Scoliosis Idiopathic Adolescent, Scoliosis,Idiopathic,Adolescent
Conditions
Keywords
scoliosis, Spinopelvic Parameters, Pelvic Floor Muscle Training, Physiotherapeutic Scoliosis-Specific Exercises (PSSE)
Brief summary
The goal of this clinical trial is to evaluate the effects of scoliosis-specific three-dimensional exercises combined with pelvic floor muscle training on scoliosis severity and spinopelvic parameters in adolescents with idiopathic scoliosis. The main questions it aims to answer are: * Does the addition of pelvic floor muscle training to scoliosis-specific three-dimensional exercises improve scoliosis severity compared with scoliosis-specific three-dimensional exercises alone? * Does the addition of pelvic floor muscle training improve spinopelvic parameters compared with scoliosis-specific three-dimensional exercises alone? Researchers will compare a scoliosis-specific three-dimensional exercise plus pelvic floor muscle training group with a scoliosis-specific three-dimensional exercise group to determine whether the combined intervention provides additional clinical benefits. Participants will: * undergo baseline clinical and radiographic assessments; * be randomly assigned to one of the two intervention groups; * receive supervised treatment for 3 months according to the assigned intervention; * undergo follow-up clinical and radiographic assessments at the end of the intervention period.
Detailed description
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity characterized by lateral curvature of the spine, vertebral rotation, and alterations in sagittal alignment. Conservative treatment, including scoliosis-specific three-dimensional exercises, is widely recommended for individuals with mild to moderate AIS to reduce curve progression and improve postural alignment and function. The pelvic floor muscles contribute to lumbopelvic stability through their interaction with the diaphragm, abdominal muscles, and paraspinal muscles. Although alterations in trunk muscle function have been reported in individuals with AIS, the potential role of pelvic floor muscle training as an adjunct to scoliosis-specific exercise programs has not been adequately investigated. This randomized controlled trial will compare scoliosis-specific three-dimensional exercises combined with pelvic floor muscle training versus scoliosis-specific three-dimensional exercises alone in adolescents with idiopathic scoliosis. The study will evaluate the effects of these interventions on scoliosis severity and spinopelvic parameters after a 3-month treatment period. The findings may contribute to optimizing conservative rehabilitation strategies for adolescents with idiopathic scoliosis.
Interventions
BEHAVIORALScoliosis-Specific Three-Dimensional Exercise
Supervised scoliosis-specific three-dimensional exercises administered twice weekly for 3 months, with additional home exercises according to the study protocol.
BEHAVIORALPelvic Floor Muscle Training
Supervised pelvic floor muscle training performed in combination with scoliosis-specific three-dimensional exercises twice weekly for 3 months, with additional home exercises according to the study protocol.
Sponsors
Gazi University
Gazi University Scientific Research Unit
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors were blinded to participants' group allocation throughout the study to minimize assessment bias.
Intervention model description
Participants were randomly assigned to one of two parallel intervention groups. One group received scoliosis-specific three-dimensional exercises, while the other received scoliosis-specific three-dimensional exercises combined with pelvic floor muscle training. Both interventions were administered over a 3-month period, and outcomes were assessed before and after treatment.
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Aged 10-18 years. * Diagnosed with adolescent idiopathic scoliosis and eligible for brace treatment. * Cobb angle between 20° and 45°. * Risser sign between 0 and 3. * Able to comply with and regularly attend the assigned treatment program. * No neurological or psychiatric disorder. * Willing to participate in the study, with written assent from the participant and informed consent from a parent or legal guardian.
Exclusion criteria
* Any contraindication to exercise. * Previous surgery involving the thoracic, abdominal, or pelvic region. * Previous scoliosis surgery or being a candidate for scoliosis surgery. * Any cognitive or mental condition that could prevent understanding or following the treatment program. * Non-idiopathic scoliosis, including neurological, congenital, or other secondary causes. * Receipt of any scoliosis treatment or pelvic floor muscle training within the previous year. * Diagnosis of urinary incontinence. * Regular participation in sports.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cobb Angle | Baseline and 3 months | Change in Cobb angle measured on standing posteroanterior spinal radiographs using the Cobb method. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Angle of Trunk Rotation | Baseline and 3 months | Change in angle of trunk rotation measured in degrees using a Baseline® scoliometer during the Adams forward bend test. Thoracic and lumbar measurements will be recorded where applicable. |
| Apical Vertebral Rotation | Baseline and 3 months | Change in apical vertebral rotation measured in degrees on spinal radiographs using the Raimondi method. |
| Pelvic Parameters | Baseline and 3 months | Changes in pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) measured on standing lateral spinal radiographs. Pelvic incidence is defined as the angle between the line perpendicular to the sacral endplate and the line connecting the center of the sacral endplate to the femoral head axis. Pelvic tilt is defined as the angle between the vertical line and the line connecting the center of the sacral endplate to the femoral head axis. Sacral slope is defined as the angle between the sacral endplate and the horizontal plane. All parameters are measured in degrees. |
| Pelvic Floor Muscle Activity | Baseline and 3 months | Change in pelvic floor muscle activity assessed using surface electromyography. Pelvic floor muscle activation during contraction and resting periods will be recorded according to the study assessment protocol. Higher activation values indicate greater pelvic floor muscle activity. |
| Sagittal Spinal Alignment Parameters | Baseline and 3 months | Changes in thoracic kyphosis (T3-T12 Cobb angle), lumbar lordosis (L1-S1 Cobb angle), cervical lordosis (C2-C7 Cobb angle), and sagittal vertical axis (SVA) measured on standing lateral spinal radiographs. Thoracic kyphosis, lumbar lordosis, and cervical lordosis are measured in degrees using the Cobb method. Sagittal vertical axis is measured as the horizontal distance between the C7 plumb line and the posterosuperior corner of S1 and is reported in millimeters. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSelda Başar, PhD
Gazi University
Outcome results
None listed