Posts

From Patient to Physiotherapist: Simone’s Story

/0 Comments/in /by

Turning a difficulty into a resource, and a vulnerability into a life choice.
This is the story of Simone Priano, a former ISICO patient, who has recently graduated in Physiotherapy from the University of Novara, in north-western Italy, with a final mark of 108/110, defending a thesis focused on scoliosis and scoliosis-specific exercises for its treatment.

A topic that was anything but coincidental.

“It is often said that one should turn weaknesses into strengths. Fortunately, I have turned mine into my profession,” Simone explains. “Today I celebrate my graduation in Physiotherapy with a thesis on scoliosis. This subject is deeply personal to me because it is thanks to my experience as a former patient that I am here today. Bringing it to my final thesis was my way of honouring that journey and closing the circle.”

Simone began his therapeutic journey as an adolescent, while attending the ISICO centre in Turin and playing volleyball. He was diagnosed with scoliosis with a significant curve, requiring a demanding course of conservative treatment: 23 hours a day wearing a brace, combined with specific exercises. His treatment lasted five years, from September 2016 to June 2021.

Initially, however, his experience was not positive. Treated elsewhere, he had been told that conservative therapy would be ineffective and that surgery was the only possible option — a prospect that could have discouraged anyone. Instead, Simone encountered a different approach, based on consistent, structured work and a strong therapeutic relationship.

“He was already a serious and determined young man during his treatment,” recalls his ISICO physiotherapist, Martina Poggio. “Being able to support him later during his thesis work was an immense pleasure for me. Through therapy, we accompany young patients throughout their growth, often for many years, and inevitably form a bond with them. Seeing them again as adults — confident, aware and fulfilled — is truly special.”

The relationship did not end with the conclusion of treatment. On the contrary, it evolved into professional dialogue and scientific collaboration.

“The fact that he chose the same professional path and career means that, despite the evident challenges of therapy, he was able to go beyond them, finding motivation and support to overcome the condition. He is the second former patient whom I have met again, years later, as a colleague.”

Today, Simone is a young physiotherapist whose training combines academic study with direct personal experience — a valuable perspective that enriches both his clinical practice and his human approach to patients.

“I wish Simone a brilliant future,” his former physiotherapist concludes, “with the certainty that he will be able to pass on to other young people what he himself has experienced: that even a difficult journey can become a source of strength.”

Scoliosis and height: how much does spinal curvature affect stature?

/0 Comments/in , /by

One of the most frequently asked questions regarding scoliosis concerns loss of height:
“My daughter has a 40° scoliosis… does that mean she is shorter than she would otherwise be?”

The answer is not straightforward. Reduction in stature associated with scoliosis does not depend solely on the angle of the curve; it is influenced by a range of structural and morphological characteristics of the spine.

The Cobb angle—commonly referred to as the curve angle—is the standard measure used to quantify the degree of lateral deviation in scoliosis. Over the years, several computational models have been proposed to estimate height loss attributable to scoliosis. However, formulae relying exclusively on the Cobb angle—such as the historical Stokes equation—have proved to be imprecise.

A study by Gardner et al. (2016) demonstrated that the original formula contained an error and emphasised that scoliosis is a three-dimensional deformity that cannot be summarised by a single parameter to estimate height loss. Similarly, Lonner et al. (2016) reported that the Cobb angle alone is insufficient to predict accurately the loss of stature: the true length of the deformed vertebral arc, the number of vertebrae involved and the degree of vertebral rotation all contribute. In other words, two patients with identical Cobb angles may nonetheless exhibit markedly different statures.

Stature is also relevant from a functional and respiratory perspective. Two recent studies from K Politarczyk et al. (2021) have shown that, in individuals with severe scoliosis, measured height may not reflect true body length, thereby affecting the interpretation of pulmonary function tests. In particular, height influences assessment of parameters such as forced vital capacity (FVC)—the total volume of air forcefully and completely exhaled after a full inspiration—and forced expiratory volume in one second (FEV₁). Consequently, in patients with severe scoliosis, it is necessary to correct the recorded height to avoid underestimating actual respiratory capacity.

In summary:

  • height loss in scoliosis is non-linear and cannot be estimated solely from the Cobb angle;
  • simple formulae, such as the Stokes equation, are now regarded as approximate;
  • a more accurate appraisal should incorporate morphological parameters of the curve and trunk, in addition to the Cobb angle;
  • for respiratory function testing, consideration of a corrected stature is particularly important in severe cases.

