Yoga for Adolescent Idiopathic Scoliosis (AIS) Patients

Study Overview
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Brief Summary
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Adolescent Idiopathic Scoliosis (AIS) is defined as a three-dimensional lateral deformity of the spine. It is described with a cobb angle of greater than 10 degrees. There is no known etiology of AIS. Once the degrees of curvature become severe (greater than 45 degrees), surgical intervention (posterior spinal fusion - PSF) is often discussed. Most adolescent patients and their families opt for surgical correction to decrease future complications of severe scoliosis, such as decreased vital capacity of the lungs, potential future activity restrictions, cosmetic appearance, and self-esteem. While the patient and family are eager to undergo PSF, they do have concerns. The major concerns are pain control and their ability to return to activities. In current literature, there are many studies completed regarding pharmacologic pain control management with the use of IV patient-controlled analgesia (PCA) with opioids, narcotics, non-steroidal anti-inflammatories, muscle relaxers, Tylenol, and gabapentin. However, there is not a well-established multimodal pain management plan for postoperative PSF patients. There is also no current literature discussing nonpharmacologic pain management methods, such as stretching, strengthening and yoga, for patients undergoing PSF. There are multiple studies discussing core stabilization used for helping AIS patients non-operatively. There is no literature discussing the use of nonpharmacologic pain management methods for improved pain control (including decreased use of pharmacologic agents) and quicker return to activities. The aim of this study is to determine if patients with AIS undergoing PSF require fewer pain medications and have an earlier return to activities if completing a yoga program six weeks prior to their surgery.

Official Title
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Efficacy of Perioperative Yoga at Reducing Pain in Surgical AIS Patients

Conditions
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Adolescent Idiopathic Scoliosis, Spinal Fusion

Intervention / Treatment
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* Behavioral: Yoga


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Idiopathic Scoliosis patients English speaking patient and parents Exclusion Criteria: Non idiopathic scoliosis diagnosis no access to internet or computer non-English speaking parents and/or patient

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Study group<br>This group will be given standard pre- and post-surgery movement instructions. | |
| Experimental: Yoga group<br>This group will be asked to do a 6 week series of yoga videos at home pre- and post-surgery. | Behavioral: Yoga<br>* 6 yoga videos to be done 2-3x a week for 6 weeks before and after surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morphine Equivalent Units | Number of narcotics taken after surgery | 7 weeks | 
| Time to first ambulation | How long it takes patient to walk after surgery | 1 week | 
| Length of hospital stay | How long before the patient was discharged after surgery | 1 week | 
| Return to school/activities | How long before the patient returned to school/activities after surgery | 7 weeks | 
| Pain scores | Pain scores before and various times after surgery using Faces Pain Scale-Revised. Range is from 0-10. 10 being most severe pain. | 14 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compliance with yoga videos | How often patients did yoga videos via patient recorded log and YouTube Analytics | 14 weeks |