Analyzing the Effectiveness of the Push-Up Method for Idiopathic Scoliosis: A Preliminary Report.

Background and objective As the standard of care for idiopathic scoliosis, observation is indicated for patients with curves between 10° and 25° who are still growing. However, if any treatment capable of controlling curve progression were offered at such an early stage, it might reduce the number of patients requiring orthotic therapy and, ultimately, surgery. We have devised the push-up method, which focuses on the gravity-based traction force for scoliosis deformity. In this study, both the temporary, immediate curve-correcting ability and the clinical outcomes of the push-up method in patients with idiopathic scoliosis were investigated to explore the potential of this procedure as a conservative treatment. Methods When performing the push-up method, the patient first sits on a high stool equipped with specially attached armrests and then lifts their buttocks by extending their elbows on the armrests. While maintaining this position, a continuous extension force is applied to the trunk to correct the scoliotic curve. Patients were instructed to perform 10 push-ups of 20 seconds each, followed by 40 seconds of rest, twice daily in the morning and evening. First, the changes in Cobb angles before and during the push-up position were evaluated in 20 curves from 13 patients with idiopathic scoliosis (all female) with a mean age of 15 years. Furthermore, changes in back muscle activity caused by the push-up position were assessed using electromyography. Next, Cobb angles before treatment and more than one year post-treatment were compared in 21 curves from 12 patients with idiopathic scoliosis (11 female, 1 male) with a mean age of 15 years. Results The average Cobb angle of 20 curves significantly decreased by approximately 7.4° during the push-up position, from 22.0 ± 2.6° to 14.6 ± 4.7°, yielding an average correction rate of 33.6%. Electromyography evaluation showed that the push-up position significantly increased activity in the latissimus dorsi muscles, while erector spinae muscle activity exhibited only mild changes. The main curve improved in 10 of the 12 patients (17 curves) and worsened in two patients (four curves). The average Cobb angle before treatment was 22.4 ± 2.9°, and at the final examination, it was 19.2 ± 6.1°, corresponding to an average correction rate of 14.3%. Conclusions Among the various procedures that use corrective traction forces for scoliosis, the push-up method is the first to be reported as specifically intended for therapeutic application. Based on the current preliminary investigation, we suggest that the push-up method could be considered as a conservative treatment option for certain patients with mild idiopathic scoliosis.