- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03663088
Effect of Global Postural Re-education in Idiopathic Scoliosis
October 6, 2021 updated by: Carole Fortin, St. Justine's Hospital
Pilot Study for a Randomized Controlled Clinical Trial on the Effect of Global Postural Re-education in the Treatment of Idiopathic Scoliosis: a Feasibility Study
In North America, children and adolescents with idiopathic scoliosis (IS) are rarely referred for a rehabilitation program whereas the European guidelines stated that scientific evidences concerning scoliosis specific physiotherapy exercises were strong enough to recommend the use of these exercises at an early stage.
The objectives of this pilot study is to assess feasibility of conducting a larger randomized control trial (RCT) on the effect of global postural re-education (GPR) on scoliosis progression (Cobb angle) and posture, back pain and participation and to assess the equivalence of two groups of GPR interventions.
A convenience sample of 60 adolescents with IS (Cobb angle 15º-50º, Risser sign ≤3) will be recruited at CHU Sainte-Justine.
Participants will be randomly allocated to GPR-A (individual sessions once a week) or GPR-B (individual sessions once per two weeks alternately with class exercises once per two weeks) for 6 months.
After 6 months, groups will be interchanged for another 6 months.
Feasibility outcomes will be recruitment rate, consent rate, completion rate and adherence to treatment at 12 months.
The primary outcome of the effect of GPR will be the Cobb angle.
Secondary outcomes will be: posture, back pain and participation at 6 and 12 months.
Statistical analyses: For feasibility, percentage of eligible patients recruited, percentage of recruited patients who completed the trial and adherence to treatment will be calculated.
For the preliminary effects of GPR, linear mixed-models will be used to assess differences in groups' changes from baseline, to 6 and 12-month while adjusting for covariates (age, Risser, adherence).
Separate analyses will be conducted for each outcome.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
20
Phase
- 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
-
-
Quebec
-
Montréal, Quebec, Canada, H3T1C5
- CHU Sainte-Justine
-
-
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
Ages Eligible for Study
8 years to 16 years (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- aged between 8 and 16 years old,
- Cobb angle between 15º and 50º,
- a Risser sign ≤3 (skeletal growth incomplete),
- having recent x-rays (4-6 weeks),
- ability to travel weekly to attend GPR interventions
Exclusion Criteria:
- patients who are planning surgery or have had surgery,
- previous regular physiotherapy or other conservative treatment (chiro, osteopathy),
- worn a brace for at least three months prior to GPR interventions,
- scheduled for clinic follow-up later than in 6±2 months,
- or to be discharged before 12 months.
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 |
Intervention / Treatment |
---|---|
Active Comparator: GPR-A
The 6-months supervised GPR-A group will receive a 1-hour-long individual session once a week plus a home program (1 or 2 exercises, 2 times a week).
|
Standard Global postural re-education physiotherapy scoliosis specific exercises
|
Experimental: GPR-B
The 6-months supervised GPR-B group will receive a 1-hour long individual session once per two weeks alternately with a 1-hour-long class of exercises once per two weeks plus a home program (1 or 2 exercises, 2 times a week).
