Schroth conscious standing posture is a way of standing that helps to correct a patient’s scoliosis by de-rotating and moving their major curve towards a corrected position. Schroth therapists teach postures that help correct curves because patients sit and stand many more hours each day than they do their Schroth exercises. A recent pilot study by K Skaggs, Lin, Andras, Illingworth, and Skaggs (2020) compared the radiographs of 10 patients standing in their in their habitual postures to standing in their corrected postures. Skaggs et al (2020) concluded that the X-rays of major scoliosis curves of corrected postures showed an average decrease of 6 degrees (Cobb angles) less and that there was a leg length discrepancy in the Schroth corrected X-Rays because the subjects bent one knee to correct their curves when they were standing in their corrected postures. The authors insinuate that the way patients are standing rather than Schroth therapy is what made their curve Cobb angles decrease.
I have a number of issues with these results. The first is that they have no statistical strength. The number of subjects was too small, there were no controls, populations, skeletal maturity, ages, and other variables were not assessed, and there was no blinding, or randomization. The second is that the degrees or kinds of conscious postures were not assessed.
People with scoliosis tend to assume postures that facilitate their scoliosis. Schroth therapists train their patients to change their prior habitual postures to new postures that correct their scoliosis instead. The corrected posture becomes the new habitual posture. We hope that a determination of the severity of scoliosis is not made in a posture that makes the scoliosis Cobb angles worse. I never have a patient bend one knee when they get an X-ray. Many of my patient’s curve Cobb angles decrease, or stay the same. Some increase. If all of my patients were standing in postures that decreased their Cobb angles, the ones that stayed the same would actually be 6 degrees worse. Since my patients have more than once X-Ray every X-Ray after the first X-Ray is taken with conscious postures. My patients often show decreased Cobb angles in X-Rays following their second X-Ray so that both the second and subsequent X-Rays were taken with the patient assuming conscious postures. While it is important to have reliable baselines (initial X-rays should also be taken of patients with conscious postures), this pilot study in no way proves that Schroth therapy doesn’t work.
Skaggs, K., Lin, A. J., Andras, L. M., Illingworth, K. D., & Skaggs, D. L. (2020). Standing in Schroth trained position significantly changes Cobb angle and leg length discrepancy: a pilot study. Spine deformity, 10.1007/s43390-020-00157-7. Advance online publication. https://doi.org/10.1007/s43390-020-00157-7A