Marek Kluszczyński, MD, PhD, graduate of the Faculty of Medicine at the Medical University of Silesia in 1987, pediatrician, specialist in medical rehabilitation. I am passionate about children's orthopedic diagnostics and treatment of posture defects, especially scoliosis - several thousand children with scoliosis treated in their rehabilitation center Częstochowa - Poland. Participant of international courses as part of SOSORT in the field of conservative treatment of scoliosis and corset treatment.
The Effectiveness of Early Rehabilitation in idiopathic scoliosis, 2024
Background: The purpose of this study was to assess specific rehabilitation methods' effectivenes... more Background: The purpose of this study was to assess specific rehabilitation methods' effectiveness in early idiopathic scoliosis (IS) development, focusing on lower limb functional inequality's role in scoliosis progression. Materials and Methods: This study comprised 812 patients aged 6-16 years at risk of developing idiopathic scoliosis (IS). The mean (SD) age was 10.66 (3.16) years. Patients were categorized into high-and medium-risk groups based on the angle of trunk rotation (ATR) size. Specific scoliosis physiotherapy was used, and the average follow-up period was 28.1 ± 14.5 months. Changes in ATR, Cobb angle, and functional length of the lower limbs pre-and post-treatment were statistically analyzed across three age groups (6-9, 10-12, and 13-16 years) and three scoliosis locations. Results: Significant effectiveness of early rehabilitation was observed in the high-risk group of children aged 6-9 years. In the medium-risk group, significant reductions in ATR were observed in both the 6-9 and 10-12 age groups across all three scoliosis locations. Additionally, there was a significant decrease in the Cobb angle in the thoracolumbar region and a significant reduction in lower limb inequality across all age groups and scoliosis locations. Conclusions: The early implementation of specific physiotherapy may enhance the efficacy of idiopathic scoliosis treatment by attenuating factors contributing to its progression.
Innowative method for the conservative treatment of idiopathic scoliosis, 2024
Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early... more Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal reflex balance using the GraviSpine device. This study is a retrospective analysis of prospectively collected data. Methods: A total of 199 patients aged 6-17 years, with a mean age of 11.26 ± 3.35 years, including 168 girls (84.4%) and 31 boys (15.6%), out of a total of 830 patients treated for IS at the Scoliosis Treatment Center in 2014-2019 were included in the assessment, which was conducted according to the inclusion and exclusion criteria. The study group was divided into three age groups. Group A subjects were 6-9 years old; group B, 10-12 years old; and group C, 13-17 years old. The mean follow-up time was 28.71 ± 10.98 months. Treatment outcomes were compared, based on changes in the Cobb angle and the angle of trunk rotation before and after treatment, both within the groups and with respect to sex and curvature location, using the Wilcoxon signed-rank test. Cobb angle changes in patients were classified as improvements, stabilizations, or deteriorations according to the SOSORT criteria. Results: A majority of patients improved or stabilized after treatment, with 67%, 71%, and 90% of subjects in groups A, B, and C, respectively, achieving these results. In group C (the oldest children), a statistically significant reduction of −1.84° ± 6.88° (6.31%) in the mean Cobb angle was achieved after treatment. With regard to sex, improvements and stabilizations accounted for 81% of cases in girls and 61% in boys, respectively. With respect to location, statistically significant reductions in the Cobb angle were noted for thoracic and thoracolumbar spines of −2.2° ± 7.54° (10.17%) p = 0.022 and −2.2° ± 6.58° (6.36%) p = 0.049, respectively. A significant reduction in the mean angle of trunk rotation was obtained in the group and in three curvature locations. Conclusions: Based on the presented research findings, the utilization of the GraviSpine device as an adjunct to specific PSSE (physiotherapeutic scoliosis-specific exercises) physiotherapy and bracing in the management of pediatric patients with mild to moderate scoliosis appears to enhance treatment efficacy.
