Application of various physiotherapeutic methods in a conservative treatment of neurogenic scoliosis in a comatose patient – a case report
Application of various physiotherapeutic methods in a conservative treatment of neurogenic scoliosis in a comatose patient – a case report

Summary/Abstract: Background: Conservative treatment of scoliosis is difficult and does not always result in improvement. Correctingscoliosis of a patient in a coma presents a great challenge due to lack of contact with the patient, thuslack of cooperation during therapy, as well as the inability to perform active movements. As a result this makesthe therapy much more difficult and reduces to a great extent the range of methods available. This problem iscomplex, so relying on one therapeutic technique is usually inefficient. However, by using a combination of differenttechniques positive results can be achieved.Aim of the study: The aim of the study is to describe the methods and results used in the treatment of neurogenicscoliosis in an eight-year-old female, comatose patient.Case report: The patient described here is an eight-year-old girl in a coma, who was diagnosed with scoliosis.In order to reduce the process of spinal deformation, the patient was treated with Vojta, NDT-Bobath, proprioceptiveneuromuscular facilitation (PNF) and fascial therapy, together with a flexible stabilizing medicalcorset. Fascial therapy was carried out on the abdominal walls, chest, shoulders, shoulder blades and in the thoracicand lumbar section of the spine. According to the Vojta method, exercises in three positions with differentcombinations were used. The NDT-Bobath method was used to practice patterns of proper head maintenancein space relative to the torso, correct positioning of the upper and lower limbs in the support and proper pelvispositioning. Exercises using the PNF method relied on the therapist performing passive movement patterns ofthe shoulder blade, pelvis, head and neck, as well as some to the upper and lower limb patterns. The effects ofthe treatments on the torso were fixed with a flexible corset.Results: The therapeutic methods used here contributed to a reduction and improvement of the scoliosis.

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