Therapy FITS

Scoliosis – a disease in which saggital plane curvatures (kyphosis,lordosis) decrease or increase, side bending and rotation of the spine appear

What causes scoliosis? It can be caused by assymetrical position of shoulder blades or pelvis, assymetry in waste angles, shifted weight bearing, costal hump placed on the convex side of the curvature, posture deterioration during the maturing growth period, weak proprioception. All these factors lead to the wrong posture tendency being fixed, movement apparatus overloaded and prompter spine arthroses.

Structural scolisis affects children and adolescents during their spine growth. The most frequently it happens when they are 1-3, 7-9 and 12-15 years old. The sooner scoliosis appeared the worse the prospects.

SCOLIOSIS CAN BE DIVIDED INTO:

  • Functional – static or reflex. The spinal changes are restricted to the frontal plane. Scoliosis relief after the cause factor is eliminated,
  • Structural – they are always a multi-plane deformation in frontal, saggital and transverse planes). They appear only in the growth period.





 

 

 

Idiopathic scoliosis

Is a development deformation of spine and thorax. The cause of the disease is not known. The deformation has three dimensions: in saggital plane – deformation of physiological thorasic kyphosis or lumbar lordosis, frontal plane – side bending and transverse plane – axis rotation of the verterbrae. Deformation appears in all three planes simultaneously. According to Scoliosis Research Society we can call scoliosis any curvature bigger than 10 Cobb degrees.



 

Therapy FITS

FITS method was created in 2004 in order to treat children with wrong posture, scoliosis and Scheuermann disease. The authors of the metod are Marianna Białek PT, MSc., PhD. and Andrzej M’hango PT, MSc., D.O. . The method was formed basing on many physiotherapeutical methods, whose techniques which the authors found useful were selected. Some of them were modified and customised to work with children. Moreover, the FITS method is full of techniques prepared by the authors themselves upon their long experience and observation of their patients.

Key of FITS concept:

  • to individualise the approach to the patient,
  • to make child aware of existing deformation of the spine and trunk, but also to indicate the direction of scoliosis correction,
  • to examine the actions of active and passive corrective movement,
  • to release myofascial structures which limit three-plane corrective movement,
  • to teach derotative breathing in functional positions,
  • to build and stabilise new corrective movement patterns,
  • to teach autocorrection in functional positions and for daily routines,
  • to correct the primary curve by adding activity compensation with a simultaneous stabilisation or correction of the secondary curve. Activity compensation refers to soft tissues and is not structural, which means that clinically there will be a rotation of the thorax above or below the primary curve (not bigger than 4-5 degrees) on the concave side of primary scoliosis and there will be no secondary curve visible in the x-ray image.

Considering trunk deformity due to scoliosis an individually adjusted programme of exercises is suggested, which depends on the size of the curvature angle and the result of clinical examination of a patient. As a result general and particular goals of the therapy are drawn.

The general goals of the therapy include the scoliosis stabilisation in children with a general flaccidity of the connective tissue or decreasing of the curvature angle in non-progressive scolioses or with an angle smaller than 30 degrees in children with correct muscle tension. Another general goal is to improve the clinical condition of a patient with a huge scoliosis whose parents are for some reason against a surgery. A general goal is also to make the scoliosis flexible in order to achieve a better correction during the surgical operation or correct the pectoral or pelvic girdle as well as to position head and neck, to improve breathing functions, patient's general fitness and efficiency after the surgery.

Particular goals refer to a particular therapy on a given treatment day, for example to position feet and knees, to try to achieve the symmetrical position of the shoulder blades, to increase the shift for scoliosis correction, to teach derotative breathing etc.

Basing on a long experience and a lot of research and scientific disputes held with orthopedists, biomechanics, physiotherapists and psychologists the FITS Method is still being developed and presented at numerous scientific conferences both in Poland and abroad. Our method was first presented during SOSORT Conference (Society on Scoliosis Orthopaedic and Rehabilitation Treatment) in 2006 in Poznań. In the following years it was also shown at SOSORT Conference in Boston (2007), Athens (2008), Lyon (2009), Barcelona (2011), Milan (2012) and Wiesbaden (2014). Apart from the method being presented there were also organised scoliosis workshops with a patient and scientific findings referring to scoliosis treatment therapy effectiveness were demonstrated.

FITS Method is one of the seven methods in the world to have received the official recommendation of Society on Scoliosis Orthopaedic and Rehabilitation Treatment - SOSORT. The other methods in the group include: SEAS – Italy, BSPTS – Spain, DoboMed – Poland, Lyon Approach – France, The SpineCor – Canada, Lehnert-Schroth – Germany).

FITS Method stages

FITS concept consists of 3 stages:

  • Stage I. Examination of patient using classical clinical assessment, but also in terms of using FITS approach.
  • Stage II. Preparation for 3D correction. Detection and elimination of myofascial restrictions which limit a three-plane corrective movement, by using different techniques of myofascial relaxation
  • Stage III. Three-dimensional correction – building and stabilisation of new corrective posture patterns in functional positions, instructing the corrective tension.