The conservative treatment of idiopathic scoliosis - Gravispine, 2024
Background. The conservative treatment of idiopathic scoliosis (IS) may be enhanced through a com... more Background. The conservative treatment of idiopathic scoliosis (IS) may be enhanced through a combination of specialized physiotherapy, bracing, and the utilization of assistive devices. Objectives. This study aims to evaluate the efficacy of the GraviSpine device in supporting the conservative treatment of IS in children. Materials and methods. A cohort of 142 patients, aged 10-17 years with an average age of 12.76 ±1.75 years, undergoing treatment for IS with specific physiotherapy and bracing, received additional treatment with the GraviSpine device. The participants, selected based on inclusion and exclusion criteria, were divided into 2 age groups: group A (10-12 years) and group B (13-17 years). The mean follow-up period was 28.71 ±10.98 months. The assessment involved changes in post-treatment trunk rotation angles (ATR), Cobb angles, and functional lower limb length discrepancies (FLLDs) concerning age groups and scoliosis location. Results. The proportion of patients showing improvement and stabilization was high in both groups A and B, at 71% and 90%, respectively. In group B, a significant reduction in the mean Cobb angle of-1.83° ±6.88°, p < 0.002, was observed. Furthermore, a significant decrease in the incidence of FLLDs was noted in thoracic and lumbar scoliosis locations, p < 0.002. Conclusions. To enhance the effectiveness of conservative treatment for IS, the utilization of an assistive device such as GraviSpine may be considered, particularly when the child presents functional inequality of the lower limbs.
Background: Early detection of idiopathic scoliosis is one factor in determining treatment effect... more Background: Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool-and school-age children, taking into account the location and size of the spine curvature. Methods: The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results: In the age groups 6-9, 10-12 and 13-17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6-9 and 10-12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis-or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004). Conclusion: A low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6-9 and 10-12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6-12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis. Trial registration. This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.
Background This research analysed discrepancies between the angle of trunk rotation (ATR) and the... more Background This research analysed discrepancies between the angle of trunk rotation (ATR) and the Cobb angle, in order to study if the commonly used 7° cut-off threshold for ATR helps diagnose scoliosis. In early stadia of scoliosis in children, ATR and the Cobb angle often disagree, increasing the risk of a false diagnosis: while the former does not suggest scoliosis, the latter does. Methods The study analysed ATR clinical parameters and the Cobb angle in the X-ray pictures of 117 (23 boys and 94 girls, aged 6–17 years) children who had not yet started treatment and whose X-ray pictures showed the Cobb angle of at least 10°, indicating idiopathic scoliosis. The degrees of lumbar lordosis and thoracic kyphosis were measured using the Saunders inclinometer, and back asymmetry was measured with Adam’s forward bend test using the Bunnell scoliometer. In the X-ray pictures, the curvature angle was plotted according to the Cobb method. The patients were stratified based on their age, an...
Introduction The three dimensional deformation of the spine in scoliosis is specific for a given ... more Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. found in the 6-9-and 10-12-year-old groups and in the lumbar and thoracolumbar section. To increase the rate of early diagnosis of scoliosis, the results suggest the need to adopt two ATI criteria for the diagnosis of scoliosis at screening, 5° for age of 6-12 years, and when asymmetry affects the lumbar and thoracolumbar section, and 7° for the remaining children. Keywords Scoliosis, Early detection of scoliosis, Adams test, Vertebral rotation Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Background Early detection of idiopathic scoliosis is one factor in determining treatment effecti... more Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, signific...
Introduction The three dimensional deformation of the spine in scoliosis is specific for a given ... more Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. Materials and methods The group consisted of 229 children who were first examined, aged 6 to 17 years, with an average age of -11.57 years (SD ± 3.26), with symptoms of idiopathic scoliosis. The correlation of the cr...