These studies underline that scoliosis is a complex three-dimensional deformity that affects not only appearance and stature but also clinical and functional outcomes. For this reason, assessment and treatment must be individualised and based on a thorough analysis of the curve and the patient’s growth.

Bibliographic references:

Long-term stability in PWS scoliosis without surgery

/0 Comments/in /by

It is rare for a single case to so clearly demonstrate the power of a conservative approach. This is what emerges from the article published in the Journal of Clinical Medicine (Effective Conservative Management of Severe Scoliosis in a Girl with Prader–Willi Syndrome: A 20-Year Case Study Follow-Up, MDPI, 2024).

Prader–Willi syndrome (PWS) is a rare genetic disorder characterized by muscle hypotonia, obesity, and cognitive difficulties, often associated with severe scoliosis.
“In many of these cases, surgery is considered the only possible solution,” explains Dr. Francesco Negrini, author of the study. “In contrast, we present the clinical case of a young patient followed for twenty years with a conservative approach, based on scoliosis-specific exercises and customized braces, from Milwaukee to Sforzesco.”

Despite an initial curve exceeding 50° Cobb, the patient avoided surgery, maintaining long-term stability of the deformity and a good quality of life.

“This case highlights the potential of a well-organized, long-term conservative approach to managing scoliosis in PWS,” adds Negrini. “It suggests that, under specific conditions, surgery may be avoided or postponed. Most importantly, it underscores the need for further research to establish standardized protocols and to support clinical decision-making in the conservative treatment of scoliosis in PWS patients. We are already working on specific protocols for ambulatory patients with scoliosis secondary to neurological diseases,” concludes Negrini. “These protocols are urgently needed, as at present they do not yet exist.”

Scoliosis in children and teenagers: could dental problems be the cause?

/0 Comments/in , /by

During a patient’s first medical visit, the parents were concerned after taking their twelve-year-old daughter to the dentist. During the dental check-up, a problem of malocclusion and swallowing emerged. The dentist suggested that this combination of factors might have contributed to the development of scoliosis.
But is it really possible that a problem in the mouth could lead to scoliosis? Let’s clear things up.

Malocclusion is a problem of how the teeth fit together: the upper and lower teeth do not align properly. It may mean crooked or crowded teeth or a jaw that protrudes or recedes. Sometimes it can affect chewing, the posture of the neck, or cause discomfort such as cervical pain.

Scoliosis. The majority of scoliosis cases in young people (around 80%) are defined as idiopathic, meaning without an identifiable cause. Despite decades of research, we still do not have a clear understanding of its origin.
What we do know, however, is that idiopathic scoliosis tends to appear in individuals with a genetic predisposition: it is often found to run in families. It is not a condition caused by bad habits, poor posture, injuries, or factors such as malocclusion.

It is important to stress this point to avoid attributing unnecessary blame or choosing therapeutic approaches that are not supported by scientific evidence.

At present, according to the data available, we know that malocclusion can influence the posture of the head and neck. In fact, malocclusion may cause the head to tilt forward or backwards and, in some cases, may even be associated with increased cervical pain. Nevertheless, while malocclusion can directly affect head position, it does not seem to have any effect on the risk of developing scoliosis, nor on the potential worsening of spinal curvature.

The same is true the other way around: a worsening scoliosis does not seem to influence malocclusion.

In patients with scoliosis, slight asymmetries are often seen in other parts of the body, including the face: this also involves the teeth and jaw. Studies have shown that people with scoliosis are about twice as likely to present with malocclusion (Class II or crossbite).
The correlation between malocclusion and scoliosis, although without a proven causal link and still not fully understood, highlights the importance of a multidisciplinary approach. Teamwork is essential in these cases.

How? Dentists and orthodontists may be among the first to detect possible postural changes that require attention. In the same way, the rehabilitation team managing conservative treatment for scoliosis can recommend a preventive orthodontic consultation.

Working as a team makes it possible to:

• monitor both conditions during growth;
• optimise the timing and therapeutic pathways;
• avoid false expectations: not assuming that one treatment will automatically affect the other, whether positively or negatively.

How should treatment proceed?
There are no contraindications to treating scoliosis and malocclusion at the same time: both orthodontic treatment and rehabilitation based on specific exercises can run in parallel, even when a brace is being worn, without fears of negative interference. No orthodontic treatment worsens scoliosis, and vice versa.

As far as we know today, no orthodontic treatment can worsen or improve scoliosis, just as no scoliosis treatment can worsen or improve malocclusion.

