- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07430098
Feedback-baseret Balance Træning for Unge med Idiopatisk Skoliose
Effekten af at tilføje feedback-baseret balancetræning til individuelle konservative skolioseøvelser sammenlignet med kun individuelle konservative skolioseøvelser på balance hos unge med idiopatisk skoliose: Et prospektivt, randomiseret kontrolleret forsøg
Studieoversigt
Status
Betingelser
Detaljeret beskrivelse
Adolescent idiopatisk skoliose (AIS) er den mest almindelige form for skoliose, der forekommer i vækstperioden. Tidligere studier, der sammenligner personer med AIS med raske kontrolpersoner, har vist signifikante ændringer i balancemønstre, og flere undersøgelser har evalueret balanceparametre ved hjælp af posturografi som reaktion på træningsbaserede interventioner.
For eksempel rapporterede Osama et al. (2021), at kombinationen af hippoterapi og Schroth-øvelser resulterede i større forbedringer i postural asymmetri og balance sammenlignet med kun Schroth-øvelser. På samme måde viste Shen et al. (2023), at integration af balancetræning med Schroth-terapi hos unge med idiopatisk skoliose førte til signifikante forbedringer i trunkrotationsvinkel, Cobb-vinkel, livskvalitet og overordnet balancefunktion.
Men indtil nu har ingen undersøgelse undersøgt effekten af balancetræning ved hjælp af HUBER® 360-systemet på balanceudfald i denne population. Derfor sigter nærværende studie på at evaluere effekten af at tilføje balancetræning ved hjælp af HUBER® 360-systemet til skoliose-specifikke øvelser på balancen hos unge med idiopatisk skoliose.
Interventionsprotokollen vil bestå af 12 sessioner leveret over 4 uger, med øvelser udført tre gange om ugen. Deltagerne vil blive tilfældigt tildelt to grupper. Kontrolgruppen vil modtage 45 minutter af individualiserede skolioseøvelser efterfulgt af 30 minutters hjemmebaseret balanceøvelser. Interventionsgruppen vil modtage 45 minutter af individualiserede skolioseøvelser efterfulgt af 30 minutters HUBER-baseret balancetræning.
Resultatvurderinger vil blive udført ved baseline, umiddelbart efter den 4-ugers intervention og ved 3-måneders opfølgning. Det primære resultat vil være ændringer i balanceparametre målt ved hjælp af Technobody-balancesystemet (statisk og dynamisk balance, svingområde, svinghastighed og stabilitetsindeks). Sekundære resultater vil omfatte livskvalitet (SRS-22-spørgeskema), postural asymmetri (DIERS 4D Formetric), dynamisk balance vurderet ved hjælp af Fukuda-trintesten og statisk balancepræstation (unipodal balancetest for højre og venstre ben hver for sig).
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Yenimahalle
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Ankara, Yenimahalle, Tyrkiet (Türkiye), 06170
- Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Alder mellem 10 og 17 år
- Diagnose af idiopatisk skoliose hos unge bekræftet af en specialist i fysikalsk medicin
- Ingen tidligere brug af korsetbehandling
- Radiologisk evaluering viser en Cobb-vinkel mellem 10° og 25°
Eksklusionskriterier:
- Medfødt skoliose
- Neuromuskulær skoliose
- Tidligere rygradskirurgi (herunder indgreb vedrørende paravertebrale muskler eller andre spinale operationer)
- Metabol knoglesygdom, der påvirker skeletstrukturen
- Svær autoimmun eller endokrinologisk sygdom
- Bindevævssygdom eller skeletdysplasi
- Psykisk retardering, der forhindrer forståelse af simple instruktioner
- Fremskreden perifer leddegigt
- Samtidig polyneuropati
- Samtidig myopati
- Central nervesystemsygdom, der kan påvirke balancen
- Tidligere maveoperation eller abdominalt traume
- Yderligere kroniske komorbiditeter
- Manglende forældresamtykke til deltagelse i studiet
- Funktionel skoliose
- Nuværende eller tidligere brug af korset
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: Individualized Conservative Scoliosis Exercises + HUBER® 360 Feedback Balance Training
Participants in this arm receive 40 minutes of clinic-based, physiotherapist-supervised individualized conservative scoliosis exercises followed by 30 minutes of HUBER® 360-based feedback balance training in the clinic.
Sessions are delivered three times per week for 4 weeks (12 sessions in total) by a physiotherapist on a one-to-one basis.
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Participants complete 30-minute balance training sessions on the HUBER® 360 Evolution multi-axial neuromuscular training platform (LPG Systems, Valence, France).
The platform delivers real-time visual biofeedback on weight distribution and applied force through force sensors in the handles and an integrated screen.
The protocol focuses on stretching the posterior chain, opening and increasing the concavity, and reinforcing the convexity.
Sessions are supervised by a physiotherapist on a one-to-one basis.
Participants perform 40-minute supervised exercise sessions tailored to each patient's curve pattern, apex location, and clinical findings.
The program includes posture exercises, pelvic tilt, symmetric extension, scapular adduction with pectoral stretching, asymmetric lateral stretching, Cotrel exercise, flexibility and strengthening exercises, and active three-dimensional postural correction.
All sessions are delivered one-to-one by a physiotherapist experienced in scoliosis rehabilitation.
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Aktiv komparator: Individualized Conservative Scoliosis Exercises + Home-Based Balance Exercise Program
Participants in this arm receive 40 minutes of clinic-based, physiotherapist-supervised individualized conservative scoliosis exercises three times per week for 4 weeks (12 clinic sessions in total).
In addition, participants perform a 30-minute structured home-based balance exercise program three times per week for the same 4-week period.