The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis i... more The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis in the form of a brief review. This article aims to point out the advantages of select methods. This article focuses on general issues without elaborating on problems strictly related to physiotherapy and treatment methods, which may be the subject of further discussions. By outlining and categorizing each method, we summarize relevant publications that may not only help introduce other researchers to the field but also be a valuable source for studying existing methods, developing new ones or choosing evaluation strategies.
The Effectiveness of Early Rehabilitation in idiopathic scoliosis, 2024
Background: The purpose of this study was to assess specific rehabilitation methods' effectivenes... more Background: The purpose of this study was to assess specific rehabilitation methods' effectiveness in early idiopathic scoliosis (IS) development, focusing on lower limb functional inequality's role in scoliosis progression. Materials and Methods: This study comprised 812 patients aged 6-16 years at risk of developing idiopathic scoliosis (IS). The mean (SD) age was 10.66 (3.16) years. Patients were categorized into high-and medium-risk groups based on the angle of trunk rotation (ATR) size. Specific scoliosis physiotherapy was used, and the average follow-up period was 28.1 ± 14.5 months. Changes in ATR, Cobb angle, and functional length of the lower limbs pre-and post-treatment were statistically analyzed across three age groups (6-9, 10-12, and 13-16 years) and three scoliosis locations. Results: Significant effectiveness of early rehabilitation was observed in the high-risk group of children aged 6-9 years. In the medium-risk group, significant reductions in ATR were observed in both the 6-9 and 10-12 age groups across all three scoliosis locations. Additionally, there was a significant decrease in the Cobb angle in the thoracolumbar region and a significant reduction in lower limb inequality across all age groups and scoliosis locations. Conclusions: The early implementation of specific physiotherapy may enhance the efficacy of idiopathic scoliosis treatment by attenuating factors contributing to its progression.
Innowative method for the conservative treatment of idiopathic scoliosis, 2024
Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early... more Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal reflex balance using the GraviSpine device. This study is a retrospective analysis of prospectively collected data. Methods: A total of 199 patients aged 6-17 years, with a mean age of 11.26 ± 3.35 years, including 168 girls (84.4%) and 31 boys (15.6%), out of a total of 830 patients treated for IS at the Scoliosis Treatment Center in 2014-2019 were included in the assessment, which was conducted according to the inclusion and exclusion criteria. The study group was divided into three age groups. Group A subjects were 6-9 years old; group B, 10-12 years old; and group C, 13-17 years old. The mean follow-up time was 28.71 ± 10.98 months. Treatment outcomes were compared, based on changes in the Cobb angle and the angle of trunk rotation before and after treatment, both within the groups and with respect to sex and curvature location, using the Wilcoxon signed-rank test. Cobb angle changes in patients were classified as improvements, stabilizations, or deteriorations according to the SOSORT criteria. Results: A majority of patients improved or stabilized after treatment, with 67%, 71%, and 90% of subjects in groups A, B, and C, respectively, achieving these results. In group C (the oldest children), a statistically significant reduction of −1.84° ± 6.88° (6.31%) in the mean Cobb angle was achieved after treatment. With regard to sex, improvements and stabilizations accounted for 81% of cases in girls and 61% in boys, respectively. With respect to location, statistically significant reductions in the Cobb angle were noted for thoracic and thoracolumbar spines of −2.2° ± 7.54° (10.17%) p = 0.022 and −2.2° ± 6.58° (6.36%) p = 0.049, respectively. A significant reduction in the mean angle of trunk rotation was obtained in the group and in three curvature locations. Conclusions: Based on the presented research findings, the utilization of the GraviSpine device as an adjunct to specific PSSE (physiotherapeutic scoliosis-specific exercises) physiotherapy and bracing in the management of pediatric patients with mild to moderate scoliosis appears to enhance treatment efficacy.