Dental treatment is essential for oral health and aesthetics, while scoliosis treatment is crucial for managing and controlling the curve over time.

Even though each specialist works on a different area, and there is no definite cause-and-effect relationship between malocclusion and scoliosis, working as part of a team made up of medical specialists, physiotherapists, and psychologists ensures higher-quality care.
This allows families to receive clear, timely, and reliable answers and enables professionals to share expertise in order to optimise timing and offer a clear, comprehensive, and highly personalised care pathway, tailored to each child.

Back to school with a brace

/0 Comments/in /by

Going back to school is not always easy for adolescents with scoliosis who wear a brace.—-> with scoliosis, and who need to wear a brace
Some are able to talk about it and share their difficulties, while others keep everything inside — and often they are the ones who suffer the most.

Of course, not all of our adolescent patients will struggle, but we need to pay particular attention to those who are changing schools: moving from primary to middle school, from middle to high school, or even simply to a new class.

Facing new teachers, new subjects, and above all new classmates is always an exciting challenge, full of curiosity… but no one knows  is aware about the brace!

It is natural, when entering a new environment, to want to give our best and show the best version of ourselves. It’s natural to want to give your best and show the best version of yourself when entering a new environment.But then comes the question: what about the brace?

“What will they think of me?”
“I can’t let them see me with the brace! Please, Mom, Dad, just the first few days without it and then I promise I’ll wear it again!”
“I’ll take it off at school and I promise I’ll put it back on afterward. In the afternoon I just do homework, I never go out anyway!”

Who could blame them? And above all, when this happens, how can we really help? It’s difficult — for the teenagers, for you the parents, and also for us professionals who care for them.

How to deal with it

If the prescribed “brace-free” hours allow it , it’s fine to leave the brace at home in the very first days. But if the free hours are limited (at least 3–4 in addition to school hours), then after a short initial adjustment it becomes important to face the class with the brace on. No adolescent will spend every afternoon locked indoors: there will be sports, birthdays, parties, get-togethers…

If, on the other hand, many hours of therapy are still required and free time is very limited, then it’s better to tackle the challenge right away. We know it’s tough, but once the “wall” is broken down, the path becomes much easier.

What we usually tell our patients

First of all, we remind them that they cannot live in seclusion. They have done nothing wrong to deserve a sort of “house arrest”: wearing the brace is already challenging enough, they shouldn’t also give up their social life.

Then we propose a kind of exercise: imagine it isn’t you with the brace, but one of your classmates. This classmate, afraid of being judged, chooses not to follow the treatment properly and doesn’t wear the brace the required hours. Nobody will ever know, because this classmate never had the courage to show up with the brace. But meanwhile, their spine is getting worse.

And then we ask: what would you want for this classmate? That they trusted you and asked for help, or that they considered you incapable of supporting them — so much so that they gave up their own health?

As always, when we put ourselves in someone else’s shoes, the answer becomes clear.

A special wish

Good luck to all the adolescents who are about to return to school wearing a brace — and good luck also to all their parents!

ISICO Online Master 2026: let’s start

/0 Comments/in , /by

Registrations for the 11th edition of the ISICO Online Master “Principles and Practice of Scoliosis Conservative Treatment – PPSCT” will open on October 15th, 2025. The course will start in January 2026.

This training program has now become a well-established part of ISICO’s educational offer, alongside the Italian Master, the SEAS courses, and the course on Sforzesco brace construction.

A truly international training program

Since its launch in 2016, the Master has welcomed 334 participants from 66 different countries:

  • 126 European
  • 96 Asian
  • 74 from the Americas
  • 18 from Africa
  • 20 from Oceania

A genuine global learning event, giving professionals from different cultures the chance to meet, exchange ideas, and grow together.

“The organisation is very didactic, starting with the basic knowledge and evaluation techniques, evolving to more specific subjects, and finally, when the students already have some knowledge framework, focusing on the suggestion and discussion of clinical cases. The live lecture was a perfect conclusion for the discussion groups. Most of the recorded lectures had great quality content and very good visual presentation.”
— Leonardo, Brazil

Course structure

The Master is delivered entirely online and self-administered through a dedicated learning platform. It is organized into 16 modules lasting two or three weeks each, including:

  • three recorded lectures of about 45 minutes;
  • scientific papers for in-depth study;
  • a final assignment for each module;
  • discussion sessions for interaction and exchange among participants.

