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Virtual Reality-based Schroth Exercise Versus Traditional Schroth Exercise on Trunk Kinematics in Scoliosis

26. august 2026 oppdatert av: hend samy saeed hassan, Cairo University

Virtual Reality-based Schroth Exercise Versus Traditional Schroth Exercise on Trunk Kinematics and Quality of Life in Scoliosis

The study will be conducted to compare three-dimensional trunk kinematics (rotation, tilt, and flexion/extension) and quality of life among adolescents with idiopathic scoliosis receiving traditional Schroth physiotherapeutic scoliosis-specific exercises, Schroth exercises combined with immersive virtual reality using Meta Quest 2 (OhShape), and Schroth exercises combined with low-cost mobile virtual reality using Google Cardboard with a gaze-controlled game.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Physiotherapeutic scoliosis-specific exercises (PSSE), particularly the Schroth method, are widely recommended as a first-line conservative treatment for adolescent idiopathic scoliosis and have demonstrated effectiveness in reducing curve progression, improving posture, and enhancing quality of life. However, the long-term success of Schroth rehabilitation is highly dependent on patient adherence and the accurate execution of complex three-dimensional corrective postures, which remain challenging for adolescents to maintain outside supervised clinical settings.

Poor adherence to traditional Schroth programs has been reported, with rates ranging between 30% and 50%, limiting the real-world effectiveness of conservative scoliosis management. Adolescents frequently report low motivation, boredom, and difficulty understanding or maintaining corrective postures without continuous feedback, which compromises motor learning and postural control.

Digital rehabilitation technologies, particularly virtual reality (VR), have emerged as promising tools to enhance engagement, motivation, and motor learning in rehabilitation programs. VR-based exercise has demonstrated positive effects on adherence, movement accuracy, and postural awareness in neurological and musculoskeletal rehabilitation. Immersive VR platforms provide real-time visual and auditory feedback and promote task-oriented training in an engaging gaming environment, which is particularly suitable for adolescent populations.

To date, no randomized controlled trial has directly compared immersive high-end VR platforms with low-cost mobile VR solutions for the delivery of scoliosis-specific exercises, nor has any study quantified real-time trunk kinematics during VR-guided Schroth rehabilitation using Wearable inertial measurement units (IMUs) technology. Evaluating these interventions may provide clinicians with valuable insight into cost-effective, scalable, and engaging rehabilitation strategies for adolescents with idiopathic scoliosis, particularly in resource-limited healthcare settings

Studietype

Intervensjonell

Registrering (Antatt)

54

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Egypt
      • Cairo, Egypt
        • Cairo University
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Age: 10-19 years.
  • Diagnosed adolescent idiopathic scoliosis (AIS) confirmed by spinal radiography .
  • Cobb angle between 20° and 35° (moderate curve, below surgical threshold).
  • No prior spinal surgery.
  • Ability to perform Schroth exercises independently.
  • Ability to use a virtual reality headset.
  • No prior virtual reality experience.
  • Free from pain or pain less than 8 on visual analogue scale.
  • Type of curve (thoracolumbar s scoliosis).

Exclusion Criteria:

  • Secondary scoliosis (neuromuscular or post-surgical scoliosis).
  • Severe structural deformity (Cobb angle >50° or severe vertebral rotation).
  • Neurological or neuromuscular disorders affecting balance or proprioception.
  • Active orthopedic injury or recent surgery (<2 years) involving the spine or lower extremities.
  • Severe cardiopulmonary disease contraindicating exercise.
  • Uncontrolled pain (Visual Analog Scale >8).
  • Current participation in another structured spinal rehabilitation program or participation within the last 6 months.
  • History of severe cybersickness or prior intolerance to virtual reality exposure.
  • Vision or hearing impairment preventing interaction with virtual reality--based games

