JMIR Publications

ABSTRACT

Background:

Schroth therapy is one of the conservative methods used to treat scoliosis. It includes not only therapeutic exercises in physiotherapy facilities but also concepts for independent training at home. Consistent and correct performance of this training has a major impact on the success of the therapy. However, without guidance and supervision by a therapist, patient motivation may decline. In addition, incorrect training techniques may be used, which can have a negative impact on the success of the therapy.

Objective:

The aim of this study was to develop a digitally assisted training system for home-based scoliosis therapy and to verify it technically on a laboratory scale.

Methods:

Based on the training devices used in Schroth therapy, such as mirrors, balance boards, wall bars, and gymnastic sticks, we developed a concept for a modular, digitally assisted scoliosis training system (iScoolio). The development process included a requirements specification, iterative design drafts, and the transfer of the concepts into a functional demonstrator. Finally, a usability test and technical verification of the measurement functions were carried out using specifically developed test scenarios.

Results:

A demonstrator with tracking, training and modification functions was developed consisting of four modules. Technical verification of the integrated measurement functions showed that the angle measurement in motion tracking (n = 50) deviated by 2.29° ± 1.66° compared to the Aramis 3D optical reference system. Respiration tracking enabled the detection of all simulated respiratory cycles (n = 40) and the significant distinction between shallow and deep breathing (t(39) = -27.4; P < .001). The investigation of the two force sensor concepts in the Handles (χ²(2) = 80.0; P < .001) and Supporting Feet (χ²(2) = 50.0; P < .001) showed a significant differentiation between three force levels, but approximately linear drift behavior in each case. When tracking the stance width (n=50), the mean value was 15.4 cm with SD of 0.54 cm. Verification of the COP measurement function (n=50) showed that 48% of the measurements had a deviation of ≤ 10 mm and 82% of the measurements had a deviation of ≤ 20 mm.

Conclusions:

In this paper, we have presented the iScoolio concept, which supports scoliosis home-based therapy through adaptable devices and tracking elements. Integrated sensors enable monitoring of movements, breathing, forces, and pressure distribution during training to ensure correct execution. An associated web application visualizes the recorded data and provides therapy instructions. With the help of technical verification, we were able to demonstrate the functionality of the integrated tracking methods, although there is still room for optimization in terms of hardware and software. Once these optimizations have been implemented, the next step is to conduct clinical trials under real-world conditions.