24 Apr 2020   |   By : Daryl David Ho

Scoliosis Traction Chair

Scoliosis Traction Chair

What is a Scoliosis Traction Chair?

A Scoliosis Traction Chair (STC) is a corrective instrument used to address adolescent idiopathic scoliosis both in children and adults. The concept of the chair was first conceived in 2002 by Dr. Dennis Woggon,D.C. He is a chiropractor and founder of the CLEARTM scoliosis institute. Through the years, the design of the STC was gradually refined before going into full production in 2007 and is now used by certified CLEAR chiropractors around the world as part of scoliosis treatment protocol.

The concept of the STC was centred around two main ideas. First, to eliminates the influence of the lower extremities on patients posture by utilising a chair. The chair itself is designed with specific type of wooden material to add weights and firm grounded position so it hold patients weight and posture without compromising its function. This allows for more targeted focus on the patient’s head, spine, and pelvis for postural correction. Second, in a seated position, the patient is still required to engage their postural and core stabilising muscles to maintain an upright, stabilised position and counteract gravity; as opposed to a recumbent position for example, where the postural muscles are not as active. The STC however is not just a normal average chair. It has other elements built into the structure of the chair which serves to act on specific areas of the scoliotic spine. These elements include an arm rest, a rotating back rest, wedged seat cushions, neck traction pulley device, a motor placed beneath the chair and a ratchet belt system. The STC is one part of the CLEAR scoliosis treatment protocol that seeks to address scoliosis in a conservative manner.

Overview of scoliosis

To understand how the STC works, we must first understand a little about the scoliotic spine. The term “Scoliosis” originated from the Greek word Skolios, which translates to “bent”. Scoliosis therefore refers to a bending of the spine, specifically in the lateral direction. A scoliotic spine loses its spinal alignment and would result in an S-shape or C-shape curvature instead of a straight line in normal spines when viewed from the back. However, unlike the literal meaning of the term “scoliosis”, a scoliotic spine loses more than just the lateral alignment. When seen from the side, a normal spine should have three natural curves, a lordosis (backward-facing curve) in the neck and lower back regions and a kyphosis (forward-facing curve) in the upper back region. In a scoliotic spine however, these natural curves are lost at varying degrees. When viewing from the top, all 33 bones (vertebrae) that make up the spine should be facing forwards in a normal spine. But in a scoliotic spine, the individual bones would rotate, either to the left or right, in response to the lateral bending of the spine. It is because of this rotation of the bones that results in the characteristic rib hump in scoliotic individuals; since the ribs are attached to the vertebrae, the position of the ribs would be altered when the vertebrae are rotated.  

Besides having a loss alignment of the spine, scoliotic individuals also have muscle imbalances. Postural and certain core stabilising muscles are attached to the bones of the spine and help keep it in place. These muscles also help to evenly redistribute the load in our body and help to keep our upright posture against gravity. When the spine rotate, bends and curves sideways, the muscles on the convex side of the curve are overactive and become tight while muscles on the concave side of the curve are inactive. Overtime, muscle imbalances will occur as the muscles on the convex side overpowers the concave side, potentially worsening the bending of the spine. The brain itself becomes accustomed to this difference in muscular activity between the left and right postural or core stabilising muscles and adopts this imbalanced posture as the new “normal”. Therefore, scoliosis is not simply the loss of spinal alignment when viewed from the back. Instead, it is a 3-dimensional loss of spinal structure and alignment accompanied by muscular imbalances and lack of direction of deep involuntary muscles. Scoliosis spine is twisted and bends away from alignment, much like how you wring a wet towel. As the towel is twisted, it bends outwards to the sides and becomes shorter in length. Thus, if the scoliotic spine is unwound in the opposite direction, it might be possible to achieve something close to a normal spine, similar to how a wring towel would uncoil itself to become straight again; and this is what the STC aims to do to de-rotate the spine back to its upright position.

How does the STC work?

As discussed earlier, the STC has several elements incorporated into it to address the complexities of a scoliotic spine – the 3-dimensional loss of spinal structure.

