be held in conjunction with the annual meeting. The course will be chaired by Josette Betany, an established member of the SOSORT Educational Committee, in collaboration with a local co-chair, selected by the local organizing committee of the annual meeting. The structure of the course will be similar to the initial design proposed for the WCPT Congress in Amsterdam, adding bracing. The first course will immediately precede the SOSORT Annual Meeting in Barcelona 2011.
The second part of the educational project will provide an opportunity for individuals to receive specific training in the different treatment techniques and approaches represented in the SOSORT. Following the instructional course, professionals can participate in the specialized courses promoted by the different schools. However, courses on physiotherapy techniques will certify only PTs, courses on bracing will certify only CPOs and courses for medical doctors would certify only medical doctors. To reiterate this point, all professionals generally accepted in the SOSORT may attend any course and will receive a certification of attendance, but only participants for whom the course is specifically designed, will earn the certification to practice that method.
The chair of the SOSORT Educational Committee will form a specific sub-committee, which will act as a first filter for course evaluation. This sub-committee should be small for optimal efficiency. According to their involvement in the Educational Committee, my proposal is: Luke Stikeleather CPO, Cindy Marti PT, Josette Betany PT, Manuel Rigo MD and one MD from the SOSORT Board.
Any candidate school will submit its course program to the chair of the Educational Committee. The sub-committee will evaluate the program; will suggest changes if necessary, and then will submit the program to the SOSORT board for approval or rejection. Once the SOSORT board has accepted a course, their promoters will be informed and allowed to announce the course with the support of the SOSORT. It also will be announced on the SOSORT web site.
The sub-committee will devise a simple protocol to serve as a guide for evaluation. Any suggestion from the board here will be highly appreciated. Some suggested points that should be included in this protocol are: experience and tradition of the specific school, experience and quality of the lecture/s, theoretical/practical number of hours, etc.
Independently, the SOSORT board should provide the sub-committee a sort of ethical code and “standard of good practice” to be sent to the different candidates. These guidelines will help them construct their course to such a code and will address points like: setting a reasonable registration fee, with a significant discount for SOSORT members, and providing information only about their specific technique, without comparison to other techniques (or comment or personal opinion from the lecturers about other techniques, unless referring to some already published scientific data), etc.
Manuel Rigo and the members of the Educational Committee
Chair: Manuel Rigo
The SOSORT Educational Committee was asked by Charles Rivard to organize the educational session in Montreal as you know. A suggested topic from out of the committee was ´posture´. After a quite long discussion, the ED has concluded that ´posture´is a weak topic at this moment considering other candidates. It was finally accepted by consensus that 'adult scoliosis´is a more interesting topic for everybody as it was never before. I would like you to consider this as the best candidate topic.
To my point of view and clinical experience, the two main problems in adults with any of the idiopahic clinical forms developed during growth and non operated are curve progression (lets avoid here the term instability) and pain. Breathing impairment is more secondary with the exception of untreated or bad treated early onset thoracic scoliosis going over 90°.
Pain is sometimes related to the scoliosis and sometimes is not. Adults with idiopathic scoliosis can suffer back pain like any other adult and related to the same factors than in general population but they have also specific causative factors like for example 'segmental instability associated to rotatory listhesis' or the 'costoiliac syndrome'.
Adults operated during adolescence with old instrumentation is also a big problem for conservative doctors and a real challenge for modern orthopaedic surgeons.
Adults developing degenerative scoliosis can be considered a third population with specific clinical problems. And finally, we have to consider a last but not least important population formed by those adults going under surgery and coming to rehabilitation later.
Dr Stefano Negrini pointed out: "I think as well that the problems in adult scoliosis are twofold: back pain on one side, and progression on the other.
You listed two specific pain syndromes due to scoliosis, but I think there are at list three other typical clinical presentations:
? postural collapse: it's a pain appearing during the day and increasing gradually until the patient needs to lie down to recover (not always possible) and it's due to the lack of muscular support of the spine; pain is typically or in the concave side (compression), or on the hump (distraction), but is not really generalized unless there is an anterior flexion
? sacro-iliac joint pain, similar to that in pregnancy (not only in scoliosis) and due to the asymmetical compression of these joints; in this case there are the typical sacroiliac tests positive postural pain due to anterior flexion, in cases in which lordosis cannot be reached any more and pain is constant as soon as the patients stand by.
In all these situations you cannot be totally certain, but the clinical description can be drawn quite easily and, even without certainity, you can understand where the pain comes from. So, a differential diagnosis is possible."
In accordance with Dr Tomasz Kotwicki the preliminary proposed program is:
1) Differential diagnosis of the back pain in adult scoliosis (non operated patients)
2) Differential diagnosis of back pain in adults with scoliosis (operated patients)
3) Interpretation of radiological signs and MRI in adults with scoliosis
4) Bracing as a realistic approach in the conservative managment of adult scoliosis
5) Surgical treatment of adult scoliosis
6) Rehabilitation in adult scoliosis: specific or not specific ?
Any change in this program will be accurately informed on time.