|
Experimental Global postural re-education physiotherapy scoliosis specific exercises combining individual and class exercises
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Cobb angle
Time Frame: 6 and 12 months
|
Change in the frontal radiologic measure of scoliosis: a decrease in Cobb angle by more than 5 degrees indicate improvement
|
6 and 12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Posture: shoulder elevation
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed between a line drawn between the left and right coracoid process markers, and the horizontal: a decrease of this angle indicate improvement
|
6 and 12 months
|
Posture: right waist angle
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end of the waist to the center of the waist, and from the cent Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end of the waist to the center of the waist, and from the center of the waist to the lower end of the waist on the right side: more symmetry with the left side indicate improvement
|
6 and 12 months
|
Posture: left waist angle
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end of the waist to the center of the waist, and from the cent Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end of the waist to the center of the waist, and from the center of the waist to the lower end of the waist on the left side: more symmetry with the right side indicate improvement
|
6 and 12 months
|
Posture: thoracic scoliosis
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end-vertebra to the apex of the thoracic scoliosis curve and from the apex to the lower end-vertebra of the curve: decrease of this angle indicate improvement
|
6 and 12 months
|
Posture: lumbar scoliosis
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed by lines drawn from the upper end-vertebra to the apex of the thoracolumbar or lumbar scoliosis curve, and from the apex to the lower end-vertebra of the curve: decrease of this angle indicate improvement
|
6 and 12 months
|
Posture: frontal trunk list
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The horizontal distance between C7 and a vertical line drawn from S1: decrease of this measure in millimeter indicate improvement
|
6 and 12 months
|
Posture: frontal pelvic tilt
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed between the line joining the two anterior superior iliac spine (ASIS) and the horizontal: decrease of this angle indicate improvement
|
6 and 12 months
|
Posture: right sagittal pelvic tilt
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed between the horizontal and the line joining the posterior superior iliac spine (PSIS) and ASIS on the right side: an angle between 20 and 30 degrees indicate a normal value and a better symmetry between right and left side indicate improvement
|
6 and 12 months
|
Posture: left sagittal pelvic tilt
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed between the horizontal and the line joining the PSIS and ASIS on the left side: an angle between 20 and 30 degrees indicate a normal value and a better symmetry between right and left side indicate improvement
|
6 and 12 months
|
Posture: scapula asymmetry
Time Frame: 6 and 12 months
|
Clinical Photographic Postural Assessment Tool: The angle formed by a line drawn from the left and right inferior angles of the scapula and the horizontal: decrease of this angle indicate improvement
|
6 and 12 months
|
Change in back pain
Time Frame: 6 and 12 months
|
Change in the intensity (score) of back pain on the Numeric Pain Rating Scale score (0 no pain to 10 very important pain), lower value indicate improvement.
|
6 and 12 months
|
Change in score of The youth version of the Child & Adolescent Scale of Participation
Time Frame: 12 months
|
Change in score of The youth version of the Child & Adolescent Scale of Participation (CASP): The CASP questionnaire has 20 items x 4 levels from 1 (unable to participate) to 4 (age expected/full participation) with a maximum of 80 points.
Higher value indicate improvement (better participation).
|
12 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Recruitment rate
Time Frame: 12 months
|
Percentage of eligible patients recruited: 70% of participants recruited indicate good recruitment rate
|
12 months
|
Completion rate
Time Frame: 12 months
|
Percentage of recruited participants who completed the trial: 75% of completion indicate good completion rate
|
12 months
|
Adherence (compliance) with GPR treatment in terms of collaboration, presence and implication in home exercises
Time Frame: 12 months
|
Adherence with GPR treatment will be measured by the physiotherapists using the validated 3-item Sport Injury Rehabilitation Adherence Scale (SIRAS, were total score varies from 3 (low adherence) to 15 (high adherence)).
We will also compute presence/absence to therapy and we will use a patient/parent logbook for home exercises.
Good adherence (compliance) to treatment will be achieved if a participant has a score of at least 12 out of 15 on the SIRAS 80 % of the treatment sessions, is present to therapy 80% of the sessions and completes home exercises 80% of the time.
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Carole Fortin, Ph.D., St. Justine's Hospital
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)
November 15, 2018
Primary Completion (Actual)
December 15, 2020
Study Completion (Actual)
March 1, 2021
Study Registration Dates
First Submitted
August 2, 2018
First Submitted That Met QC Criteria
September 5, 2018
First Posted (Actual)
September 10, 2018
Study Record Updates
Last Update Posted (Actual)
October 14, 2021
Last Update Submitted That Met QC Criteria
October 6, 2021
Last Verified
October 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- StJustineH_CFortin
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Undecided
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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