The experience of a global community

One of the most valued aspects is the opportunity to connect with colleagues from all over the world: a unique chance to discover treatment practices, expectations, and experiences in different countries.

“From this course, I hope to gain in-depth knowledge of scoliosis, learn from renowned experts, and connect with specialists from all over the world to understand how they manage it in their own countries.”
— Joy Igudia-Akumabor, Nigeria

Early bird registration is available until December 8th, 2025.

From therapy to dance: ISICO patients perform at AIFI

/0 Comments/in /by

Two young ISICO patients made the recent AIFI event truly special, held on 13 September in Pavia, in the Aula Magna of ICS Maugeri.

The meeting, “Connected Bodies: the Physiotherapy of the Future between Human Relationships, Identity and Digital Innovation”, featured not only contributions from professionals and lecturers, but also the performance of Chiara and Silvia, dancers, who brought to the stage the fruits of their passion and determination.

Chiara first came to ISICO three years ago, already a professional dancer, performing for the Ukrainian Academy in Milan. “During my fitness-for-competition assessment, they noticed an anomaly in my back,” recalls Chiara. “From there, together with my parents, we looked for a specialist centre and arrived at ISICO, where I was diagnosed with adolescent idiopathic scoliosis, with a thoracic curve of about 40 degrees. The journey was not easy, especially at the beginning when I had to wear the brace for 23 hours a day while doing SEAS exercises daily. I had to find a balance between treatment and passion, without giving up my four hours of lessons each day.”

Chiara wore a “Sforzesco Open Pelvis” brace, designed to leave the hips completely free and allow greater mobility of the hip joints. This meant she was able to take part in her daily classes wearing the brace, using her hour of freedom for modern dance lessons, as the brace was too restrictive for this discipline.

Today, as she nears skeletal maturity, Chiara wears her brace for only 14 hours a day and has achieved a stability that allows her to look to the future with a healthy, functional back—ready to support her on stage as in life.

Silvia, on the other hand, completed her treatment some time ago but still does maintenance exercises and, of course, continues to dance!

We thank them both for this moving moment, which reminded us that, alongside innovation and professional perspectives, physiotherapy is above all about caring for people—their talents and their dreams.

Scientific free Tools for Clinical Practice: ISYQOL and IS-GROWTH

/0 Comments/in , /by

With a demanding condition such as scoliosis, it is essential to build a relationship of trust with the patient and guide them through a treatment path that allows for a good quality of life.

For this reason, at ISICO we have developed two free tools available online.

ISYQOL – Italian Spine Youth Quality of Life

Originally created as a questionnaire in which our patients could describe the impact of brace treatment on their daily life, ISYQOL has evolved into a digital model consisting of 10 questions, allowing anyone to evaluate their own well-being in the presence of scoliosis, kyphosis, or other spinal disorders.

Its strength lies in being based on the concerns expressed directly by patients, making it particularly suitable for adolescents with idiopathic scoliosis who have not undergone surgery. Over the years, it has been translated and validated into several languages ( English, Chinese, Polish, Korean, Arabic, Persian, French, Spanish, Greek, and Turkish) and is now recognised as one of the most reliable questionnaires for measuring quality of life in brace wearers.

Measure your ISYQOL online

IS-GROWTH – Idiopathic Scoliosis Graphical Representation Of Worsening Trend of Natural History

IS-GROWTH is a visual model that shows the expected evolution of a scoliosis curve in each patient during growth (pre-pubertal, pubertal, and post-pubertal phases).

Developed from more than 3,000 radiographs of nearly 2,000 untreated patients, and validated on more than 500 additional cases, the model reaches 95% accuracy after correcting for radiographic measurement error. The graph displays a range of expected progression (between minimum and maximum scenarios), into which the patient’s real clinical data are gradually added over time.

This tool has proven extremely useful in clearly communicating the natural history of scoliosis and in supporting long-term treatment decisions during growth.

Access it here – IS-GROWTH online

Watch the video alongside to see how to use them in practice.

ISYQOL video: https://youtu.be/bFLuaTNrsA4  
Is-Growth video: https://youtu.be/0dt_38tTiCQ

Artificial intelligence and rehabilitation medicine: the revolution has begun

/0 Comments/in /by

Artificial intelligence (AI) is already a concrete reality at ISICO, where it is actively used in daily clinical practice, as a research tool in studies published in scientific journals, and as part of the European PREPARE project, in which our institute is a partner. AI is fundamentally transforming the work of rehabilitation professionals, opening up new possibilities in early diagnosis, patient monitoring, treatment personalisation, and therapeutic education.

