Effectiveness of Virtual Reality- Based Rehabilitation Program in Individuals With Adolescent Idiopathic Scoliosis After Posterior Fusion Surgery

The aim of this clinical study is to investigate the effect of virtual reality based rehabilitation program on kinesiophobia, respiratory muscle strength, spinal mobility, physical activity, spinopelvic parameters and quality of life after posterior fusion surgery in individuals diagnosed with Adolescent Idiopathic Scoliosis (AIS). The main questions it aims to answer are:

• Does a virtual reality based rehabilitation program after posterior fusion surgery have an effect on kinesiophobia, respiratory muscle strength, spinal mobility, physical activity, spinopelvic parameters and quality of life in individuals diagnosed with AIS?
• Is the virtual reality-based rehabilitation program after posterior fusion surgery more effective for individuals diagnosed with AIS than the routine physiotherapy and rehabilitation program applied in the clinic?

They will compare it with the [routine physiotherapy and rehabilitation program] to see if the virtual reality-based rehabilitation program is effective in individuals with AIS after posterior fusion.

Participants :

After being evaluated in terms of kinesiophobia, respiratory muscle strength, spinal mobility, physical activity, spinopelvic parameters and quality of life, the Virtual Reality-Based Exercise Group will be given an exercise program via the games in Kinect Sports Ultimate for 30 minutes a day for a total of 6 weeks, 2 days . At the end of the 6 week, the participants will be re-evaluated and the results will be compared according to the control group.

Study Overview

• Status: Completed
• Conditions: Adolescent Idiopathic Scoliosis (AIS)
• Intervention / Treatment: Other: To the Virtual Reality Based Exercise; Other: Routine physiotherapy and rehabilitation program

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Fatih
    • Istanbul, Fatih, Turkey (Türkiye), 34093
      • Istanbul University Faculty of Medicine Department of Orthopedics and Traumatology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed with AIS December 10-18
• Underwent posterior spinal fusion surgery
• Post-operative (post-op) 6.during the week and after
• Absence of vision, speech and hearing problems
• Regular participation in the program to be implemented
• Volunteering of individuals

Exclusion Criteria:

• Have a history of previous spinal surgery
• Have any contraindications to exercise
• Have a mental problem
• Have a neuromuscular, mesenchymal, rheumatic disease
• Have pulmonary and cardiac complications

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
Experimental: Virtual Reality Based Exercise Group; The Virtual Reality Based Exercise Group will be given an exercise program based on the games in Kinect Sports Ultimate (Soccer, Basketball, Skiing, Tennis, Baseball, Volleyball, Boxing, Track & Field) for 30 minutes a day for a total of 6 weeks, 2 days a week. The games include movements such as lateral flexion, extension and flexion of the torso and upper limb movements, running, short-urea standing on one leg, jumping.	Other: To the Virtual Reality Based Exercise; After posterior fusion surgery, a rehabilitation program will be applied to individuals with AIS using Kinect Sports Ultimate for 30 minutes per day for a total of 6 weeks, 2 days a week.
Active Comparator: Control Group; The participants who make up the control group will be followed up with a routine physiotherapy and rehabilitation program for 6 weeks.	Other: Routine physiotherapy and rehabilitation program; 14 patients with posterior fusion AIS routinely in the postoperative clinic for 6 weeks. the physiotherapy program used will be applied.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Respiratory Muscle Strength	The respiratory muscle strength of the participants will be measured according to the criteria of the American Thoracic Society /European Respiratory Society using a portable, electronic intraoral pressure measuring device. After the maximum expiration, the participant will be asked to perform maximal inspiration lasting at least 1.5 seconds in the residual volume. At the total lung capacity after maximum inspiration, the person will be asked to perform a maximum expiration lasting at least 1.5 seconds against the closed system. The tests will be applied in a sitting position with the nose closed with a soft latch. Of at least three measurements that are technically acceptable and do not differ by more than 5 cmH₂O from each other, the highest one will be recorded.	6 weeks
Spinal Mobility	The spinal mobility of the participants will be measured with the modified Schober test before and after 6 weeks of treatment. When the person is in an upright position, the lumbosacral junction and 10 cm above will be marked, and a third marker will be placed 5 cm below the lumbosacral junction. After the anterior flexion, which is performed as far forward as possible, the distance between the top and bottom deceleration will be measured and the test will be terminated.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Spinopelvic Parameters	All the spinal anterior, posterior and lateral spine ortho x-rays of the participants and spinal parameters and pelvic parameters will be measured before and after virtual reality based rehabilitation applications and the effect of virtual reality based rehabilitation program on the sagittal balance of the spine will be examined	6 weeks
Kinesiophobia	Participants' fear of movement will be questioned using the TAMPA Kinesiophobia scale. The minimum score that can be taken from the scale is 17 and the maximum score is 68. High scores indicate that the patient's fear of movement is high.	6 weeks
Physical Activity	Individuals with AIS will be taught to use pedometers and will be asked to use the device from the moment they get up in the morning until the moment they go to bed at night for 6 weeks, to record the number of steps values before going to bed at night.	6 weeks
Scoliosis Quality of Life	The Scoliosis Research Society-22 Questionnaire (SRS-22) will be used to evaluate the health-related quality of life of individuals with AIS before and after rehabilitation practices performed via virtual reality. The score range for each item ranges from zero (worst) to five (best). Decembers are applied to the following items. The sum of the points received from all the questions will be divided by the total number of questions and the total score will be obtained. A high score indicates that the quality of life is increasing, a low score indicates that it is decreasing.	6 weeks

Collaborators and Investigators

• Sponsor: Elif Yagmur Ozger
• Collaborators: Health Institutes of Turkey
• Investigators: Study Chair: Berk NIMETOGLU, Medical Doctor, Istanbul University Faculty of Medicine Department of Orthopedics and Traumatology

Publications and helpful links

General Publications

• Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O'Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. doi: 10.1186/s13013-017-0145-8. eCollection 2018.
• Dahl-Popolizio S, Loman J, Cordes CC. Comparing Outcomes of Kinect Videogame-Based Occupational/Physical Therapy Versus Usual Care. Games Health J. 2014 Jun;3(3):157-61. doi: 10.1089/g4h.2014.0002. Epub 2014 Apr 17.
• Hawes MC. The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature. Pediatr Rehabil. 2003 Jul-Dec;6(3-4):171-82. doi: 10.1080/0963828032000159202.

Study record dates

Study Major Dates

• Study Start (Actual): July 10, 2024
• Primary Completion (Actual): January 7, 2025
• Study Completion (Actual): February 20, 2025

Study Registration Dates

• First Submitted: December 16, 2024
• First Submitted That Met QC Criteria: December 22, 2024
• First Posted (Actual): December 31, 2024

Study Record Updates

• Last Update Posted (Actual): March 31, 2026
• Last Update Submitted That Met QC Criteria: March 27, 2026
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: kinesiophobia; Adolescent Idiopathic Scoliosis; Respiratory Muscle Strength; spinal mobility; virtual reality based rehabilitation; Posterior Fusion Surgery; spinopelvic parameter
• Additional Relevant MeSH Terms: Mental Disorders; Phobic Disorders; Anxiety Disorders; Kinesiophobia; Therapeutics; Patient Care; Health Services; Health Care Facilities Workforce and Services; Aftercare; Continuity of Patient Care; Rehabilitation
• Other Study ID Numbers: 2023/2091

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: it has been stated that it is necessary to protect the patient information contained in the patient rights regulation, and since the data must be stored, no sharing will be made. If necessary, the data will be shared collectively. Data will not be shared individually.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No