Three-dimensional corrective exercise therapy for idiopathic scoliosis: study protocol for a prospective non-randomized trial

Xuan Zhou,Xiaoqing Zhu,Xin Li,Mengdie Jin,Qikai Wu,Qing Du,Haibin Guo,Juping Liang

doi:10.1186/s12891-022-05057-7

Abstract

BackgroundAlthough physiotherapeutic scoliosis-specific exercises (PSSEs) with or without other conservative treatments may improve scoliotic deformities, the evidence is insufficient. Three-dimensional corrective exercises (TDCEs) for scoliosis are based on the theory of PSSEs and are characterized by a combination of outpatient treatment and home-based exercise. This study aims to evaluate the effectiveness of TDCEs for idiopathic scoliosis (IS).MethodsThe participants will be divided into two age- and sex-matched groups: an experimental group (EG) treated with three-dimensional corrective exercise therapy (TDCET) and a control group (CG) receiving generalized exercise therapy. In each arm, mild and moderate IS cases will be reclassified based on the Cobb angle and biopsy results. The primary endpoint is the change in the largest Cobb angle; the secondary endpoints are the sagittal index, forced vital capacity, peak oxygen uptake, and peak oxygen uptake. Sixty-six patients with mild IS and 78 patients with moderate IS will be included.DiscussionThis study is the first controlled trial to systematically assess the effectiveness of TDCEs for IS. In addition to TDCET including three-dimensional corrective exercises, family rehabilitation and basic body awareness therapy may help patients adopt supportive attitudes and appropriate behaviours, thus enhancing their compliance with exercises and achieving better outcomes.Trial registrationThe study protocol was registered at www.clinicaltrials.gov (number identifier: NCT04539522). Registered on August 27, 2020.

Highlights

Physiotherapeutic scoliosis-specific exercises (PSSEs) with or without other conservative treatments may improve scoliotic deformities, the evidence is insufficient
One of the reasons for this is that many health care professionals are not conversant with the differences between generalized physiotherapy exercises and physiotherapeutic scoliosis-specific exercises (PSSEs); while the former exercises are generic exercises usually consisting of low-impact stretching and strengthening activities such as yoga, Pilates and the Alexander technique, PSSEs consist of curvespecific exercises that are individually adapted to a patient’s curve site, curve magnitude and clinical characteristics [23]
On the basis of the quality of the available studies, the final conclusion of the Cochrane review on the effect of exercises for scoliosis was that it is not possible to recommend the use of PSSEs for idiopathic scoliosis (IS) [13]

Summary

Introduction

Physiotherapeutic scoliosis-specific exercises (PSSEs) with or without other conservative treatments may improve scoliotic deformities, the evidence is insufficient. The latest review concluded that insufficient evidence is available to suggest that PSSEs with or without other conservative treatments can reduce the Cobb angle and improve trunk appearance and balance, [10] and three other reviews of studies conducted between 2005 and 2020 suggested that the few clinical trials on the effects of PSSEs on scoliotic deformities that exist are of low quality [11,12,13]. Cantele et al affirmed that quality of life and selfperception can be impaired in scoliotic girls, especially when they practise PSSEs, because PSSEs are often perceived by adolescents as stressful, boring and limiting to other everyday activities, even when specific exercise programmes may help prevent scoliosis curve progression and improve their health and fitness status when routinely performed [14]

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