The Effect of Inspiratory Muscle Training on Postural Stability, Posture Perception and Trunk Rotation in Children With Adolescent Idiopathic Scoliosis.

Study Overview
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Brief Summary
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Trunk rotation and distortion of the rib cage, which are common in patients with adolescent idiopathic scoliosis, result in abnormal configuration of the diaphragm and intercostal muscles. This reduces the capacity of the respiratory muscles to produce force, and results in respiratory muscle weakness. The diaphragm, which is the major respiratory muscle, is also a component of the core muscles responsible for postural stability. Therefore, diaphragm muscle weakness results in deterioration of postural stability. Our aim in this study is to investigate the effect of inspiratory muscle training added to the routine scoliosis exercise program on postural stability and posture perception.

Official Title
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The Effect of Inspiratory Muscle Training on Postural Stability, Posture Perception and Trunk Rotation in Children With Adolescent Idiopathic Scoliosis.

Conditions
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Adolescent Scoliosis

Intervention / Treatment
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* Other: Conventional Scoliosis Exercise Program
* Other: Inspiratory Muscle Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having adolescent idiopathic scoliosis with a Cobb angle of 20-50° diagnosed by an orthopedic surgeon Exclusion Criteria: Having a documented diagnosis of neurological disorders Having a documented diagnosis of mental disorders which may affect cooperation Having a documented diagnosis of chronic airway diseases Having a documented diagnosis of orthopedic disorders which may affect mobility

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Group<br>Patients in this group will receive conventional scoliosis exercise program for 1 hour, 6 days a week for 8 weeks. One exercise session will be supervised in a clinic per week, other sessions will be performed at home. | Other: Conventional Scoliosis Exercise Program<br>* Program will include breathing exercises, spinal stabilization and strengthening exercises, posture exercises and stretching execises.<br>|
| Experimental: Training Group<br>In addition to the conventional scoliosis exercise program, patients in this group will also receive inspiratory muscle training for 15 minutes, twice a day, 6 days a week for 8 weeks. One exercise session will be supervised in a clinic per week, other sessions will be performed at home. | Other: Conventional Scoliosis Exercise Program<br>* Program will include breathing exercises, spinal stabilization and strengthening exercises, posture exercises and stretching execises.<br>Other: Inspiratory Muscle Training<br>* Threshold IMT device will be used for the training. Training intensity will set at 30% of the maximum inspiratory pressure.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline postural stability test score in Biodex Balance System SD at 8 weeks |  | 8 weeks | 
| Change from baseline limits of stability test score in Biodex Balance System SD at 8 weeks |  | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline Walter Reed Visual Assessment Scale at 8 weeks | Walter Reed Visual Assessment Scale evaluates posture perception. It consists of a visual test including seven items that deal with various aspects of the deformity. Each question has a set of five figures that represent degrees of severity of the deformity: spinal deformity, rib prominence, lumbar prominence, thoracic deformity, trunk imbalance, shoulder asymmetry and scapular asymmetry. | 8 weeks | 
| Change from baseline maximum inspiratory pressure (MIP) at 8 weeks |  | 8 weeks | 
| Change from baseline maximum expiratory pressure (MEP) at 8 weeks |  | 8 weeks | 
| Change from baseline angle of trunk rotation at 8 weeks. | Angle of trunk rotation will be evaluated using Bunnell scoliometer in forward bending position | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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postural stability, posture perception, inspiratory muscle training, adolescent idiopathic scoliosis