Lateral Curvature Of The Spine. Part 2.

LATERAL CURVATURE OF THE SPINE. Part 2.
15. Raising of the Arm of the Convex Side. - The patient is standing with the arm of the concave side flexed over the head as in Fig. 111. The arm of the convex side is raised from the side to the head. A weight is generally used. Careful instructions in regard to respiration should be given.
16. St. Bending of the Knees; Book on Head ("Deep Knee-Bend"). The hands are placed on the hips with fingers in front; the patient bends slowly downward, counting: (1) raising on the tiptoes; (2) bending down as far as possible; (3) resuming tiptoe position; (4) back to original standing position (see Fig. 112). The effort of keeping the body erect in balancing makes this a very useful exercise in the earlier stages of curvatures. The operator should watch the patient carefully to see that the proper position is maintained from start to finish.

17. Stretch-standing Bending of the Knees. - Similar to 16, only the patient stands with his arms stretched upward close to his ears, as shown in Fig. 49.
18. St. Bending of the Body. - The right (if the convexity is on the right side) foot forward; right hand on hip; left arm raised up and left hand down the back, between the shoulder-blades; the patient should bend slowly forward. Generally single active, but may also be duplicated active.
19. Kneeling Bending of the Body. - Same exercise as 18, only the patient rests on the knee of the concave side and places the foot of the convex side forward. Single active.
20. Bending Backward; Free-standing. - "The patient stands at a distance somewhat less than the length of his own foot from the wall. He places his hands on his hips with his elbows well thrown back. Then he stretches himself and bends backward. When the movement can not be continued any farther, the patient falls back until the back of his head touches the wall by which he stands. Then he slowly rises up on his toes, and while doing so draws a deep inspiration and goes slowly down again " (Kellgren).

21. St. Bending of the Head Forward and Backward. - The patient stands with his hands against the wall and with his feet about twenty inches from the wall; the operator places his hand on the back of the patient's head and resists in the movement. This movement is very effective, and the author begs to suggest to his reader to have it applied to himself so as to personally feel its remarkable effect upon the different muscles of the back.
22. St. Stretching of the Vertebral Column. - This is a new movement, recommended by the well-known Mr. H. Kellgren, of London. The patient stands as straight as possible; the operator stands in front of him and places one hand on the patient's head, and with the other he steadies him by placing it over the sternum or abdomen; he presses firmly down with the hand on the head, while the patient is told to stretch upward as far as possible. Be careful to see that it does not become only a simple raising of the shoulders. We want a stretching of the whole spinal column.
23. Susp. Bending of the Head. - The patient is suspended a few inches from the floor. The operator, standing at his side, places one hand on the forehead, the other on the back of his head. The patient moves the head forward and backward, the operator resisting, according to the strength.
24. Susp. Separating and Closing of Legs. - If the patient is weak, make the movement active at first, while the operator supports the sides. Afterward make it concentric, the operator grasping around the ankles.
25. Susp. Flexion of Legs upon the Abdomen. - The patient is suspended and flexes his extended limbs upon the abdomen. This is a very strong movement and should be used only when the patient's strength allows.

It is very important to watch the patient in regard to his position for each movement. A rest should be given after every exercise, and it may be well to mention that the most complete rest is obtained when the patient lies flat on his abdomen with pillows under chest and stomach. Measure the patient's height; also curvature itself. This is best done by putting the end of the tape-measure on the vertebra corresponding to the extreme point of the convexity ; carry it forward over the highest point of the convexity to the sternum or a fixed point on the sternum ; then measure the concave side in the same manner and you will know from time to time how your patient improves. Always have a set rule to measure either before or after taking the movements. It becomes the operator's absolute duty to explain to the patient the tedious process of the treatment and the patient's own responsibility in regard to the final result. Exercise should be taken every morning and evening in the patient's own home. The results are remarkably good if proper judgment is used in the selection of movements. This treatment for curvature of the spine is very little known in America, but if given a fair trial, and the movements properly performed, many-unfortunates might be saved from being crippled for life.

A few cases of Pott's disease have been treated by the author. Massage of back and chest with respiratory movements were given with good results. Of course it will be understood that there was no inflammatory process going on in the spinal column at the time of treatment. By the use of the pneumaucetor the author fully convinced himself of the increased respiratory capacity. The patients would invariably express themselves as feeling more able to hold the head and thorax erect and the increased respiratory power was always a great relief in this very trying deformity.