Spinal Stabilization Exercises for Low Back Pain in Adolescents With Idiopathic Scoliosis

Study Overview
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Brief Summary
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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? 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
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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.

Official Title
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Effectiveness of Spinal Stabilization Exercises for Low Back Pain in Adolescents With Idiopathic Scoliosis

Conditions
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Adolescent Idiopathic Scoliosis, Low Back Pain

Intervention / Treatment
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* Other: supervised spinal stabilization exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adolescents (ages 10-17), Idiopathic Scoliosis, Low Back Pain (> 2/10 on Numeric Pain Rating Scale) Exclusion Criteria: other pathology of lumbar spine (like spondylotic lesion), current treatment (like bracing and chiropractic care), back pain located beyond the lumbar spine

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 17 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 |
| --- | --- |
| Experimental: Home Exercise Group<br>Perform home exercises of unsupervised spinal stabilization exercises for 8 weeks | Other: supervised spinal stabilization exercises<br>* 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.<br>|
| Experimental: Weeky Physical Therapy Group<br>weekly physical therapy of supervised spinal stabilization exercises for 8 weeks | Other: supervised spinal stabilization exercises<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pain from initial visit | Numeric Pain Rating Scale | Initial visit 'day 1', After 8 weeks, After 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in back muscle endurance from initial visit | Prone double leg raise | Initial visit 'day 1', After 8 weeks, After 6 months | 
| Change in quality of life since initial visit | SRS-22 | Initial visit 'day 1', After 8 weeks, After 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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back pain, scoliosis, home exercise program