The conservative treatment of idiopathic scoliosis - Gravispine, 2024
Background. The conservative treatment of idiopathic scoliosis (IS) may be enhanced through a com... more Background. The conservative treatment of idiopathic scoliosis (IS) may be enhanced through a combination of specialized physiotherapy, bracing, and the utilization of assistive devices. Objectives. This study aims to evaluate the efficacy of the GraviSpine device in supporting the conservative treatment of IS in children. Materials and methods. A cohort of 142 patients, aged 10-17 years with an average age of 12.76 ±1.75 years, undergoing treatment for IS with specific physiotherapy and bracing, received additional treatment with the GraviSpine device. The participants, selected based on inclusion and exclusion criteria, were divided into 2 age groups: group A (10-12 years) and group B (13-17 years). The mean follow-up period was 28.71 ±10.98 months. The assessment involved changes in post-treatment trunk rotation angles (ATR), Cobb angles, and functional lower limb length discrepancies (FLLDs) concerning age groups and scoliosis location. Results. The proportion of patients showing improvement and stabilization was high in both groups A and B, at 71% and 90%, respectively. In group B, a significant reduction in the mean Cobb angle of-1.83° ±6.88°, p < 0.002, was observed. Furthermore, a significant decrease in the incidence of FLLDs was noted in thoracic and lumbar scoliosis locations, p < 0.002. Conclusions. To enhance the effectiveness of conservative treatment for IS, the utilization of an assistive device such as GraviSpine may be considered, particularly when the child presents functional inequality of the lower limbs.
Background: Early detection of idiopathic scoliosis is one factor in determining treatment effect... more Background: Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool-and school-age children, taking into account the location and size of the spine curvature. Methods: The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results: In the age groups 6-9, 10-12 and 13-17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6-9 and 10-12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis-or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004). Conclusion: A low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6-9 and 10-12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6-12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis. Trial registration. This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.
Background This research analysed discrepancies between the angle of trunk rotation (ATR) and the... more Background This research analysed discrepancies between the angle of trunk rotation (ATR) and the Cobb angle, in order to study if the commonly used 7° cut-off threshold for ATR helps diagnose scoliosis. In early stadia of scoliosis in children, ATR and the Cobb angle often disagree, increasing the risk of a false diagnosis: while the former does not suggest scoliosis, the latter does. Methods The study analysed ATR clinical parameters and the Cobb angle in the X-ray pictures of 117 (23 boys and 94 girls, aged 6–17 years) children who had not yet started treatment and whose X-ray pictures showed the Cobb angle of at least 10°, indicating idiopathic scoliosis. The degrees of lumbar lordosis and thoracic kyphosis were measured using the Saunders inclinometer, and back asymmetry was measured with Adam’s forward bend test using the Bunnell scoliometer. In the X-ray pictures, the curvature angle was plotted according to the Cobb method. The patients were stratified based on their age, an...
Introduction The three dimensional deformation of the spine in scoliosis is specific for a given ... more Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. found in the 6-9-and 10-12-year-old groups and in the lumbar and thoracolumbar section. To increase the rate of early diagnosis of scoliosis, the results suggest the need to adopt two ATI criteria for the diagnosis of scoliosis at screening, 5° for age of 6-12 years, and when asymmetry affects the lumbar and thoracolumbar section, and 7° for the remaining children. Keywords Scoliosis, Early detection of scoliosis, Adams test, Vertebral rotation Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Background Early detection of idiopathic scoliosis is one factor in determining treatment effecti... more Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, signific...
Introduction The three dimensional deformation of the spine in scoliosis is specific for a given ... more Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. Materials and methods The group consisted of 229 children who were first examined, aged 6 to 17 years, with an average age of -11.57 years (SD ± 3.26), with symptoms of idiopathic scoliosis. The correlation of the cr...
The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis i... more The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis in the form of a brief review. This article aims to point out the advantages of select methods. This article focuses on general issues without elaborating on problems strictly related to physiotherapy and treatment methods, which may be the subject of further discussions. By outlining and categorizing each method, we summarize relevant publications that may not only help introduce other researchers to the field but also be a valuable source for studying existing methods, developing new ones or choosing evaluation strategies.
Uploads
Papers by marek kluszczynski