The potential of AI is immense. In a context where the volume of clinical, instrumental and functional data is growing exponentially, intelligent algorithms enable the rapid and efficient analysis of this information, turning it into tangible support for clinical decision-making.

“We are only at the beginning of a transformation that will become increasingly far-reaching” – explains Francesco Negrini, physiatrist at ISICO and Associate Professor at the University of Insubria – “Just as the first computers revolutionised our work in the 1980s, AI is set to become an indispensable tool in the daily work of clinicians”.

In recent years, research on AI in the medical field has experienced a dramatic acceleration. Between 2022 and 2023 alone, funding in this sector increased eightfold, reaching $25 billion. Applications range from imaging diagnostics and outcome prediction to motor rehabilitation support and functional assessment.

ISICO has contributed to this evolution. One example is a 2023 study on the use of AI to improve scoliosis screening. The team developed an algorithm capable of combining multiple variables (ATR, age, sex, BMI, family history, prominence height, curve location) to detect the condition early — going beyond the limitations of traditional tools like the scoliometer.

But AI’s applications in rehabilitation go far beyond scoliosis. Through data collection from wearable sensors, surface electromyography, and robotic devices, it is now possible to analyse patients’ movements in real time, support the monitoring of gait and speech disorders, classify levels of motor dysfunction, and adapt treatment plans in a truly personalised way.

At ISICO, AI is also used to enhance the patient experience through projects such as ISAIA (ISICO AI Assistant) — a virtual assistant designed to improve communication between clinicians and patients, answer frequently asked questions, and support the management of emails and FAQs. This approach helps maintain an informative and educational dialogue beyond the consultation, responding to patients’ ongoing concerns during treatment.

Another promising frontier is the integration of AI into telerehabilitation. Smartwatches and dedicated apps now make it possible to monitor home exercises with precision, optimising therapeutic pathways remotely. One recent study, for instance, demonstrated that AI could automatically recognise post-stroke rehabilitation exercises with over 99% accuracy.

Of course, with opportunity comes challenge. The handling of sensitive data, the lack of transparency in algorithms (often still “black boxes”), the risk of over-reliance on automated solutions, and the quality of training data are all critical issues requiring careful oversight and regulation. A responsible adoption of AI must be grounded in strong clinical supervision, ongoing human oversight, and the scientific quality of the sources used.

In conclusion, artificial intelligence will not replace clinicians — it will support them, helping them become more accurate, more efficient, and better equipped to offer truly personalised care.
At ISICO, that revolution has already begun.

When the Brace Goes Travelling: Tips and Hints to Enjoy Your Holidays

/0 Comments/in , /by
At some point during treatment, every young person wearing a brace finds themselves asking the same questions:

“What should I do with my brace while I’m on holiday or a school trip? Should I bring it with me or can I leave it at home? I’ve always worn it consistently and followed my prescribed hours – surely missing a few days won’t hurt…”

Let’s start by repeating a golden rule:
Brace treatment should be followed with the same precision and consistency throughout the year, whether you’re at home or away for a few days or even several weeks.

Why? There are several reasons.
First of all, taking the brace off for many more hours than usual — or not wearing it at all for a few days — could undo the hard-earned results achieved in the previous months.

Secondly, your back relies on the daily brace break to gradually learn how to support itself actively. Suddenly being left unsupported for much longer than usual could lead to back pain, and those long-awaited holiday days might not be quite so enjoyable after all.

The next questions usually are:
“Alright, I’ll take it with me… but where do I put it? Can I take it on the plane?”

The best way to bring your brace with you is also the simplest: wear it.

There are several advantages to this. First of all, it saves space — no need to worry about which suitcase or bag to squeeze it into, and there’s also less risk of damaging it in transit.

What’s more, wearing your brace during the journey means you won’t lose valuable treatment hours, and once you arrive at your destination, you can take it off and be freer to enjoy your time.

A handy tip if you’re travelling by train or plane: try to sit in an aisle seat, so you can get up from time to time, stretch your legs and change position.

Feeling reassured, the final question inevitably pops up — and often with the hope that there’s no comeback:
“But what if the metal detector goes off? How do I explain what I’m wearing? Surely they’ll make me take the brace off…”

No need to worry. Simply ask your doctor in advance for a certificate explaining the importance of wearing the brace during travel, so you can show it if necessary to the security staff during checks.

Safe and smooth travels to all of you!