education course a exercises lyon method.pdf · 2017-05-15 · scoliosis < scoliosis > 20°...

09/05/2014 1

Education

Course A

Exercises

SOSORT - Wiesbaden

References:"New method of treating deviations of the spine""Gymnastics applied to treatment of some constitutional diseases."

Institut Orthopédique et Pneumatique Bellevue Lyon ‐ 1835

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Balance exercises

Adjustment of asymmetric paravertebral tension

Auto elongation


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Gymnastics from the early 1900's involved stretching, exercises and the use of traction from machines that had names like "trunk bending apparatus" and "shoulder pushing apparatus". The apparatus equipment of the early 20th century was similar to modern traction equipment.

SOSORT - Wiesbaden

• Stopping evolutivity of scoliosis ?– No

Group with physiotherapy

Decreasing evolutivity

1,5° / year

Group without physiotherapy

Evolutivity

>10°/yearInsufficient to modify natural history

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• Pain– But no pain due to scoliosis < 70°

• (Weinstein 2003)

• Pulmonary Function– But no limitation due to scoliosis < 70°


• Psychological disturbance

• Well being

Physiotherapy or psychotherapy ?


• Out Patient physiotherapy– 1‐2 / week + daily 30 min

• Scoliosis Intensive Rehabilitation (SIR) program– 3‐4 weeks 4‐6 hours/day


• For this reason we can discuss physiotherapy for scoliosis at risk of brace under 25°…

This confusion exists because under 25°, scoliosis evolves in a chaoticway…And the spine should be considered as a tensegrity system

> 25° Vicious Circle


1 Method

Lyon Method

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Principles1. No complex material. All the exercices have to be repeated at home. 2. No sportive counter indication. The sport practiced by the child must be continued :

By adapting if necessary the sportive gesture ( avoid the deep quick inspiration, and the flexion of the trunk forward)By completing if necessary the sportive activity thanks to physiotherapy.

3. The exercises are symmetric in the frontal plane.4. No chapel and miracle exercice. Choosing the best technical way for every child, at every age,

and every therapeutic sequence.5. No revolution, therefore but an evolution in the exercises which are repeated few minutes a

day at home.6. We treat a child and not a scoliosis or an X‐ray.

SOSORT - Wiesbaden

• Stopping evolutivity of scoliosis ?– No

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Group with physiotherapy

Decreasing evolutivity

1,5° / year

Group without physiotherapy

Evolutivity

>3°/yearInsufficient to modify natural history

SOSORT - Wiesbaden

1 Method

Lyon Method

2 Phases

ChaoticScoliosis < 20°

Linear Scoliosis> 20°


• Scoliosis occurs in approximately 2,5 % of the adolescent population (> 10°), occurring equally among both genders

• But only 0,25 % are progressing to a curve magnitude that requires treatment, females are eight times more likely to.

SCOLIOSIS

LinearChaotic


• A Chaotic Scoliosis is a real 3D structural scoliosis (dynamic deterministic system) with:– Highly sensitivity to initial conditions (butterfly effect)

– Topological mixing of the curves– Strange attractor…


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The system is : 0pen (standing position, exchange with the outside)

Nonpredictive (butterfly effect)

Complex (multifactorial)

Discontinuous (steps) Deterministic (not by luck)

Patternable (4th fractal dimension) Strange attractor

Change of physiological behaviour at puberty timeSOSORT - Wiesbaden

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Physiotherapy can’t avoid the scoliotic earthquake but realize an antisismic building.

SOSORT - Wiesbaden

09/05/2014 212010 – Kiwirail – New ZealandSOSORT - Wiesbaden

1 Method

Lyon Method

2 Phases

Chaotic Scoliosis< 20°

Linear Scoliosis > 20°

3 Stages Before bracing

In plaster cast

In Lyon Brace


1 Method

Lyon Method

2 Phases ChaoticScoliosis < 20°

LinearScoliosis > 20°

3 Stages Before bracing

In plaster cast

In Lyon Brace

4 Major Positions Lying Rolling Sitting Standing


1 Method

Lyon Method

2 PhasesChaotic

Scoliosis < 20°

LinearScoliosis >

20°

3 Stages Before bracing In plaster cast In Lyon Brace

4 Major Positions

Lying Rolling Sitting Standing

5 StepsLumbar

lordotisation & thoracic

kyphotisation

Lateral corrective bending Derotation

Maintaining correct posture

during unbalanced situations

Strengthening in correct posture


Molécule de Mélatonine

Removal of the pineal gland in chickens produced scoliosis similar in many respects to human pathology, but the level of melatonin in the blood of scoliosis is normal.

