针对特发性脊柱侧凸青少年的反馈式平衡训练

实验性的：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.

行为的：HUBER® 360 Balance Training

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.

行为的：Individualized Conservative Scoliosis Exercises

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.

有源比较器：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.

行为的：Home-Based Balance Exercise Program

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.

行为的：Individualized Conservative Scoliosis Exercises

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.

Change in Stability Index measured by the TecnoBody balance system

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.

Change in Mediolateral Standard Deviation of the Center of Pressure (CoP)

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.

Change in Romberg Area Ratio

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.

Change in Limits of Stability (LOS)

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.

Change in Postural Asymmetry Measured by the DIERS Formetric 4D Rasterstereographic Surface Topography System

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

Change in Unipodal Balance Test Performance

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.

Change in Health-Related Quality of Life Measured by the Scoliosis Research Society-22 Patient Questionnaire (SRS-22)

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.

参与者的人口统计学特征

将收集包括年龄、性别、身高、体重和身体质量指数（BMI）在内的人口统计学数据，以描述研究人群并探索与平衡结果之间的潜在相关性。