JMIR Publications

ABSTRACT

Background:

Adolescent idiopathic scoliosis is a three-dimensional spine distortion with an unidentified etiology. It results in noticeable trunk deformity, decreased muscle strength and endurance at the trunk, changes in chest volume, breathing issues, and ultimately a decline in the quality of life. Trunk bracing and corrective exercises make up most of scoliosis patients’ treatment when their deformity is between 20 and 45 degrees and they have not yet attained skeletal maturity. Evidence suggests that spinal deformity in people with scoliosis may result from improper motor control. Automatic response training is an exercise therapy technique that can modify the pattern of trunk muscle control for supporting the spinal column in normal alignment. An apparatus called a cantilever device is required for this kind of exercise which facilitates training at home. In spite of research showing the benefit of braces and therapeutic exercise in adolescents with scoliosis, less emphasis has been given to the impact of home-based training, especially when this intervention is paired with braces.

Objective:

This study aims to compare the efficacy of bracing and conventional exercise program to a combination treatment that includes trunk bracing and exercises with a cantilever device performed at home on the degree of spine curvature, pulmonary function, trunk muscular endurance, and quality of life.

Methods:

This study will be a two-arms parallel-groups clinical study. Sixteen adolescents with idiopathic scoliosis and single lumbar and thoracolumbar curves of 20-45 degrees will be recruited and randomly assigned into two groups. Group A will receive a combination of trunk bracing and exercise using an instrument known as a “cantilever”. Group B (controls) will receive a trunk bracing and conventional exercise program (without a tool). The study outcomes are the Cobb angle of the scoliotic curve, pulmonary function, the endurance of the trunk muscles, and quality of life. The study outcomes will be measured at two time points: before the intervention (T1) and twelve weeks following interventions began (at this time, the intervention period is completed) (T2). Multivariate analysis of variance will be used to test between- and within-group differences.

Results:

Recruitment for this study will begin in fall 2022 and is expected to be completed by the end of summer 2023.

Conclusions:

In this study, the efficacy of a combined trunk bracing program and postural response exercises using a cantilever device in treating adolescent idiopathic scoliosis will be compared to trunk bracing and conventional home exercises. Exercises performed at home using a cantilever device are anticipated to raise the trunk muscles' endurance, which will help reduce trunk deformity, enhance pulmonary function, and improve participants' quality of life. Clinical Trial: This research protocol was registered in the Iranian Registry of Clinical Trials on May 9, 2022 (IRCT20220330054371N1).