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Traditional supervised exercise group
participants will perform traditional supervised Schroth physiotherapeutic scoliosis-specific exercises for 45 minutes.
Annen: Traditional schroth supervised exercise
participants will perform traditional supervised Schroth physiotherapeutic scoliosis-specific exercises. The intervention consists of two supervised sessions per week, 45 minutes each, for 12 weeks
Eksperimentell: Schroth scoliosis-specific exercises and OhShape virtual reality group
Participants will perform identical Schroth physiotherapeutic scoliosis-specific exercises in addition of integration into the OhShape virtual reality gameplay environment for 45 minutes
Annen: Traditional schroth supervised exercise
participants will perform traditional supervised Schroth physiotherapeutic scoliosis-specific exercises. The intervention consists of two supervised sessions per week, 45 minutes each, for 12 weeks
Annen: OhShape virtual reality gameplay environment
OhShape is a posture-matching rhythm-based VR game that requires users to perform precise trunk and body movements in response to visual and auditory cues, thereby promoting postural awareness, motor coordination, and movement accuracy. The Meta Quest 2 headset provides a fully immersive virtual reality experience with six degrees of freedom (6DOF) head and body tracking, allowing real-time spatial interaction and posture-based feedback during exercise execution.
Eksperimentell: Schroth scoliosis specific exercise and Google Cardboard Mobile virtual reality Zombie Shooter
Participants will perform identical Schroth physiotherapeutic scoliosis-specific exercises in addition of a low-cost mobile virtual reality intervention delivered via Google Cardboard for 45 minutes.
Annen: Traditional schroth supervised exercise
participants will perform traditional supervised Schroth physiotherapeutic scoliosis-specific exercises. The intervention consists of two supervised sessions per week, 45 minutes each, for 12 weeks
Annen: Google Cardboard Mobile Virtual reality Zombie Shooter
It is a low-cost mobile virtual reality (VR) intervention delivered via Google Cardboard. A custom Unity-based zombie-shooting VR game will be used, in which participants are required to maintain the corrected Schroth posture while engaging in a gaze-controlled shooting task, using head and trunk alignment to aim and interact with virtual targets. Mobile VR platforms such as Google Cardboard provide three degrees of freedom (3DOF) tracking and represent an accessible, low-cost alternative to high-end immersive VR systems.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Trunk kinematics: Trunk rotation angle (Yaw)
Tidsramme: 16 weeks
Derived from gyroscope data(gyroZ) using wearable inertial measurement units (IMUs) to measure dynamic rotation toward midline during exercise execution.
16 weeks

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Trunk kinematics: trunk tilt angle (roll/ pitch)
Tidsramme: 16 weeks
derived from accelerometer data (accX, accY) using IMUs to assess frontal plane trunk asymmetry correction during exercise execution.
16 weeks
Trunk Kinematics: Trunk flexion/ extension angle
Tidsramme: 16 weeks
Derived from accelerometer data relative to gravity using wearable inertial measurement unit (IMUs) to monitor sagittal plane alignment during exercise execution.
16 weeks
Corrected posture holding time
Tidsramme: 16 weeks
The cumulative duration (seconds ) and percentage of session time during which participants maintain the predefined curve specific corrected trunk posture within acceptable angular deviation threshold, quantified via real-time 50 Hz.
16 weeks
Health related quality of life (SRS-22r)
Tidsramme: 16 weeks
Assessed using the scoliosis research society-22r questionnaire mean domain scores evaluating pain, self image, function, mental health and satisfaction. The score is graded from 1 to 5; 1 means the worst and 5 means the best quality of life.
16 weeks
pediatric health utility (EQ-5D-Y and EQ-VAS)
Tidsramme: 16 weeks
Assessed using the EuroQol 5 dimention youth version utility scores and the self rated EuroQol visual analogue scale (0-100) to measure overall health status. 0 means the worst and 100 means the best health.
16 weeks
Trial retention rate
Tidsramme: 16 weeks
To assess feasibility, calculated as the percentage of randomized participants who successfully complete post treatment assessment and follow-up periods.
16 weeks
intervention adherence rate
Tidsramme: 16 weeks
Quantified using clinic attendance logs calculated as (attended sessions / scheduled sessions)*100 to categorize participants into high, moderate or low adherence.
16 weeks
Safety and incidence of adverse events
Tidsramme: 16 weeks
Percentage of participants experiencing treatment related adverse events such as muscle strain or safe withdrawals from the study.
16 weeks

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Cairo University

Etterforskere

  • Studiestol: Enas youssef, professor, Cairo University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

20. februar 2027

Studiet fullført (Antatt)

28. februar 2027

Datoer for studieregistrering

Først innsendt

26. august 2026

Først innsendt som oppfylte QC-kriteriene

26. august 2026

Først lagt ut (Faktiske)

31. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

31. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

26. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • P.T.REC/012/006415

Legemiddel- og utstyrsinformasjon, studiedokumenter

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Nei

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