Spinal Stabilization Exercises for Low Back Pain in Adolescents With Idiopathic Scoliosis
Condition: Adolescent Idiopathic Scoliosis; Low Back Pain
MeSH terms: Scoliosis; Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      1. Do spinal stabilization exercises demonstrate immediate and long-term effects of weight
           weeks of spinal stabilization exercises as measured by pain intensity and quality of
           life scores?

        2. Does eight weeks of spinal stabilization exercises improve back muscle endurance in
           adolescents with Idiopathic Scoliosis (IS) with low back pain (LBP), compared to a
           one-time treatment (control)?

      Hypotheses:

      The research hypothesis for Question 1 is: Participants who receive eight weeks of spinal
      stabilization exercises will demonstrate significantly improved pain intensity and quality of
      life scores compared to participants who receive a one-time treatment after eight weeks of
      the intervention period and at six-month follow-up.

      The research hypothesis for Question 2 is: Participants who receive eight weeks of the spinal
      stabilization exercises will demonstrate significantly improved back muscle endurance,
      compared to participants who receive a one-time treatment after eight weeks of intervention.
    

Detailed description: 
      Although idiopathic scoliosis (IS) is the most common type of scoliosis, no studies have
      evaluated the effectiveness of physical therapy exercises for managing low back pain (LBP) in
      this population. Spinal stabilization exercises are of particular importance in adolescents
      with IS due to possible reduced spinal stability from structural deformity. Spinal
      stabilization exercises have been reported to prevent recurrent episodes of LBP in the adult
      population. However, standardized treatment options cannot be recommended for LBP in
      adolescents with IS, because the investigators are not certain if spinal stabilization
      exercises will have the same effect on this patient population. Given the high prevalence of
      LBP in AIS and limited evidence of conservative interventions, researching the effectiveness
      of spinal stabilization exercises is warranted.

      Currently, there are two common practices for managing adolescents with IS who have LBP: 1)
      supervised physical therapy and 2) a one-time treatment with no follow-up. No studies have
      examined which of these two approaches is superior. This study will provide information on
      optimal management of LBP in AIS. If there is no difference in outcomes between these two
      approaches, a one-time visit will be the optimal choice of treatment since it is more
      cost-effective and less burdensome for the family. If the outcomes favor the eight-week
      supervised physical therapy, specifically the spinal stabilization exercises, this treatment
      approach should be recommended for managing LBP in AIS.
    

Intervention name(s): supervised spinal stabilization exercises
Intervention type(s): Other
Intervention description(s): Supervised or unsupervised exercises to be done for 20 minutes at home, at least 5 times a week for the first 2 weeks and at least 3 times a week after 2 weeks. The supervised weekly physical therapy group will complete 8 weeks of weekly physical therapy. The unsupervised home exercise group will complete 8 weeks of a prescribed home exercise program.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: back pain; scoliosis; home exercise program