Effects of Core Stabilization Exercises and Rotation Angular Breathing Exercises Among Idiopathic Scoliosis Patients (CSE RAB IS)

Core stabilization exercises: planks, bridges, bird dog, and dead bug Rotational angular breathing exercises: emphasizing thoracic expansion, asymmetric rib cage mobility, and postural correction through controlled inhalation and prolonged exhalation All exercises will be performed under supervised conditions initially, with emphasis on neuromuscular control, spinal stability, and coordinated breathing.

Each session will last 40 minutes, including:

3 sessions per week 12-week intervention period 5 minutes warm-up 25 minutes core stabilization exercises 10 minutes rotational angular breathing exercises

• Cool-down and postural awareness exercises

Participants in the active comparator group will receive conventional physiotherapy routinely provided for individuals with idiopathic scoliosis. The program will focus on general posture correction, flexibility, spinal mobility, and basic strengthening exercises without specialized core stabilization or rotational angular breathing techniques.

Standard Care Intervention:

General stretching exercises for trunk and lower limb muscles Active range of motion exercises for spinal mobility Conventional postural correction exercises Basic strengthening exercises for back and abdominal muscles Breathing awareness exercises without rotational angular emphasis Education regarding posture maintenance and ergonomic advice Frequency: 3 sessions per week Total Duration: 12 weeks Session Duration: 40 minutes Session Structure 5 minutes warm-up 25 minutes conventional physiotherapy exercises 5 minutes breathing and relaxation exercises 5 minutes cool-down and posture education

Participants in the control group will receive conventional physiotherapy management routinely used for idiopathic scoliosis. The intervention will focus on posture correction, spinal mobility, flexibility, general strengthening, and breathing awareness exercises without specialized core stabilization or rotational angular breathing techniques.

The program will include:

Warm-up exercises Stretching exercises for trunk and lower limb muscles Spinal mobility exercises Basic abdominal and back strengthening exercises Postural correction and ergonomic education Diaphragmatic breathing and relaxation exercises Cool-down exercises

Sessions will be supervised initially by a physiotherapist to ensure correct technique and safety.

Frequency and Duration 3 sessions per week 12-week intervention period 40 minutes per session

Session Structure 5 minutes warm-up 25 minutes conventional physiotherapy exercises 5 minutes breathing exercises 5 minutes cool-down and posture education

Cobb angle is a radiographic measure used to quantify the degree of spinal curvature in scoliosis. It is measured by identifying the most tilted vertebrae at the upper and lower ends of the curve on an anteroposterior spinal radiograph and calculating the angle between intersecting perpendicular lines drawn from these vertebrae.

Time Frame: Baseline, 4 weeks, 8 weeks and 12 weeks

Inspiratory capacity is defined as the maximum volume of air that can be inhaled after a normal expiration. It is measured using spirometry with a calibrated spirometer to assess pulmonary function and thoracic expansion.

Time Frame: Baseline, 4 weeks, 8 weeks and 12 weeks

Angle of Trunk Rotation is assessed using a scoliometer during the Adam's Forward Bend Test. The device is placed over the spine at the point of maximum deformity to quantify axial trunk rotation and rib hump prominence.

Time Frame: Baseline, 4 weeks, 8 weeks and 12 weeks

The Spinal Appearance Questionnaire is a patient-reported outcome measure that evaluates the perception of spinal deformity and cosmetic appearance. It includes domains related to trunk asymmetry, curve perception, and self-image.

Time Frame: Baseline, 4 weeks, 8 weeks and 12 weeks