Abstract
BackgroundIdiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis.Methods/designPatients: Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25–40 degrees will be included. A total of 135 participants will be randomly allocated in groups of 45 patients each to receive one of the three interventions.Interventions: All three groups will receive a physical activity prescription according to the World Health Organisation recommendations. One group will additionally wear a hyper-corrective night-time brace. One group will additionally perform postural scoliosis-specific exercises.Outcome: Participation in the study will last until the curve has progressed, or until cessation of skeletal growth. Outcome variables will be measured every 6 months. The primary outcome variable, failure of treatment, is defined as progression of the Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity Questionnaire (IPAQ) short form, and Cobb angle at end of the study.DiscussionThis trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis.Trial registrationNCT01761305
Highlights
Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents
This trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis
Idiopathic scoliosis occurs in otherwise healthy children and is often diagnosed at the time of the pubertal growth spurt
Summary
Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis. Adolescent idiopathic scoliosis (AIS) is a three-dimensional structural deformation of the spine and trunk with lateral shift and rotation of the vertebrae [1]. Idiopathic scoliosis occurs in otherwise healthy children and is often diagnosed at the time of the pubertal growth spurt. The aim is to find the children with moderate scoliosis These are often treated with a brace to prevent progression to severe scoliosis. More severe curves are treated with spinal fusion surgery. The spinal curve is corrected and fused with limitation in mobility as a result
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