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This randomized controlled trial evaluates the effectiveness of Physiotherapeutic Scoliosis-Specific Exercises (PSSE-Schroth) compared with General Exercises in adolescents with idiopathic scoliosis over a 12-month intervention period. Primary outcomes include Cobb angle progression and brace prescription rate. Secondary outcomes include trunk rotation, quality of life, self-image, and body symmetry.
Adolescent idiopathic scoliosis is a three-dimensional spinal deformity that may progress during growth. Although PSSE is increasingly recommended in conservative scoliosis management, comparative randomized evidence remains limited. This study aims to compare PSSE-Schroth exercises with General Exercises in adolescents with mild idiopathic scoliosis over 12 months. Participants are randomized into intervention or control groups receiving matched exercise dosage and supervision. Outcomes assess radiographic progression, trunk rotation, need for bracing, and patient-reported clinical parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PSSE-Schroth Group | Experimental | Participants performed individualized PSSE-Schroth exercises based on curve pattern, including corrective breathing, postural correction, and ADL training. |
|
| General Exercise Group | Active Comparator | Participants performed general strengthening and stretching exercises without scoliosis-specific correction. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PSSE-Schroth Exercises | Other | Participants performed individualized PSSE-Schroth exercises based on curve pattern, including corrective breathing, postural correction, and ADL training |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Cobb Angle | Cobb angle will be measured on standing anteroposterior spinal radiographs using the standard Cobb method. The angle is defined as the intersection of lines drawn parallel to the superior endplate of the upper-end vertebra and the inferior endplate of the lower-end vertebra of the primary curve. Measurements will be performed at baseline and after the intervention period, and the change in Cobb angle (in degrees) will be calculated. Lower values indicate an improvement in spinal curvature. | Baseline to 12 Months |
| Brace Prescription Rate | The proportion of participants requiring orthotic bracing during the study period will be recorded. Brace prescription will be determined by a specialist according to established clinical criteria (e.g., curve magnitude, skeletal maturity, and risk of progression). The rate will be expressed as the percentage of participants prescribed a brace in each group during the follow-up period. | 12 Months |
| Measure | Description | Time Frame |
|---|---|---|
| SRS-22 Questionnaire Score | Health-related quality of life will be assessed using the Scoliosis Research Society-22 Questionnaire (SRS-22). This validated instrument includes five domains: function/activity, pain, self-image/appearance, mental health, and satisfaction with management. Each item is scored on a 5-point Likert scale, with higher scores indicating better health status. Assessments will be performed at baseline and after the intervention period, and changes in domain and total scores will be analyzed. |
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Inclusion Criteria:
Diagnosis of adolescent idiopathic scoliosis
Exclusion Criteria:
Previous brace treatment * Non-idiopathic scoliosis
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hasan Kalyoncu University | Gaziantep | Şahinbey | 27000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39078854 | Result | Zhang Y, Chai T, Weng H, Liu Y. Pelvic rotation correction combined with Schroth exercises for pelvic and spinal deformities in mild adolescent idiopathic scoliosis: A randomized controlled trial. PLoS One. 2024 Jul 30;19(7):e0307955. doi: 10.1371/journal.pone.0307955. eCollection 2024. | |
| 38687741 | Result | Mohamed N, Acharya V, Schreiber S, Parent EC, Westover L. Effect of adding Schroth physiotherapeutic scoliosis specific exercises to standard care in adolescents with idiopathic scoliosis on posture assessed using surface topography: A secondary analysis of a Randomized Controlled Trial (RCT). PLoS One. 2024 Apr 30;19(4):e0302577. doi: 10.1371/journal.pone.0302577. eCollection 2024. |
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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Participants were randomized in a 1:1 ratio to either PSSE-Schroth or General Exercise intervention.
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Outcome assessors and statisticians were blinded to group allocation. Participants and treating therapists were not blinded due to the nature of exercise interventions.
| General Exercises | Other | Participants performed general strengthening and stretching exercises without scoliosis-specific correction. |
|
| Baseline to 12 Months |
| TAPS Score | Trunk appearance will be assessed using the Trunk Appearance Perception Scale (TAPS). This patient-reported outcome measure evaluates subjective perception of trunk deformity using a set of standardized drawings viewed from different perspectives. Each item is scored on a Likert scale, with higher scores indicating better perceived trunk appearance (less deformity). Assessments will be conducted at baseline and after the intervention period, and changes in TAPS scores will be analyzed. | Baseline to 12 Months |
| TRACE Score | Clinical trunk deformity will be assessed using the Trunk Aesthetic Clinical Evaluation (TRACE) scale. This clinician-rated tool evaluates visible asymmetries of the shoulders, scapulae, waist, and hemithorax. Each domain is scored based on the severity of asymmetry, and a total score is calculated, with higher scores indicating greater aesthetic deformity. Assessments will be performed at baseline and after the intervention period, and changes in TRACE scores will be analyzed. | Baseline to 12 Months |
| 25780260 | Result | Kuru T, Yeldan I, Dereli EE, Ozdincler AR, Dikici F, Colak I. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil. 2016 Feb;30(2):181-90. doi: 10.1177/0269215515575745. Epub 2015 Mar 16. |
| 29435499 | Result | Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O'Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. doi: 10.1186/s13013-017-0145-8. eCollection 2018. |
| 24047455 | Result | Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med. 2013 Oct 17;369(16):1512-21. doi: 10.1056/NEJMoa1307337. Epub 2013 Sep 19. |
| 20338048 | Result | Bago J, Sanchez-Raya J, Perez-Grueso FJ, Climent JM. The Trunk Appearance Perception Scale (TAPS): a new tool to evaluate subjective impression of trunk deformity in patients with idiopathic scoliosis. Scoliosis. 2010 Mar 25;5:6. doi: 10.1186/1748-7161-5-6. |
| 12544958 | Result | Asher M, Min Lai S, Burton D, Manna B. The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis. Spine (Phila Pa 1976). 2003 Jan 1;28(1):63-9. doi: 10.1097/00007632-200301010-00015. |
| 23443679 | Result | Langensiepen S, Semler O, Sobottke R, Fricke O, Franklin J, Schonau E, Eysel P. Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review. Eur Spine J. 2013 Nov;22(11):2360-71. doi: 10.1007/s00586-013-2693-9. Epub 2013 Feb 27. |