**3.1. Cobb angle**

**Figure 1.** Measurements of the radiographic parameters. (a) "x" stands for the coronal offset. It is the distance between the center of the body of C7 and a perpendicular line from the center of sacrum (CSL). When C7 is situated to the right of CSL, the measurement was designated at "−;" otherwise it was regarded as "+." (b) SVA stands for sagittal vertebral axis. It is the distance between a perpendicular line from the center of the body of C7 to the superoposterior corner of S1. When the line is in front of the superoposterior corner of S1, the measurement was regarded as "+;" otherwise it was

regarded as "−." (c) The measurements of other spinopelvic parameters.

96 Innovations in Spinal Deformities and Postural Disorders

The mean baseline Cobb angle was 31.2 ± 9.6°, which dropped to 27 ± 7.4° after 9 months. Based on the criterion that a reduction of 6° Cobb angle represents improvement [30], four subjects had improvement of the curves. The improvement rate is thus 33.3%. Pre- and postintervention paired t test showed that *p* = 0.0032, which was statistically very significant (**Table 2**).

**Figure 2.** The flowchart of adult scoliosis patients.


S/C, side of convexity; AIS, adult idiopathic scoliosis; DLS, degenerative lumbar scoliosis.

**Table 1.** The age, sex, and the curve characteristics of the subjects.



**Table 2.** The Cobb angle and the coronal offset (the distance between the centre of C7 from the central sacral line) at baseline and conclusion of the study .

#### **3.2. Coronal offset**

**Patient Age Sex S/C Range of curve Apex Types of** 

 24 F L T11-L4 T10-L4 L2 L2 AIS 56 F L L1-L4 L1-L4 L3 L3 AIS+DLS 51 F L L2-L5 L1-L4 L3 L2 AIS 58 F L T12-L4 L1-L4 L2 L2-L3 DLS 41 F L L1-L4 L1-L4 L3 L3 AIS 61 F L T12-L4 T12-L4 L2 L2 AIS 70 F R T12-L3 T12-L4 L2 L2 DLS 43 F R T10-L4 T10-L4 L2 L1 AIS 31 F L T11-L4 T10-L4 L1 T12 AIS 10 24 M L L1-L4 L1-L4 L3 L3 AIS 11 37 F R T12-L4 T12-L4 L1 L1 AIS 55 F L T12-L4 T12-L4 L2 L2 AIS

S/C, side of convexity; AIS, adult idiopathic scoliosis; DLS, degenerative lumbar scoliosis.

**Table 1.** The age, sex, and the curve characteristics of the subjects.

**Figure 2.** The flowchart of adult scoliosis patients.

98 Innovations in Spinal Deformities and Postural Disorders

Mean 45.9 SD 15

**scoliosis Initial 9 months Initial 9 months**

Seven curves had C7 offset to the left of CSL and 5 had offset to the right at baseline. After 9 months, four subjects in the former group had reduced coronal imbalance and three had increased coronal imbalance (**Figure 3**). For the latter group, four had an increase in coronal imbalance and only one had an improved coronal balance. The change in coronal offset, however, was not statistically significant (**Table 2**).

#### **3.3. ATR measurement**

Ten subjects had improvement of ATR after the program. Statistically, there was a significant difference between the baseline and post-intervention measurements (*p* = 0.0115) (**Table 3**).

The reduction of ATR during RAB in a forward bending position was more marked, at 2.08 ± 1.83° after the 9 months of training (**Table 3**). The difference was statistically very significant, with *p* = 0.0023.

#### **3.4. T4-12 kyphosis, L1-S1 lumbar lordosis, T10-L2 kyphosis**

In general, there was a trend toward a reduction in thoracic kyphosis. The change in lumbar lordosis and thoracolumbar kyphosis was not statistically significant (**Table 4**).

**Figure 3.** Posteroanterior full spine X-rays of a patient pre-intervention (a) and (b) post-intervention. It is noteworthy that her coronal balance improved. (c and d) The pre- and post-intervention X-rays of another patient, and the improvement of Cobb angle was noted.


A Pilot Study on the Effect of Outpatient Schroth Exercises on Thoracolumbar and Lumbar Curves in Adult Scoliosis... http://dx.doi.org/10.5772/intechopen.68183 101

**Table 3.** Angle of trunk rotation (ATR) in normal and rotational angular breathing at baseline and conclusion of the study.
