The Effects of Core Stability Training in Children With Adolescent Idiopathic Scoliosis

In The Light of Isokinetic Test and sEMG: How Effective Is Core Stability Exercise Training On Cobb Angle Muscle Strenght and Quality of Life In Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) is a three-dimensional structural deformity of the spine in which lateral flexion and axial rotation are seen in vertebrae with a Cobb (method for measuring spinal curvature) angle of 10° and above. AIS is the most common type of scoliosis and it occurs in the period from the onset of puberty (up to 10 years) until the closure of growth plates.

Children with AIS have cosmetic effects, decrease in functional capacity, muscle weakness in certain parts of the body, decrease in quality of life and posture disorders. Lack of core stability might be causing these problems.

Core stability training may have a positive effect for these problems experienced by children with AIS.

Pathologies that cause the disease may originate from the nervous system and musculoskeletal system. In this study, the investigators will evaluate these systems objectively with EMG biofeedback and Isokinetic Testing.

The aim of this study is to show the effect of core stability training on various problems (as we mentioned before) caused by the disease. In addition, the investigators of this study hope to contribute to the literature(with objective evaluations) about the pathological background and treatment of this challenging disease which the cause is unknown.

Study Overview

• Status: Completed
• Conditions: Adolescent Idiopathic Scoliosis
• Intervention / Treatment: Other: Home Based Traditional Scoliosis Exercises; Other: Core Stability Training

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Fatih
    • Istanbul, Fatih, Turkey, 34093
      • Istanbul University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 20 years (Child, Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed with AIS between the ages of 10-20
• Cobb angle is between 15-40 degrees
• The child's and family's consent to participate in the study
• The child does not receive any other treatment that will affect his scoliosis.

Exclusion Criteria:

• Surgical operation in the last 3 months
• Presence of an orthopedic, neurological, systemic disease that will prevent him from exercising
• Having mental, communicative and behavioral disorders that may cause problems understanding commands and questions or performing exercises
• Exercising 3 or more days a week.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group; The control group will be given home based traditional scoliosis exercise training for 8 weeks, 5 days a week for 45 minutes.	Other: Home Based Traditional Scoliosis Exercises; Patients in this group will receive posture exercises, strengthening exercises, diaphragmatic breathing exercises and stretching exercises.
Experimental: Training Group; In addition to conventional home based traditional scoliosis exercises, patients in this group will also receive core stabilization exercise training for 45 minutes, 5 times in a week for 8 weeks. Every two sessions will be supervised in a clinic per week.	Other: Home Based Traditional Scoliosis Exercises; Patients in this group will receive posture exercises, strengthening exercises, diaphragmatic breathing exercises and stretching exercises.; Other: Core Stability Training; Patients in this group will receive traditional scoliosis exercises. In addition, the training group will receive core stabilization exercises for multifidus, diaphragm,erector spines, rectus abdominis, internal and external obliques, quadratus lumborum, iliopsoas, gluteus maximus, and pelvic floor muscles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Strength	Evaluation of the muscle strength with using a non-invasive Myomed 932 EMG-biofeedback device (Enraf-Nonius, The Netherlands)	8 week
Muscle Electromyographic Activity	Measurement of the surface electromyographic activity with using a non-invasive Myomed 932 EMG-biofeedback device (Enraf-Nonius, The Netherlands)	8 week
Muscle Strength of Trunk Flexion / Extension	Measurement of isokinetic and isometric muscle strength with Biodex System 3Pro Multijoint System Isokinetic Dynamometer.	8 week
Cobb Angle	Cobb Angle measurement with AP Radiography	8 week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Trunk Rotation	Evaluation of the thoracic, thoracic-lumber junction, lumber axial trunk rotation with Bunnell Scoliometer	8 week
Patients Quality of Life	Quality of life will be measured with using the Scoliosis Research Society 22 item questionnaire (SRS-22r). SRS-22 has a minimum score of 22 and a maximum score of 110. Each question is scored on 1-5 scale. Questions are sorted into different domains and total and mean scores for each domain are calculated. A total score for the entire questionnaire is also calculated.	8 week
Cosmetic Deformity Evaluation	Patients cosmetic deformity will be evaluated with Walter Reed Visuel Assesment Scale. This scale includes seven items with figures representing different aspects of the spinal deformity: spinal deformity, rib prominence, lumbar prominence, thoracic deformity, trunk imbalance, shoulder asymmetry and scapular asymmetry. The figures are scored from minimum (1, no deformity) to maximum (5, severe deformity) and summed up to yield a total score (minimum: 5 points, maximum: 35 points).	8 week
Flexibility Measurement	Patients flexibility will be measured with forward and lateral bending tests	8 week

Collaborators and Investigators

• Sponsor: Istanbul University
• Investigators: Principal Investigator: Fuat Gökdemir, Istanbul University

Study record dates

Study Major Dates

• Study Start (Actual): October 5, 2021
• Primary Completion (Actual): March 10, 2022
• Study Completion (Actual): March 25, 2022

Study Registration Dates

• First Submitted: September 15, 2021
• First Submitted That Met QC Criteria: September 15, 2021
• First Posted (Actual): September 24, 2021

Study Record Updates

• Last Update Posted (Estimated): February 21, 2024
• Last Update Submitted That Met QC Criteria: February 19, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Isokinetic Testing; EMG Biofeedback; Core Stability
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Spinal Diseases; Bone Diseases; Spinal Curvatures; Scoliosis
• Other Study ID Numbers: IUFGokdemir01

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