Fascia, Low Back Pain, Scoliosis Idiopathic
Conditions
Keywords
Scoliosis, Low Back Pain, Fascia, Exercise Therapy
Brief summary
The use of various muscle energy techniques to address fascial restrictions, in addition to three-dimensional correction within scoliosis-specific exercise approaches, suggests that these exercises may have different effects on thoracolumbar fascia thickness. This may, in turn, lead to varying impacts on low back pain and functional improvement. Therefore, the aim of this study is to investigate the effects of different scoliosis-specific exercise approaches on thoracolumbar fascia thickness, low back pain, and function in individuals with idiopathic lumbar scoliosis and chronic low back pain.
Detailed description
Low back pain is the most common complaint among individuals with lumbar scoliosis. In a study conducted in Japan, the prevalence of low back pain was reported as 34.7%, which was nearly three times higher than that observed in students without scoliosis. Pain resulting from scoliosis leads to a high level of functional disability, which consequently reduces quality of life. The thoracolumbar fascia consists of dense connective tissue layers separated by loose connective tissue that allows the tight layers to glide over one another during trunk movement. It provides a mechanical connection between the lumbar spine and several muscles, including the transversus abdominis, portions of the latissimus dorsi, and the internal oblique muscles. In individuals with idiopathic scoliosis, thickening of this fascia has been observed, and it has been reported that this thickening is further increased in the presence of chronic low back pain. Fascial thickening in individuals with scoliosis has been proposed as a potential factor contributing to both pain and movement restrictions. In the treatment of scoliosis, scoliosis-specific exercise approaches are widely used. These approaches typically include various active self-correction strategies (based on the location, shape, and magnitude of the curve) and individually tailored exercises. Some scoliosis-specific exercise approaches incorporate techniques such as contract-relax, myofascial release, trigger point therapy, and joint mobilization to eliminate muscular and fascial restrictions that impede movement, thereby preparing individuals with scoliosis for three-dimensional correction. In addition, these exercises have been reported to exert positive therapeutic effects on pain and quality of life in individuals with idiopathic scoliosis. The use of various muscle energy techniques to address fascial restrictions, in addition to three-dimensional correction within scoliosis-specific exercise approaches, suggests that these exercises may have different effects on thoracolumbar fascia thickness. This may, in turn, lead to varying impacts on low back pain and functional improvement. Therefore, the aim of this study is to investigate the effects of different scoliosis-specific exercise approaches on thoracolumbar fascia thickness, low back pain, and function in individuals with idiopathic lumbar scoliosis and chronic low back pain.
Interventions
BEHAVIORALScientific Exercise Approach to Scoliosis (SEAS) Exercises
Participants in the SEAS group will receive one supervised 60-minute clinical session per week for 8 weeks, combined with a 40-minute home exercise program performed 6 days per week according to the SEAS protocol.
BEHAVIORALFunctional Individual Therapy of Scoliosis Exercises
Participants in the FITS group will receive one supervised 60-minute clinical session per week for 8 weeks, along with a 40-minute home exercise program performed 6 days per week following the FITS method.
Sponsors
Hacettepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
In this study, both the participants and the assessor measuring thoracolumbar fascia thickness are blinded to group allocation.
Intervention model description
Participants will be allocated into two parallel groups to compare the effects of different scoliosis-specific exercise approaches on thoracolumbar fascia thickness, pain, and quality of life.
Eligibility
Sex/Gender
ALL
Age
11 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
* Aged 11-24 years * Diagnosed with idiopathic scoliosis * Presenting a single lumbar curve pattern * Experiencing low back pain for more than 3 months * Pain intensity ≥3 on the Visual Analog Scale (VAS)
Exclusion criteria
* History of spinal surgery * Received any scoliosis treatment within the last year * Current use of a spinal brace * Regularly used pain medication * Presence of neurological, congenital, rheumatological or psychological disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Thoracolumbar Fascia Thickness | Baseline and 8 weeks after the intervention | Thoracolumbar fascia thickness will be measured using ultrasound at two bilateral points, located 2-3 cm lateral to the L3 spinous processes. Thoracolumbar fascia thickness will be measured in millimeters using ultrasound imaging. Fascia organization will be classified using a Likert scale as follows: very disorganized, somewhat disorganized, somewhat organized, and very organized, according to the method described in the study protocol. |
| Pain intensity | Baseline and 8 weeks after the intervention | Pain intensity will be assessed using a 100-mm Visual Analog Scale (0 = no pain, 100 = worst imaginable pain). |
| Pain quality | Baseline and 8 weeks after intervention | Pain quality will be measured using the Short-Form McGill Pain Questionnaire (SF-MPQ) sensory and affective subscale scores. Higher scores indicate worse pain quality. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Disability | Baseline and 8 weeks after the intervention | Functional disability will be assessed using thethe Revised Oswestry Disability Questionnaire (RODQ), a 10-item questionnaire evaluating the impact of low back pain on daily activities using a 5-point Likert scale. |
| Health-Related Quality of Life | Baseline and 8 weeks after the intervention | Health-related quality of life was evaluated using the Scoliosis Research Society-22 (SRS-22) questionnaire, which is specifically designed and validated for individuals with scoliosis. This instrument consists of 22 items covering five domains: function/activity, pain, self-image, mental health, and satisfaction with management. Higher scores obtained from the questionnaire indicate a better health status and improved quality of life across the evaluated domains. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAlev Doğan Özbudak, PT, MSc (PhD Candidate)
Hacettepe University
Outcome results
None listed