1) It is very common to observe uneven shoulders and hips in patients with scoliosis. The arm rests that are installed into the chair are adjustable and can be tailored to address the differences in shoulder height. For example, if the right shoulder is higher than the left, the left arm rest can be raised to be higher than the right arm rest to balance out the shoulders.

2) The wedged seat cushions work in the same manner to address the uneven hips. The wedged cushion would be positioned such that the lower hip is placed higher than the other hip when seated on the wedged cushion to balance out the hips.

3) The rotating back rest can be positioned against the rib hump – often on the right side – to provide a pushing stimulus into the rib cage and promote de-rotation of the spine.

4) The neck traction pulley device serves multiple purposes. First, it provides a form of head and neck support, reducing the burden borne by the already tight muscles to uphold the head and neck. Second, when the head is strapped onto the device, it helps to place the head in a centered position to create upright traction of the spine. Lastly, weights can be placed at the other end of the pulley device to provide gentle traction forces, helping to lengthen and straighten out the twisted spine.

5) The ratchet belt system is installed by the sides of the chair, below the arm rests. The purpose of the belts is to provide pulling forces into the spine to reduce the lateral curvature. At the same time, the direction in which the belt is tighten applies a rotatory force in either a clockwise or counter-clockwise direction to help de-rotate the spine. The positions of the belts and ratchet system can be adjusted to accordingly based on the spinal curvatures and rotation. This ensures that when the belts are setup, it places the spine in the exact mirror-image configuration so as to better reduce the curvature. Importantly, the use of a ratchet system allows the doctor better control over the amount of traction forces applied to the spine to maximise the effect.

6) The motor placed beneath the chair is set to vibrate at a specific frequency of 30 Hz and is based on the concept of whole-body vibration (WBV) therapy. Multiple studies on WBV therapy suggests that it has positive effects on bone and muscular activity. Scoliotic individuals are often found to have poor bone mass density, placing them at higher risk of stress fractures and osteoporosis. This risk would be increased further in postmenopausal women. Research found that individuals who underwent WBV therapy had higher bone mass density when compared to control groups who did not undergo any WBV therapy over a period of 6 or 12 months. The increase in bone mass density is believed to be due to the increase in activity of their bone-forming cells. WBV therapy has also been observed to increase neuromuscular activity in individuals with spinal cord injuries. Furthermore, the use of an unstable surface – wedged cushions – further increases the muscular activity of the postural and core stabilising muscles, which are often inactive in scoliotic individuals. Lastly, there is evidence to suggest that postural and balance control are impaired in scoliotic individuals. As WBV therapy has been associated with improved postural and balance control in the elderly and those afflicted with Parkinson’s, it could possibly have the same effect on scoliosis patients. Taken together, the use of WBV therapy can potentially address the various deficiencies observed in a scoliosis patient. 

In summary, the Scoliosis Traction Chair (STC) is designed to first place the spine back into its normal, natural alignment by unwinding the spine. In other words, STC is creating mirror image of the patient’s scoliosis curve and possibly over correcting the spine so patient’s neuromuscular connection between Central Nervous system of the brain and spinal cords and the muscles can be re-educate and reset to a balance upright posture. Then, it helps to activate and strengthen the postural and core stabilising muscles so that the alignment of the spine can be maintained. At the same time, it also trains the brain to learn the “new” correct, normal posture and helps to improve balance and postural control. This way, the brain can understand what the correct posture is and would be able to activate the required postural and core stabilising muscles to maintain this posture. It is important to note however that the STC is but one part of the CLEAR scoliosis treatment protocol and only CLEAR scoliosis Institute certified chiropractors are able to operate and understand the purpose and function of this equipments. In addition, Certified CLEAR chiropractors also will provide the whole protocol as MIX-FIX-SET in order to be fully effective in correcting the scoliosis curves. All Well Scoliosis Centre chiropractor has more than 10 years experience in scoliosis treatment and has been CLEAR Institute certified ever since. We are here to implement most effective and non-invasive ways of scoliosis treatment for all ages.

Reference

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