title: [The spa and health resort- based treatment of back pain syndrome in the adolescents presenting with juvenile idiopathic scoliosis].
abstract: The relevance of the problem arises from the lack of substantiation for the inclusion of transcutaneous spinal direct current stimulation (tSDCS) in the comprehensive spa and health resort-based treatment of back pain syndrome in the adolescents presenting with juvenile idiopathic scoliosis.
  
  
  OBJECTIVE
  The objective of the present study was to demonstrate the effectiveness of transcutaneous spinal direct current stimulation for the comprehensive spa and health resort-based treatment of back pain syndrome in the adolescents presenting with juvenile idiopathic scoliosis.
  
  
  METHODS
  A total of 18 patients with scoliosis forming the study group 1 received the traditional comprehensive spa and health resort-based treatment. The course of transcutaneous spinal direct current stimulation was prescribed to 38 other patients (comprising group 2) in addition to the standard procedures. Another control group was comprised of 15 practically healthy adolescents having no signs of spinal deformations. The visual analog scale for pain, the McGill questionnaire, the scale for the assessment of the situational and personal uneasiness levels (Spilberger Ch.D., Khanin Yu.L.), and the Beck and Tsung depression scales were used, beside the routine clinical methods. Statistical data processing was carried out with the use of the Statistica 6.0 software package.
  
  
  RESULTS
  In the group of patients treated with the use of transcutaneous spinal direct current stimulation, regression of pain syndrome was well apparent. In the boys with the severity of pain estimated at 2 points based on the visual analog scale who received the standard course of the spa and health resort-based treatment, the pain rank index and the index of the number of the selected descriptors decreased significantly but nonetheless remained higher than in the patients treated by means of tSDCS as a component of the combined therapy (p=0.039). Simultaneously, the significantly lower level of situational (Q1=25.00; Me=36.50; Q3=45.00; p=0.036) and personal (Q1=26.00; Me=36.50; Q3=44.00; p=0.07) anxiety was observed in the group of girls in comparison with the group of those given only the standard course of the spa and health resort-based treatment. In addition, the level of trait anxiety in the female patients treated with the use of tSDCS was lower than in the girls of the control group (Q1=46.00; Me=49.00; Q3=51.5; p=0.001). In the boys undergoing the course the of tSDCS treatment, the levels of trait anxiety (Q1=29.00 ; Me=37.00 ; Q3=42.00; p=0.021) and depression estimated from the Tsung scale (Q1=2.85; Me=3.00; Q3=3.60; p=0.014) and the cognitive-affective scale of Beck (Q1=0.50; Me=2.00; Q3=5.50; p=0.041) were significantly lower than in the boys of the control group. The level of depression based on the Tsung scale was significantly lower (p=0.020) in the boys and after the standard spa and health resort-based treatment (Q1=2.50; Me=2.90; Q3=3.60) was comparable with that in the boys of the control group (Q1=4.00; Me=4.60; Q3=4.80).
  
  
  CONCLUSIONS
  The present study has demonstrated the expediency of inclusion of a course of transcutaneous spinal direct current stimulation in the programs of the combined spa and health resort-based treatment for the adolescents presenting with scoliosis.
authors.affiliation: Federal state budgetary educational institution of higher professional education 'Academician E.A. Wagner Perm State Medical University, Perm, Russia.
authors.forename: E Yu
authors.initials: EY
authors.lastname: Kravtsova
authors.affiliation: Federal state budgetary educational institution of higher professional education 'Academician E.A. Wagner Perm State Medical University, Perm, Russia.
authors.forename: S V
authors.initials: SV
authors.lastname: Murav'ev
authors.affiliation: Federal state budgetary educational institution of higher professional education 'Academician E.A. Wagner Perm State Medical University, Perm, Russia.
authors.forename: Yu I
authors.initials: YI
authors.lastname: Kravtsov
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000209:etiology / Q000628:therapy*; D005260:Female; D006294:Health Resorts; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold; D012426:Russia; D012600:Scoliosis / Q000150:complications / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome