Idiopathic Scoliosis: The Harms Study Group Tre...
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Layout table for study information Study Type : Interventional (Clinical Trial) EstimatedEnrollment : 172 participants Allocation: Non-Randomized Intervention Model: Parallel Assignment Masking: Single (Outcomes Assessor) Primary Purpose: Treatment Official Title: A Prospective Clinical Study on the Efficacy of a Three-dimensionally Corrective Exercise Therapy for Scoliosis Actual Study Start Date : October 30, 2020 Estimated Primary Completion Date : December 31, 2021 Estimated Study Completion Date : September 30, 2022 Resource links provided by the National Library of Medicine MedlinePlus related topics: Exercise for Children Scoliosis U.S. FDA Resources Arms and Interventions Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Arm Intervention/treatment Experimental: Three-dimensionally corrective exercise for scoliosisExperimental group will perform three-dimensionally corrective exercise for scoliosis for a 60-min period for 1-2 times a week under the guidance of physical therapist in an outpatient clinic, and a 40-min period per day under the supervision of the parents at home.For moderate patients, additional brace treatment for more than 22 hours a day.The treatment regimens lasted for 12 months. Behavioral: Three-dimensionally corrective exercise for scoliosisThree-dimensionally corrective exercise for scoliosis is based the theory of physiotherapeutic scoliosis specific exercises, which focus on 3-dimension self-correction and consists of two parts:1)outpatient treatment including stretching, three-dimensional auto-correction(combine with specific breathing mode, isometric training to correct abnormal spinal physiological curvatures in sagittal plane, and accompany with wedge pad to modify humpback, waist asymmetry, pelvic rotation in horizontal. While in coronal plane, longitudinal axial stretching, pelvic adjustments will be conducted to reduce the lateral curvature.), balance and stability training, combined with manual fascia relaxation therapy, and and breathing training; 2)family rehabilitation: combines self-correcting gymnastics with daily posture management, etc., forming the individual exercise approach for each patient. Active Comparator: Conventional exerciseControl subjects will perform conventional exercise for a 60-min period for 1-2 times a week under the guidance of physical therapist in an outpatient clinic, and a 40-min period per day under the supervision of the parents at home. For moderate patients, additional brace treatment for more than 22 hours a day.The treatment regimens lasted for 12 months. Behavioral: Conventional exerciseConventional exercise consists a series of spine exercises focusing on core strength training. Outcome Measures Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Primary Outcome Measures : Change of Cobb angle [ Time Frame: up to 12 months ]It is recommended that curve magnitude of scoliosis is measured using the Cobb method. The Cobb angle will be measured on the standing frontal radiograph according to the Cobb method by the physician specializing in the treatment of scoliosis. Secondary Outcome Measures : Angle of trunk rotation [ Time Frame: up to 12 months ]The angle of trunk rotation will be measured with a Scoliometer. Patients will be asked to bend forward, and the physician will measure the angle of trunk rotation using the Scoliometer. Sagittal index [ Time Frame: up to 12 months ]The Sagittal index (SI) is the sum of plumbline distances from C7 and L3. When SI90 mm is considered to kyphosis. Forced vital capacity [ Time Frame: up to 12 months ]Forced vital capacity (FVC) is an established measure of pulmonary function. Forced expiratory volume in first second [ Time Frame: up to 12 months ]Forced expiratory volume in first second is an established measure of pulmonary function. Peak oxygen uptake [ Time Frame: up to 12 months ]Peak oxygen uptake is recognised as the best expression of exercise endurance and will be measured by cardiopulmonary exercise testing. Scoliosis Research Society-22 (SRS-22) questionnaire score [ Time Frame: up to 12 months ]Scoliosis Research Society-22 (SRS-22) questionnaire was designed for patients with scoliosis specially , which consists of 22 items with 5 dimensions: function/activity, pain, self-Image, mental health, and satisfaction with treatment. The higher scores mean a better outcome. Eligibility CriteriaGo to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Layout table for eligibility information Ages Eligible for Study: 8 Years to 16 Years (Child) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria(meet all the following conditions):
Conservative approaches such as Schroth exercises and core stabilization exercises showed effective results in the treatment of idiopathic scoliosis. This study aimed to critically evaluate the magnitude effect of Schroth and core stabilization exercises using a systematic review and meta-analysis.
This study has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The following three databases were searched for articles collection: Web of Science, PubMed, and Google Scholar. The key search terms were: Schroth exercise, core exercise, idiopathic scoliosis, Cobb angle, angle of trunk rotation, and quality of life. The articles included in our study was limited to original articles written only in English that met the following inclusion criteria: (1) Participants with idiopathic scoliosis; (2) Schroth exercises and core stabilization exercises used as interventions; (3) Cobb angle or angle of trunk rotation or quality of life used as outcome measures.
The current systematic review and meta-analysis indicates that both Schroth method and core stabilization exercises have a positive effect in subjects with idiopathic scoliosis. Subgroup analysis showed that the Schroth method had a larger effect size than the core stabilization exercises.
PICOS (Population, Interventions, Comparators, Outcomes, Study Designs) eligibility criteria described in PRISMA were adopted for inclusion/exclusion of the studies [20]. To be included in our study, the articles had to meet the following inclusion criteria: (1) Participants with idiopathic scoliosis; (2) Schroth exercises and core stabilization exercises used as interventions; and (3) Cobb angle or angle of trunk rotation (ATR) or quality of life (QoL) used as the outcome measures. The inclusion of articles in our study was limited to original articles written only in English. The inclusion/exclusion of studies was carried out by two investigators by consultation and consensus.
Figures 2 and 3 present the summary of the risk of bias for each included study. For the item of random sequence generation, twelve studies were randomized controlled trials, while one study did not report information regarding the randomization process [16] as shown in Risk of bias (Fig. 3). The item concerning the allocation concealment to the group was unclear in one study [18]. Because of the nature of the intervention, participants and investigators could not be blinded to the treatment, but one study reports that it used blinding [9]. For outcome blinding, four studies adopted a single-blind method to evaluate the intervention measures [3, 24,25,26]. All studies had low risk in incomplete outcome data. One study had unclear risk in selective reporting, while 12 studies had low risk. Because of objective outcome measures, outcome data were considered at low risk in 12 studies [27].
This study addressed two conservative methods used in the treatment of subjects with IS. The current meta-analysis indicates that Schroth method and core stabilization exercises have a positive effect on subjects with IS. Depending on the outcome, the magnitude of the effect ranged from small to almost large. Subgroup analysis showed that the Schroth method had a larger effect size than the core stabilization exercises. Of the four outcomes we used in our meta-analysis, the most representative result is an estimate of the effect size for Cobb angle, as 11 studies participated in the analysis. We believe that our meta-analysis would be a good tool for specialist in physical activity, physiotherapists, and clinicians in solving IS-related problems, as well as an incentive for further work and future research.
In this study, the pre and post exercise FMS scores were significantly different in both the SERME and SE group. In a previous study on FMS, a significant improvement in FMS scores was reported after conducting corrective exercise in athletes [23]. The ability to perform was enhanced more in athletes with a FMS score of 14 or higher than those with a lower FMS score [24]. The risk of injury was higher if the FMS score was below 14 points [25]. In addition, there is a correlation between respiratory pattern abnormality and FMS scores, and those with respiratory problems reported low FMS scores [26]. FMS is constructed with fundamental movements to detect the motor control ability of fundamental movements and actions. While making a FMS movement, the limitation, asymmetry and defects of such movement should be monitored and then, linked with its results. More precise measurements can be us