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

26 augusti 2026 uppdaterad 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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

Studietyp

Interventionell

Inskrivning (Beräknad)

54

Fas

  • Inte tillämpbar

Kontakter och platser

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Studiekontakt

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Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Barn
  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Traditional supervised exercise group
participants will perform traditional supervised Schroth physiotherapeutic scoliosis-specific exercises for 45 minutes.
Övrig: 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
Experimentell: 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
Övrig: 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
Övrig: 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.
Experimentell: 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.
Övrig: 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
Övrig: 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.

Vad mäter studien?

Primära resultatmått

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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Trunk kinematics: trunk tilt angle (roll/ pitch)
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 16 weeks
Percentage of participants experiencing treatment related adverse events such as muscle strain or safe withdrawals from the study.
16 weeks

Samarbetspartners och utredare

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Sponsor

Cairo University

Utredare

  • Studiestol: Enas youssef, professor, Cairo University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 september 2026

Primärt slutförande (Beräknad)

20 februari 2027

Avslutad studie (Beräknad)

28 februari 2027

Studieregistreringsdatum

Först inskickad

26 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

26 augusti 2026

Första postat (Faktisk)

31 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

31 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • P.T.REC/012/006415

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