Exercise Effects on Fascia, Low Back Pain, and Function in Scoliosis

Investigation of the Effects of Different Exercise Approaches on Thoracolumbar Fascia Thickness, Low Back Pain, and Function in Individuals With Idiopathic Lumbar Scoliosis and Chronic Low Back Pain

The use of various muscle energy techniques to address fascial restrictions, in addition to three-dimensional correction within scoliosis-specific exercise approaches, suggests that these exercises may have different effects on thoracolumbar fascia thickness. This may, in turn, lead to varying impacts on low back pain and functional improvement. Therefore, the aim of this study is to investigate the effects of different scoliosis-specific exercise approaches on thoracolumbar fascia thickness, low back pain, and function in individuals with idiopathic lumbar scoliosis and chronic low back pain.

Study Overview

• Status: Recruiting
• Conditions: Low Back Pain; Scoliosis Idiopathic; Fascia
• Intervention / Treatment: Behavioral: Scientific Exercise Approach to Scoliosis (SEAS) Exercises; Behavioral: Functional Individual Therapy of Scoliosis Exercises

Detailed Description

Low back pain is the most common complaint among individuals with lumbar scoliosis. In a study conducted in Japan, the prevalence of low back pain was reported as 34.7%, which was nearly three times higher than that observed in students without scoliosis. Pain resulting from scoliosis leads to a high level of functional disability, which consequently reduces quality of life.

The thoracolumbar fascia consists of dense connective tissue layers separated by loose connective tissue that allows the tight layers to glide over one another during trunk movement. It provides a mechanical connection between the lumbar spine and several muscles, including the transversus abdominis, portions of the latissimus dorsi, and the internal oblique muscles. In individuals with idiopathic scoliosis, thickening of this fascia has been observed, and it has been reported that this thickening is further increased in the presence of chronic low back pain. Fascial thickening in individuals with scoliosis has been proposed as a potential factor contributing to both pain and movement restrictions.

In the treatment of scoliosis, scoliosis-specific exercise approaches are widely used. These approaches typically include various active self-correction strategies (based on the location, shape, and magnitude of the curve) and individually tailored exercises. Some scoliosis-specific exercise approaches incorporate techniques such as contract-relax, myofascial release, trigger point therapy, and joint mobilization to eliminate muscular and fascial restrictions that impede movement, thereby preparing individuals with scoliosis for three-dimensional correction. In addition, these exercises have been reported to exert positive therapeutic effects on pain and quality of life in individuals with idiopathic scoliosis.

The use of various muscle energy techniques to address fascial restrictions, in addition to three-dimensional correction within scoliosis-specific exercise approaches, suggests that these exercises may have different effects on thoracolumbar fascia thickness. This may, in turn, lead to varying impacts on low back pain and functional improvement. Therefore, the aim of this study is to investigate the effects of different scoliosis-specific exercise approaches on thoracolumbar fascia thickness, low back pain, and function in individuals with idiopathic lumbar scoliosis and chronic low back pain.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alev Doğan Özbudak, PT, MSc (PhD Candidate); Phone Number: +905549263892; Email: fztalevdogan@gmail.com

Study Locations

• Turkey (Türkiye)
  • Samanpazarı
    • Ankara, Samanpazarı, Turkey (Türkiye), 06100
      • Recruiting
      • Hacettepe University, Faculty of Physical Therapy and Rehabilitation
      • Contact: Alev Doğan Özbudak, PT, MSc (PhD Candidate); Phone Number: +905549263892; Email: fztalevdogan@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Aged 10-50 years
• Diagnosed with idiopathic scoliosis
• Presenting a lumbar scoliosis pattern
• Cobb angle greater than 15°
• Experiencing low back pain for more than 3 months
• Pain intensity ≥3 on the Visual Analog Scale (VAS)
• Able to read and write

Exclusion Criteria:

• History of spinal surgery
• Received any scoliosis treatment within the last year
• Current use of a spinal brace
• Use of pain medication
• Scoliosis due to non-idiopathic causes (e.g., neurological, congenital)
• Presence of neurological, psychological, congenital, or rheumatologic disorders
• Any musculoskeletal pathology affecting the spine or trunk

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: Scientific Exercise Approach to Scoliosis (SEAS) Group; Participants receive the Scientific Exercise Approach to Scoliosis (SEAS) program focusing on active self-correction and functional stabilization.	Behavioral: Scientific Exercise Approach to Scoliosis (SEAS) Exercises; Participants in the SEAS group will receive one supervised 60-minute clinical session per week for 8 weeks, combined with a 40-minute home exercise program performed 6 days per week according to the SEAS protocol.
Active Comparator: Functional Individual Therapy of Scoliosis (FITS) Group; Participants receive the Functional Individual Therapy of Scoliosis (FITS) program, designed to improve symmetry, muscular balance, and spinal alignment.	Behavioral: Functional Individual Therapy of Scoliosis Exercises; Participants in the FITS group will receive one supervised 60-minute clinical session per week for 8 weeks, along with a 40-minute home exercise program performed 6 days per week following the FITS method.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Thoracolumbar Fascia Thickness	Thoracolumbar fascia thickness will be measured using ultrasound at two bilateral points, located 2-3 cm lateral to the L3 spinous processes. Thoracolumbar fascia thickness will be measured in millimeters using ultrasound imaging. Fascia organization will be classified using a Likert scale as follows: very disorganized, somewhat disorganized, somewhat organized, and very organized, according to the method described in the study protocol.	Baseline and 8 weeks after the intervention
Pain intensity	Pain intensity will be assessed using a 100-mm Visual Analog Scale (0 = no pain, 100 = worst imaginable pain).	Baseline and 8 weeks after the intervention
Pain quality	Pain quality will be measured using the Short-Form McGill Pain Questionnaire (SF-MPQ) sensory and affective subscale scores. Higher scores indicate worse pain quality.	Baseline and 8 weeks after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Disability	Functional disability will be assessed using the Oswestry Disability Index (ODI), a 10-item questionnaire evaluating the impact of low back pain on daily activities using a 5-point Likert scale.	Baseline and 8 weeks after the intervention
Health-Related Quality of Life	Health-related quality of life will be measured using the Scoliosis Research Society-30 (SRS-30) questionnaire, a 30-item tool widely used in scoliosis populations. The first 22 items assess general health-related quality of life, while the last 8 items are completed only by patients with scoliosis who underwent surgery. The questionnaire includes a body diagram to mark painful areas.	Baseline and 8 weeks after the intervention

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Principal Investigator: Alev Doğan Özbudak, PT, MSc (PhD Candidate), Hacettepe University

Study record dates

Study Major Dates

• Study Start (Actual): November 2, 2025
• Primary Completion (Estimated): February 16, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: February 6, 2026
• First Submitted That Met QC Criteria: February 11, 2026
• First Posted (Actual): February 18, 2026

Study Record Updates

• Last Update Posted (Actual): February 18, 2026
• Last Update Submitted That Met QC Criteria: February 11, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Low Back Pain; Scoliosis; Fascia; Exercise Therapy
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Bone Diseases; Musculoskeletal Diseases; Spinal Diseases; Back Pain; Spinal Curvatures; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Low Back Pain; Scoliosis; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Physical Phenomena; Environment; Ecological and Environmental Phenomena; Biological Phenomena; Geological Phenomena; Seawater; Saline Waters; Exercise; Oceans and Seas
• Other Study ID Numbers: HU-FTR-ADO-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual Participant Data (IPD) will not be shared due to ethical considerations and participant privacy. The study involves sensitive health information of participants with chronic low back pain and idiopathic lumbar scoliosis. Sharing individual-level data could risk identifiability, despite anonymization efforts. Data will be used solely for the current research purposes, including thesis work and related publications.

Drug and device information, study documents

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