Investigation of the Effects of Proprioceptive Neuromuscular Facilitation Techniques and Core Stabilization Exercises on Physical and Functional Parameters in Adolescents With Idiopathic Scoliosis

June 17, 2025 updated by: Mehmet Hanifi Kaya, Kirsehir Ahi Evran Universitesi
Adolescent Idiopathic Scoliosis (AIS) is a prevalent three-dimensional torsional disorder, primarily affecting adolescents during puberty. Characterized by a lateral deviation of the spine greater than 10°, AIS can lead to physical and psychological issues, including back pain, cosmetic deformity, and reduced quality of life. This study aims to compare the effects of Proprioceptive Neuromuscular Facilitation (PNF) techniques and Core Stabilization exercises on physical and functional parameters in adolescents with idiopathic scoliosis. This randomized controlled trial was conducted with 52 adolescents aged 10-18 years, diagnosed with AIS (Cobb angle of 10-30°). Participants were randomly assigned to either the PNF group or the Core Stabilization group. Both groups underwent a 10-week supervised exercise program, supplemented by a home exercise regimen. Primary outcomes included changes in the Cobb angle and Angle of Trunk Rotation (ATR). Secondary outcomes assessed quality of life (SRS-22), perceived trunk appearance (WRVAS), and physical function (6MWT and STS).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Adolescent Idiopathic Scoliosis (AIS) is a prevalent three-dimensional torsional disorder, primarily affecting adolescents during puberty. Characterized by a lateral deviation of the spine greater than 10°, AIS can lead to physical and psychological issues, including back pain, cosmetic deformity, and reduced quality of life. This study aims to compare the effects of Proprioceptive Neuromuscular Facilitation (PNF) techniques and Core Stabilization exercises on physical and functional parameters in adolescents with idiopathic scoliosis. This randomized controlled trial was conducted with 52 adolescents aged 10-18 years, diagnosed with AIS (Cobb angle of 10-30°). Participants were randomly assigned to either the PNF group or the Core Stabilization group. Both groups underwent a 10-week supervised exercise program, supplemented by a home exercise regimen. Primary outcomes included changes in the Cobb angle and Angle of Trunk Rotation (ATR). Secondary outcomes assessed quality of life (SRS-22), perceived trunk appearance (WRVAS), and physical function (6MWT and STS).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
52

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Kırşehir, Turkey, 40100
        • Mehmet Hanifi KAYA

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Aged between 10 and 18 years old,
  2. First-time diagnosis of AIS,
  3. Risser sign of 0-3 and a Cobb angle of 10-30°,
  4. Sanders classification of 0-6,
  5. Lenke curve Type 1 or Type 1A,
  6. Volunteered to participate in the study.

Exclusion Criteria:

  1. The presence of other types of scoliosis (e.g., congenital or neuromuscular scoliosis),
  2. a history of spinal surgery,
  3. use of a brace,
  4. contraindications for exercise (e.g., cardiovascular or respiratory disorders),
  5. previous AIS treatment,
  6. rheumatological diseases, and/or other neuromuscular problems.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: PNF group
Proprioceptive Neuromuscular Facilitation Group: The Proprioceptive Neuromuscular Facilitation (PNF) PNF exercises focused on enhancing neuromuscular control, flexibility, and strength of the spinal and core muscles. The exercise regimen included spiral and diagonal movement patterns, rhythmic stabilization, and contract-relax techniques. Participants were instructed on the activation of the transverse abdominus (TrA) muscle, starting with palpation techniques to feel the muscle contraction. Exercises progressed from supine positions to more challenging postures, incorporating breathing control to avoid the Valsalva maneuver.
Other: Exercise
Exercise therapy was applied to individuals in both groups.
Active Comparator: core stabilization group
Core Stabilization Group: The core stabilization exercises aimed to improve the stability and strength of the core muscles, which are crucial for maintaining spinal alignment and posture. The exercise regimen included static and dynamic postural control exercises, balance training, and functional movement patterns. The core stabilization exercises focused on strengthening the deep trunk muscles, including the transverse abdominis, multifidus, and pelvic floor muscles.
Other: Exercise
Exercise therapy was applied to individuals in both groups.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Cobb
Time Frame: 24 weeks
The Cobb: Lines are drawn parallel to the upper edge of the superior vertebra and the lower edge of the inferior vertebra. Then, perpendicular lines are drawn to these parallel lines, and the angle between the two perpendiculars is measured. This angle, known as the Cobb angle, indicates the degree of scoliosis.
24 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
The Walter Reed Visual Assessment Scale
Time Frame: 24 weeks
WRVAS: Perceived trunk appearance was evaluated using the Walter Reed Visual Assessment Scale (WRVAS), which assesses the cosmetic impact of scoliosis from the patient's perspective. The WRVAS consists of seven items, each scored from 1 (no deformity) to 5 (severe deformity), with a higher total score indicating a greater perceived deformity.
24 weeks
Trunk Rotation Angle,
Time Frame: 24 weeks
Trunk Rotation Angle: The ATR was evaluated using a scoliometer and Adam's forward bend test. Participants were asked to bend forward, and the ATR was measured at the apical vertebrae of the curve. This measurement is sensitive to changes in the rotational aspect of the scoliosis deformity.
24 weeks
Scoliosis Research Society-22
Time Frame: 24 weeks
Scoliosis Research Society-22: Quality of Life was assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire, a validated self-report instrument that measures health-related QoL across five domains: function/activity, pain, self-image/appearance, mental health, and satisfaction with management. The total score is the average of the domain scores.
24 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Kirsehir Ahi Evran Universitesi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 12, 2022

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 15, 2022

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 10, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 5, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 27, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 6, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 18, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 17, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 55485

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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