Cobb Angle Reduction in a Nearly Skeletally Mature Adolescent (Risser 4) After Pattern-Specific Scoliosis Rehabilitation (PSSR)

Marc Moramarco*, Kathryn Moramarco, Maja Fadzan
Scoliosis 3DC, 3 Baldwin Green Common, Suite 204, Woburn, MA 01801

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Creative Commons License
© 2017 Moramarco et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Scoliosis 3DC, 3 Baldwin Green Common, Suite 204, Woburn, MA 01801; Tel: 7819388558; Fax: 7819339934; E-mail:



It has long been said that exercise-based rehabilitation for scoliosis is ineffective, however, these reports studied general exercises. This case report is a prospective one-year follow-up of a nearly skeletally mature adolescent female (Risser 4) with idiopathic scoliosis treated with Pattern-Specific-Scoliosis Rehabilitation (PSSR).


The 15-year old patient recommended for surgery (initial Cobb angle of 45°) completed a 16-hour scoliosis-specific back school (according to Schroth Best Practice®), over the course of five weeks. She continued with her program at home, and followed up with the lead author after 6 months and 1 year.


The patient achieved a 13° reduction in her primary thoracic Cobb angle. Postural improvement and reduction in trunk rotation (ATR) was also achieved (-4° in the thoracic spine, and -5° in the lumbar spine).


Pattern-specific scoliosis rehabilitation (PSSR) works to reduce the asymmetrical load caused by scoliosis. PSSR is effective in stabilizing Cobb angle, and can, in some cases, reduce Cobb angle in adolescents. Patients recommended for surgery may be candidates for conservative treatment. This case suggests that the practice of discontinuing conservative treatment at Risser stage 4 should be re-evaluated.

Keywords: Scoliosis-specific exercise, Pattern-specific scoliosis rehabilitation, Adolescent idiopathic scoliosis, Schroth method, Schroth Best Practice.