Trial on Two Treatments for Adolescent Idiopathic Scoliosis
Study Details
Study Description
Brief Summary
Adolescent Idiopathic scoliosis is a three-dimensional structural deformity of the spine and pelvic that occurs in children. More evidence has arisen to emphasize the important role played by pelvic asymmetry during the progression of scoliosis. The purpose of this study is to compare the effectiveness of pelvic adjustments accompanied with Schroth-based exercises, with the latter alone in adolescent idiopathic scoliosis, to assess the impact of pelvic asymmetry on the spinal three-dimensional parametric features in scoliosis.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
Adolescent idiopathic scoliosis is the most common three-dimensional structural deformity of the spine among adolescence, the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment recommend specific exercise therapy to delay the progression of scoliosis. Many specific exercise therapies are effective in reducing the angle of coronal scoliosis, but their efficiency in sagittal and axial deformities hasn't been convincing. Recent studies have found that the axial asymmetry of the pelvis may be involved in the pathogenesis of idiopathic scoliosis, but there is no clinical study on the treatment of scoliosis by correcting the axial torsion of the pelvis neither at home nor abroad. So in this study, "3 plus 1" multidimensional exercise therapy was applied to mild adolescent idiopathic scoliosis for the first time.
The present study is a single-center randomized controlled trial conducted at the department of rehabilitation medicine, Aerospace Center Hospital. The written Informed consent will be obtained from each patient and one of their parents before inclusion. Eligible subjects will be randomized by a 1:1 allocation ratio either to the experimental group, in which the "3 plus 1" multidimensional exercise therapy will be performed and pelvic correction technique was adopted to correct pelvic axial rotation, or the control group, in which they will receive the Schroth-based exercise therapy. Blinded assessments will be conducted at baseline and 6-month after the intervention, including the differences in three-dimensional structural parameters of pelvis and spine, such as the ratio of the iliac widths, SRS-22 questionnaire, etc, to compare the efficacy of two different groups in improving the three-dimensional balance of the spine and the quality of daily life in adolescent idiopathic scoliosis.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: "3 plus 1" multidimensional exercise therapy The intervention consists of a Schroth-based exercise session and a manipulative therapy of pelvic asymmetry. |
Behavioral: "3 plus 1" multidimensional exercise therapy
The intervention is set to be delivered in a 90-minute exercise session, which will be performed for 6 months, in the frequency of twice a week during the first month and once a month for the rest 5 months. The exercise consists of a one-hour Schroth-based exercise session and an additional 30-minute manipulative therapy of pelvic asymmetry.
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| Active Comparator: Schroth based scoliosis specific exercise The intervention consists of the Schroth-based exercise session. |
Behavioral: Schroth based scoliosis specific exercise
The intervention is set to be delivered in a one-hour Schroth-based exercise session, that will be performed for 6 months, in the frequency of twice a week during the first month and once a month for the rest 5 months. The exercise consists of active auto-correction in 3D, stabilizing the corrected posture, and training in ADL.
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Outcome Measures
Primary Outcome Measures
- Change From Baseline in Ratio of Iliac Widths at 6 months [baseline and 6 months]
Rotation in the transverse plane of pelvic seen on a spinal standing full-length posteroanterior radiograph.
Secondary Outcome Measures
- Change in Cobb Angle [baseline and 6 months]
The largest coronal convex curve measured by the Cobb method on a spinal standing full-length posteroanterior radiograph.
- Change in Apical Translation in Main Curves [baseline and 6 months]
When a apical vertebra or disc is identified as the apex of the curve, the center of the vertebra or disc is identified by drawing a horizontal line through the vertebra or disc, apical translation of the disc is measured from the disc centroid to the center sacral vertical line (CSVL).
- Change in Coronal Pelvic Tilt [baseline and 6 months]
The vertical distance between the horizontal tangents of the highest point of the bilateral iliac crest.
- Change in Dynamic Balance Test [baseline and 6 months]
Dynamic postural control was evaluated and exercised using the Star Excursion Balance Test (SEBT), which consists of 8 reaching directions: anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral and anterolateral. Subjects were requested to reach as far as possible along the designated line, the average of the 8 reaches was normalized by dividing by the previously measured leg length to standardize the maximum reach distance ((excursion distance/leg length)*100 = % maximum reach distance). The higher excursion distance reflected the greater dynamic balance.
- Change in Angle of Trunk Rotation [baseline and 6 months]
The angle of trunk rotation will be measured with a Scoliometer.
- Change in Scoliosis Research Society-22 Questionnaire [baseline and 6 months]
The SRS-22 contains 22 questions covering 5 domains: function/activity 5 items; pain 5 items; self-perceived image 5 items; mental health 5 items; and satisfaction with treatment 2 items. Each item is scored from 1 (worst) to 5 (best). The sum of the 5 domains is 110.
Eligibility Criteria
Criteria
Inclusion Criteria:
- A diagnosis of adolescent idiopathic scoliosis; Age from 10 to 18 years; A Cobb angle of 10 to 25 degrees; All maturity levels (Risser sign of 0-5).
Exclusion Criteria:
- Non-idiopathic scoliosis, which is caused by a neuromuscular, neurological, congenital malformation, or trauma-related comorbidity; Having mental problems or other contraindications to exercise; Previous fractures, rheumatic diseases, or operation history of lower extremities; Previous or current brace or surgical treatments for scoliosis.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Zhang yafei | Beijing | China |
Sponsors and Collaborators
- Peking University Aerospace Centre Hospital
Investigators
- Study Director: Zhang Meng, Aerospace Centre Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- HP2022-50-507005