- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07430098
Feedback-baserad balansträning för ungdomar med idiopatisk skolios
Effekten av att lägga till feedbackbaserad balansträning till individuellt anpassade konservativa skoliosövningar jämfört med enbart individuellt anpassade konservativa skoliosövningar på balansen hos ungdomar med idiopatisk skolios: En prospektiv, randomiserad kontrollerad studie
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
Adolescent idiopatisk skolios (AIS) är den vanligaste formen av skolios som uppträder under tillväxtperioden. Tidigare studier som jämför individer med AIS med friska kontroller har visat betydande förändringar i balansmönster, och flera undersökningar har utvärderat balansparametrar med posturografi som svar på träningsbaserade interventioner.
Till exempel rapporterade Osama et al. (2021) att kombinationen av hippoterapi och Schroth-övningar resulterade i större förbättringar i postural asymmetri och balans jämfört med enbart Schroth-övningar. På liknande sätt visade Shen et al. (2023) att integrering av balansträning med Schroth-terapi hos ungdomar med idiopatisk skolios ledde till betydande förbättringar i rotationsvinkel i ryggraden, Cobb-vinkel, livskvalitet och övergripande balansfunktion.
Men hittills har ingen studie undersökt effekterna av balansträning med HUBER® 360-systemet på balansutfall i denna population. Därför syftar denna studie till att utvärdera effekten av att lägga till balansträning med HUBER® 360-systemet till skolios-specifika övningar på balansen hos ungdomar med idiopatisk skolios.
Interventionsprotokollet kommer att bestå av 12 sessioner som ges över 4 veckor, med övningar som utförs tre gånger per vecka. Deltagarna kommer att slumpmässigt tilldelas till två grupper. Kontrollgruppen kommer att få 45 minuter av individuella skoliosövningar följt av 30 minuter av hembaserad balansträning. Interventionsgruppen kommer att få 45 minuter av individuella skoliosövningar följt av 30 minuter av HUBER-baserad balansträning.
Utfallsmätningar kommer att utföras vid baslinje, omedelbart efter den 4-veckors interventionen och vid 3-månadersuppföljningen. Det primära utfallet kommer att vara förändringar i balansparametrar mätta med Technobody balanssystem (statisk och dynamisk balans, svajyta, svajhastighet och stabilitetsindex). Sekundära utfall kommer att inkludera livskvalitet (SRS-22 frågeformulär), postural asymmetri (DIERS 4D Formetric), dynamisk balans bedömd med Fukuda stegtest, och statisk balansprestation (unipodal balanstest för höger och vänster ben separat).
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
Yenimahalle
-
Ankara, Yenimahalle, Turkiet (Türkiye), 06170
- Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Barn
Tar emot friska volontärer
Beskrivning
Inklusionskriterier:
- Ålder mellan 10 och 17 år
- Diagnos av idiopatisk skolios hos tonåringar bekräftad av specialist i fysikaliska medicin
- Ingen tidigare behandling med ortopedisk korsett
- Radiologisk utvärdering som visar Cobb-vinkel mellan 10° och 25°
Exklusionskriterier:
- Medfödd skolios
- Neuromuskulär skolios
- Tidigare ryggkirurgi (inklusive ingrepp som involverar paravertebrala muskler eller andra ryggoperationer)
- Förekomst av metabola skelettsjukdomar som påverkar skelettstrukturen
- Allvarlig autoimmun eller endokrinologisk sjukdom
- Bindvävssjukdom eller skelettdysplasi
- Psykisk utvecklingsstörning som förhindrar förståelse av enkla instruktioner
- Avancerad perifer ledssjukdom
- Samtidig polyneuropati
- Samtidig myopati
- Centralnervsjukdom som kan påverka balansen
- Tidigare bukkirurgi eller buktrauma
- Förekomst av ytterligare kroniska komorbiditeter
- Brist på föräldrars samtycke för deltagande i studien
- Funktionell skolios
- Nuvarande eller tidigare användning av ortopedisk korsett
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Enda
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: 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.
|
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.
|
|
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.
|
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.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Change in Stability Index measured by the TecnoBody balance system
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Change in Mediolateral Standard Deviation of the Center of Pressure (CoP)
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
|
Change in Romberg Area Ratio
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
|
Change in Limits of Stability (LOS)
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
|
Change in Postural Asymmetry Measured by the DIERS Formetric 4D Rasterstereographic Surface Topography System
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
|
Change in Unipodal Balance Test Performance
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
|
Change in Health-Related Quality of Life Measured by the Scoliosis Research Society-22 Patient Questionnaire (SRS-22)
Tidsram: Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
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.
|
Baseline (T0), immediately post-intervention (T1, week 4), and at 12-week follow-up (T2, week 16)
|
Andra resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Demografiska egenskaper hos deltagarna
Tidsram: Baslinje
|
Demografiska data inklusive ålder, kön, längd, vikt och kroppsmassaindex (BMI) kommer att samlas in för att beskriva studiepopulationen och för att utforska potentiella korrelationer med balansutfall.
|
Baslinje
|
Samarbetspartners och utredare
Sponsor
Utredare
- Studiestol: Ece Ünlü Akyüz, MD, Professor, Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
- Studierektor: Damla Cankurtaran, MD, Associate Professor, Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
Publikationer och användbara länkar
Allmänna 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.
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Andra studie-ID-nummer
- AEŞH-EK-2025-0136
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Studerar en amerikansk FDA-reglerad produktprodukt
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .