Posts

Message in a bottle: an Isico research

Isico’s study, “Torsion bottle, a very simple, reliable, and cheap tool for a basic scoliosis screening, published by Scoliosis and Spinal Disorders, demonstrates how and why scoliosis can be identified using a bottle of water. 

“One of the reasons that make scoliosis a disease that scares so much the parents, is its specific characteristic of being difficult to detect on its onset – explains Michele Romano, director of physiotherapists in Isico – A scoliometer is a professional medical instrument used by specialists such as doctors and physiotherapists to detect the pathology. In the absence of this instrument, is there a simple test for scoliosis that we can do in our own homes? Yes, the Torsion Bottle. Our paper aimed to check the possible usefulness of a simple tool (the Torsion Bottle) developed to offer an instrument for home-use by parents but also for screening purposes in low-income countries”.

The study was divided into two parts. The main purpose was to compare the measurements collected with the torsion bottle and the same measurements collected with the scoliometer in a population of patients accessing our clinic for the rehabilitation treatment following Isico standard evaluation protocols.

The secondary aim was to verify the reliability of blinded inter-operator assessments, performed with the torsion bottle on the same patients by two physiotherapists. These double-blinded measurements were taken periodically for a short-time-interval in our clinic to verify measurement accuracy in the everyday clinical activities.

The conclusion? The torsion bottle is useful to perform a pre-investigation of the presence of a prominence, permitting a simplified assessment of its value, thus referring to a specialist for a medical assessment.

We remind you that you can perform a quick and simple assessment/check for scoliosis or curved back on the website screening.isico.it,where you are simply asked to take some measurements with easily procurable tools like a ruler and others again to be detected with the help of a simple bottle of water, the Torsion Bottle

My kid is always slouching: bad posture or a medical problem?

In today’s digital age, the incredible exponential curves of technological growth and innovation are increasingly reflected in curves of another kind, namely those affecting our spines, as we assume various odd and unnatural positions when using our electronic devices.  

Parents are the first to notice their youngsters’ tendency to adopt these awkward and unattractive positions. The most frequent is the hunched back position, where the upper spine, shoulders and head are bent forward in relation to the rest of the body.
As a consequence, we now see countless humps like that of Quasimodo, the famous “Hunchback of Notre Dame”.

The tendency to slouch or adopt slumped postures is prevalent among the young. Youngsters (and adults too) often assume incorrect postures simply because it is easier and requires less effort.
As a result, they simply allow the force of gravity to take its toll on their backs, without trying to counteract it. 
Some situations, however, require careful assessment, as incorrect postures can sometimes indicate a spinal disorder.

Initially, it is up to parents to check their children’s backs, and if they have any doubts at all they should seek the opinion of expert medical spine specialists.

How do you tell the difference between incorrect posture and a spinal disorder?

If you have the youngster stand in front of you with his/her back exposed and look at him/her sideways on, you should immediately notice the classic shape of back, created by two natural and opposing curves; starting from the base of the spine and moving upwards, you will see the first, lower curve.
Known as lumbar lordosis, this is a physiological curve in which the lumbar spine appears more anteriorly positioned and concave. Immediately above it, you will see that the dorsal spine instead shows a posterior convex curve.

In normal conditions, these two curves are harmonious and not too pronounced. However, if, on observing the youngster, you notice that one curve is more pronounced or protruding, or that both are marked, then this could be a sign of a spinal disorder. In such cases, screening by a qualified professional or a consultation with a specialist spine doctor is strongly recommended.

In the same way, you might notice that the youngster’s back appears flat, with the physiological curves barely visible or not visible at all. This profile, too, can indicate the presence of a spinal disorder.

The spinal disorder most commonly associated with the rounded back or hunchback posture is hyperkyphosis, i.e. excessive curvature of the thoracic spine, evident on clinical examination as posterior protrusion of a section of the thoracic spine, often with the protruding vertebrae clearly visible under the skin.  

But how can a parent distinguish between incorrect posture and hyperkyphosis, which is a fairly frequent condition among youngsters?
Incorrect posture is always easily remedied simply by reminding the youngster to stand up straight: indeed, in this case, this action is enough to completely straighten his/her back.
In the presence of a spinal disorder, on the other hand, he/she will show more or less marked stiffness: even when he/she tries to stand up straight, part of the spine will remain curved as a result of the disease having stiffened his/her back.

Long kyphosis is another frequent vertebral alteration. In this case, the thoracic convexity extends down as far as the lumbar vertebrae, invading the space normally occupied by the upper part of the lumbar lordotic curve: the back therefore presents with a long convexity that reaches down to the base of the back.

Dorsal hyperkyphosis and long kyphosis are sometimes caused by Scheuermann disease, which is characterised by a wedge-shaped deformity of the vertebral bodies with anterior thinning of the vertebrae.
This makes it difficult and sometimes impossible for affected youngsters to hold their back straight: as a result, they become curled up like hedgehogs, and unfortunately their growth exacerbates the vertebral deformity.

Conclusion

Like scoliosis, spinal deformities in the sagittal plane need to be diagnosed early in order to allow timely and effective treatment. Families have the important task of trying to spot spinal disorders as opposed to simple cases of poor posture. Whenever they are in any doubt, they should always contact a specialist spine doctor for a proper diagnosis and any necessary treatment. 

Now screening comes online!

Isico launches online screening. Just connect to the dedicated screening website and you can perform a quick and simple assessment and check whether, with respect to pathologies such as scoliosis or curved back, it is appropriate to carry out a specialist medical visit that investigates further.
The idea, which has been in the works for some time, has had a further stimulus thanks to the departure of Telemedicine during the Covid-19 emergency period. We know how essential an early screening is to set up adequate rehabilitation therapy in case of vertebral deformities.
At Isico, screening has always been done, free of charge for the siblings of our patients. Now the novelty is given by an additional online tool that everyone can access as well in several languages; in addition to Italian and English, the German version is now available as well. 
How does the site work?
After viewing a short explanatory video of Michele Romano, head of physiotherapy in Isico, the evaluation begins either for scoliosis or for the curved back. 
The process is always guided by an introductory video given by Michele Romano. He explains how to make a part of these evaluations through observation only, others where you are asked to take measurements with a ruler and others again to be detected with the help of a simple bottle of water, the Torsion Bottle. 
On the basis of the data entered, it will be possible to know if it is appropriate to contact the evaluation of an expert in vertebral pathology or if there is nothing at the moment to worry about.


The next steps?
Translating the site into other languages ​​so that more people can use it easily. In this regard, we will be pleased to accept those who want to collaborate with us for the translation into other languages, in case you contact the email: isico@isico.it