There is a malfunction in the melatonin signaling at the level of musculoskeletal tissues in a series of patients with AIS (Moreau et al. 2004). This defect was confirmed in a larger number of patients and by using new technology (cellular dielectric spectroscopy).


Failure of postural controlVestibular dysfunction and imbalance

Failure of proprioception

Platelet abnormalitiesIncreased levels of calmodulin

osteopenia

Reduction of muscle spindles

Abnormalities of muscle fibersAbnormal muscle tone

Growth hormone secretion

Mel

i

GTP

AC

MT1-2 ATP AMPcGDP

Malfunction of cellular signaling of melatonin Based on Jean Dubousset


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awareness of postural defectswith camcorderDeveloping perception of the spine with the video feed back

SOSORT - Wiesbaden

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1st positionSupineKyphotisationwith cushion

SOSORT - Wiesbaden

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Lateral bendingDerotationConcavity stretching

SOSORT - Wiesbaden

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2nd positionFoetal positionwith cushion

SOSORT - Wiesbaden

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Analytic mobilisation ‐pressure on the convex transverse apophysis

SOSORT - Wiesbaden

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1 ‐ Adjustment of the lumbar lordosis in sitting position

SOSORT - Wiesbaden

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2 ‐ Positioning of the upper limbs

SOSORT - Wiesbaden

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Lumbar side shift

SOSORT - Wiesbaden

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Proprioceptive exercise on swiss ballIn lumbar lordosis andThoracic kyphosis

SOSORT - Wiesbaden

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Derotation exercise on swiss ballIn thoracic kyphosis

SOSORT - Wiesbaden

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Corrective bending exercise on swiss ball

SOSORT - Wiesbaden

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Lumbar mobilisationon swiss ball

SOSORT - Wiesbaden

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Balance of the shoulder girdle

SOSORT - Wiesbaden

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Balance exercises on the tilt tray

SOSORT - Wiesbaden

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Thoracic mobilization Lumbar mobilization Shoulder balance

Concave stretch, Posture SOSORT - Wiesbaden

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Axial Active Auto‐elongation, integration during the movementSOSORT - Wiesbaden

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Klapp quadrupedic positionStretching left upper limb, right lower limbFast stretch is better than low stretchPreparation for the dissociation of scapular and pelvic girdle

SOSORT - Wiesbaden

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Pelvic mobilisationSlow reversal Hold Relax

SOSORT - Wiesbaden

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On a side horizontal position

SOSORT - Wiesbaden

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In constrained inspiration

SOSORT - Wiesbaden

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Vestibular stimulationWith thoracic kyphotisation

Development of balance reactionsCoordination and Agility

SOSORT - Wiesbaden

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The Romans many centuries ago discovered that their slaves who were employed in rowing, if always kept on the same side of the ship, developed lateral curvature of the spine. To prevent this they frequently changed from one side of the boat to the other.

From The Home Physician and Guide to Health, Mountain View. Pacific Press. Pub. Assoc. 1931

SOSORT - Wiesbaden

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The practice of sport is encouragedSOSORT - Wiesbaden

Before lateralization(< 7 years)

Before Puberty growth(7‐11 years –girls)

During Puberty growth(11‐15 years)

During Bone Mass acquisition(15‐20 years)

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Higher activities of bipedalism and

walkingBalance exercises

Adjustment of asymmetric

paravertebral tension

Step,Grand porterAxial impact

SOSORT - Wiesbaden

Best conservative orthopedic treatment results with children who practice regular sporting activity.

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Sportpas de sport

0

10

20

30

40

Initial Plâtre Corset Ablation

Sport pas de sport

SOSORT - Wiesbaden

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Asymmetric SportsSki, skating

SOSORT - Wiesbaden

Sarah Michelle Gellar John Galliano

Buffy has a thoraco-lumbar scoliosis and John Galliano must adapt fashionto braces.

The daughter of Prince Andrews and Sarah Ferguson was also operated for scoliosis…


Thank you for attention


education course a exercises lyon method.pdf · 2017-05-15 · scoliosis < scoliosis > 20°...

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