Schroth Exercises Alone Versus Schroth Exercises Integrated With Dynamic Stabilization
Schroth Exercises Alone Versus Schroth Exercises Integrated With Dynamic Stabilization in Adolescent Idiopathic Scoliosis: An Assessor-Blinded Randomized Controlled Trial
This assessor-blinded, parallel-group randomized controlled trial compared Schroth exercises alone with Schroth exercises integrated with dynamic (core, pelvic and scapular) stabilization exercises in adolescents aged 10-19 years with idiopathic scoliosis (Cobb angle 10°-40°). Fifty participants were randomized 1:1. Both groups received 16 individualized, one-to-one supervised sessions of approximately 60 minutes (2 sessions per week for 8 weeks) with total session time matched; in the integrated group, about 15 minutes of each 50-minute exercise block were allocated to stabilization exercises instead of Schroth exercises. A home exercise programme was prescribed on 2 additional days per week in both groups. The primary outcome was health-related quality of life measured with the Scoliosis Research Society-22 questionnaire (modified 20-item total). Secondary outcomes were self-perceived deformity (Spinal Appearance Questionnaire), postural awareness (Postural Awareness Scale), thoracic and lumbar angle of trunk rotation (scoliometer) and sleep quality (Pittsburgh Sleep Quality Index), assessed at baseline and at 8 weeks.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Participants were recruited at a single private physiotherapy and wellness centre in Bursa, Türkiye, between 13 December 2024 and 20 June 2025. Allocation was performed at enrolment by drawing sealed, opaque, sequentially numbered envelopes (25 per arm) prepared and held by an independent researcher; the outcome assessor and the data analyst were blinded to allocation. Exercises were individualized to curve direction and pattern and performed as 2 sets of 10 repetitions with Schroth rotational breathing. Attendance was logged at every session; adverse events were screened before and after each session. Between-group differences at 8 weeks were analysed by analysis of covariance with the baseline value as covariate.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Bursa, Turkije (Türkiye)
- Bursa Eforfiz Healthy Living Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Age 10-19 years
- Radiologically confirmed idiopathic scoliosis with Cobb angle 10°-40°
- No previous scoliosis surgery
- No systemic condition precluding participation in an exercise programme
- Willingness of the participant and (for minors) the parent/legal guardian to attend regular sessions and provide written informed consent/assent
Exclusion Criteria:
- Cobb angle above 40°
- Previous spinal surgery
- Cognitive impairment preventing understanding or performance of the exercises
- Inability to commit to the study schedule
- Current brace use
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Actieve vergelijker: Schroth alone (Sc)
Individualized, curve-specific Schroth exercises, delivered one-to-one by a physiotherapist: 2 supervised sessions/week for 8 weeks (16 sessions, ≈60 min each: 5 min preparation, 50 min Schroth exercises, 5 min cool-down). Home exercise programme prescribed on 2 additional days/week. |
Three-dimensional, curve-specific Schroth exercises (auto-elongation, rotational angular breathing, scapular and pelvic counter-corrections, rib-cage de-rotation) in lying, sitting, kneeling and standing, using a pole, elastic band, wall bar, chair and positioning pads; 2 sets of 10 repetitions each with prolonged exhalation; verbal correction throughout. Progression by reducing external support and increasing active self-correction. |
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Experimenteel: Schroth integrated with dynamic stabilization (ScSt)
Same session structure, frequency and duration as the Sc arm (16 supervised sessions, ≈60 min). The 50-min exercise block is divided into ≈35 min of curve-specific Schroth exercises and ≈15 min of core, pelvic and scapular stabilization exercises. Home exercise programme prescribed on 2 additional days/week. |
Three-dimensional, curve-specific Schroth exercises (auto-elongation, rotational angular breathing, scapular and pelvic counter-corrections, rib-cage de-rotation) in lying, sitting, kneeling and standing, using a pole, elastic band, wall bar, chair and positioning pads; 2 sets of 10 repetitions each with prolonged exhalation; verbal correction throughout. Progression by reducing external support and increasing active self-correction. Core, pelvic and scapular stabilization exercises integrated with Schroth breathing: supine leg slide with pole, supine bracing with scapular setting, elastic-band pull-apart with overhead raise, wall-supported diagonal band pull; 2 sets of 10 repetitions; side of execution matched to curve direction. Approximately 15 minutes per session. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Scoliosis Research Society-22 (SRS-22) questionnaire, modified 20-item total
Tijdsspanne: Baseline and 8 weeks (end of intervention)
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Health-related quality of life. Items 1-20 in four domains (function/activity, pain, self-image/appearance, mental health), each scored 1-5; domain score = mean of its five items; total = mean of the four domain means (range 1-5; higher = better quality of life). The satisfaction-with-management domain (items 21-22) is not included. Turkish version. |
Baseline and 8 weeks (end of intervention)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Spinal Appearance Questionnaire (SAQ)
Tijdsspanne: Baseline and 8 weeks
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Self-perceived spinal deformity; items scored 1-5; total = mean of items (lower = more favourable perception). Turkish version. |
Baseline and 8 weeks
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Change in Postural Awareness Scale (PAS)
Tijdsspanne: Baseline and 8 weeks
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Awareness of one's own posture; 12 items scored 0-5; total 0-60 (higher = greater awareness). Turkish translation of the original scale. |
Baseline and 8 weeks
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Change in thoracic angle of trunk rotation (ATR)
Tijdsspanne: Baseline and 8 weeks
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Measured in Adam's forward-bend position with a fluid-filled inclinometer (scoliometer), 0°-30°, mean of three measurements (lower = better). |
Baseline and 8 weeks
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Change in lumbar angle of trunk rotation (ATR)
Tijdsspanne: Baseline and 8 weeks
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As above, lumbar region. |
Baseline and 8 weeks
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Change in Pittsburgh Sleep Quality Index (PSQI)
Tijdsspanne: Baseline and 8 weeks
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Sleep quality over the previous month; seven components scored 0-3; global score 0-21 (higher = poorer sleep; >5 indicates poor sleep quality). Turkish version. |
Baseline and 8 weeks
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie stoel: Sude Asya ALŞAN MOVAHHEDİ, Uskudar University
Publicaties en nuttige links
Algemene publicaties
- Almahmoud OH, Baniodeh B, Musleh R, Asmar S, Zyada M, Qattousah H. Overview of adolescent idiopathic scoliosis and associated factors: a scoping review. Int J Adolesc Med Health. 2023 Nov 21;35(6):437-441. doi: 10.1515/ijamh-2023-0166. eCollection 2023 Dec 1.
- Mohamed N, Acharya V, Schreiber S, Parent EC, Westover L. Effect of adding Schroth physiotherapeutic scoliosis specific exercises to standard care in adolescents with idiopathic scoliosis on posture assessed using surface topography: A secondary analysis of a Randomized Controlled Trial (RCT). PLoS One. 2024 Apr 30;19(4):e0302577. doi: 10.1371/journal.pone.0302577. eCollection 2024.
- Gan X, Liu X, Cai D, Zhang R, Li F, Fang H, Huang J, Qiu C, Zhan H. Wearable accelerometers reveal objective assessment of walking symmetry and regularity in idiopathic scoliosis patients. PeerJ. 2024 Jul 16;12:e17739. doi: 10.7717/peerj.17739. eCollection 2024.
Studie record data
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Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- Uskudar18
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
Participants were minors and the approved informed consent form states that personal data will not be shared with third parties; individual participant data will therefore not be shared. Summary data are available from the corresponding author on reasonable request.
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