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

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: Completed
• Conditions: Adolescent Idiopathic Scoliosis
• Intervention / Treatment: Other: 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: Interventional
• Enrollment (Actual): 52
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Cobb	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

Outcome Measure	Measure Description	Time Frame
The Walter Reed Visual Assessment Scale	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,	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	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

• Sponsor: Kirsehir Ahi Evran Universitesi

Study record dates

Study Major Dates

• Study Start (Actual): January 12, 2022
• Primary Completion (Actual): December 15, 2022
• Study Completion (Actual): February 10, 2023

Study Registration Dates

• First Submitted: June 5, 2024
• First Submitted That Met QC Criteria: December 27, 2024
• First Posted (Actual): January 6, 2025

Study Record Updates

• Last Update Posted (Actual): June 18, 2025
• Last Update Submitted That Met QC Criteria: June 17, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Spinal Diseases; Spinal Curvatures; Scoliosis
• Other Study ID 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