The home-based balance program is taught in detail by a physiotherapist prior to the intervention period and performed independently by the participant at home.
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Participants complete a 30-minute structured home-based balance exercise program three times per week for 4 weeks.
The program is taught in detail by a physiotherapist prior to the intervention period and performed independently by the participant at home.
It includes bilateral and unilateral stance exercises, balance tasks with eyes open and closed, exercises on different surfaces, and controlled weight-shifting tasks, organized according to a progressive difficulty principle.
No device-based or real-time biofeedback is used.
Participants perform 40-minute supervised exercise sessions tailored to each patient's curve pattern, apex location, and clinical findings.
The program includes posture exercises, pelvic tilt, symmetric extension, scapular adduction with pectoral stretching, asymmetric lateral stretching, Cotrel exercise, flexibility and strengthening exercises, and active three-dimensional postural correction.
All sessions are delivered one-to-one by a physiotherapist experienced in scoliosis rehabilitation.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Change in Stability Index measured by the TecnoBody balance system
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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The primary outcome is the change in the Stability Index measured by the TecnoBody ProKin PK252 stabilometric platform (TecnoBody S.r.l., Dalmine, Italy).
The Stability Index reflects overall postural control during a multi-axial dynamic balance task on the TecnoBody platform, where lower values indicate better postural stability.
This parameter is conceptually comparable to the Overall Stability Index (OSI) reported by the Biodex Balance System, which was used as the reference source for the a priori sample size calculation.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Change in Mediolateral Standard Deviation of the Center of Pressure (CoP)
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Mediolateral postural sway variability is assessed during quiet standing on the TecnoBody ProKin PK252 stabilometric platform.
The standard deviation of the medio-lateral component of the CoP trajectory is computed in millimeters, with lower values indicating reduced lateral postural sway.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Change in Romberg Area Ratio
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Visual contribution to postural balance is quantified using the Romberg area ratio, calculated as the ratio of the eyes-closed CoP sway area to the eyes-open CoP sway area, both measured by the TecnoBody ProKin PK252 stabilometric platform.
Higher ratios indicate greater visual dependence for postural control.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Change in Limits of Stability (LOS)
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Functional dynamic balance is assessed using the Limits of Stability (LOS) test on the TecnoBody ProKin PK252 stabilometric platform.
Participants perform controlled weight shifts toward eight directional targets, and the test result is expressed as the percentage of successfully reached targets within a fixed time.
Higher LOS values indicate greater dynamic balance capacity.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Change in Postural Asymmetry Measured by the DIERS Formetric 4D Rasterstereographic Surface Topography System
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Postural asymmetry and three-dimensional spinal alignment are assessed using the DIERS Formetric 4D system (DIERS International GmbH, Wiesbaden, Germany), a validated, radiation-free rasterstereographic surface topography method that reconstructs the three-dimensional shape of the back from projected light patterns.
Pre-specified parameters include scoliosis angle, coronal and sagittal trunk imbalance, pelvic obliquity, pelvic torsion, kyphotic and lordotic angles, vertebral surface rotation, and lateral deviation.
For all parameters, values closer to zero indicate greater postural symmetry
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Change in Unipodal Balance Test Performance
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Static balance will be assessed using the Unipodal Balance Test.
The duration (in seconds) that the participant is able to maintain balance on the right and left leg separately will be recorded.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Change in Health-Related Quality of Life Measured by the Scoliosis Research Society-22 Patient Questionnaire (SRS-22)
Tidsramme: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Health-related quality of life is assessed using the Scoliosis Research Society-22 Patient Questionnaire (SRS-22), a validated patient-reported outcome measure for adolescent idiopathic scoliosis.
Four domains (function/activity, pain, self-image/appearance, mental health) and a total score derived from these four domains are analyzed.
The original instrument's fifth domain (satisfaction with management) is excluded because it cannot be administered at baseline.
Each item is rated on a 5-point Likert scale, and a mean score is calculated for each domain and as a total.
Possible scores range from a minimum of 1 to a maximum of 5, with higher scores indicating better health-related quality of life.
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Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Demografiske karakteristika for deltagere
Tidsramme: Baseline
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Demografiske data inklusive alder, køn, højde, vægt og kropsmasseindeks (BMI) vil blive indsamlet for at beskrive undersøgelsespopulationen og for at undersøge potentielle sammenhænge med balanceudfald.
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Baseline
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studiestol: Ece Ünlü Akyüz, MD, Professor, Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
- Studieleder: Damla Cankurtaran, MD, Associate Professor, Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
Publikationer og nyttige links
Generelle publikationer
- Le Berre M, Guyot MA, Agnani O, Bourdeauducq I, Versyp MC, Donze C, Thevenon A, Catanzariti JF. Clinical balance tests, proprioceptive system and adolescent idiopathic scoliosis. Eur Spine J. 2017 Jun;26(6):1638-1644. doi: 10.1007/s00586-016-4802-z. Epub 2016 Nov 14.
- Shen X, Yang Z, Zhang P, Xu Y, Wang J. Effects of balance training combined with Schroth therapy on adolescents with mild idiopathic scoliosis: A six-week randomized controlled trial. J Back Musculoskelet Rehabil. 2023;36(6):1365-1373. doi: 10.3233/BMR-220383.
- Abdel-Aziem AA, Abdelraouf OR, Ghally SA, Dahlawi HA, Radwan RE. A 10-Week Program of Combined Hippotherapy and Scroth's Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study. Children (Basel). 2021 Dec 30;9(1):23. doi: 10.3390/children9010023.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- AEŞH-EK-2025-0136
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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