Clinical trial NCT06407843: Effects of Schroth Method in Idiopathic Scoliosis
Official title: Effects of Schroth Method on Curve Magnitude, Endurance of Lumbar Extensors, and Chest Mobility in Idiopathic Scoliosis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Idiopathic Scoliosis
Keywords: Cobb angle
Chest mobility
Idiopathic scoliosis
Lumbar muscle endurance
Schroth Exercise therapy
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-05-09
Enrollment: 32
Sex: ALL
Minimum age (years): 9
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: A spinal malformation called scoliosis typically manifests in the first two decades of life. It is defined as a lateral curvature of the spine larger than 10, which can be identified by an x-ray using the Cobb angle. Clinically, idiopathic scoliosis is defined as a spinal curvature in the coronal plane of more than 10 degrees. It accounts for 85% of nearly all scoliosis cases. It is advised that patients with curves less than 45° get nonoperative care. The Schroth technique is mostly utilized in the treatment of scoliosis. This technique uses a physiotherapeutic approach to stretch and strengthen any weak muscles. The study's objective is to ascertain how the Scroth method affects the size of the curve, the lumbar extensors' endurance, and the mobility of the chest in cases with idiopathic scoliosis.

The present research will employ a randomized control trial design, with data sourced from the Children Hospital and Institute of Child Health in Lahore, as well as the Pakistan Society for the Rehabilitation of the Disabled, Lahore (PSRD). Thirty-two patients total will be randomly assigned to two equal groups for the study. The study's inclusion criteria will include any patient with idiopathic scoliosis who is between the ages of 9 and 17 and has a Cobb angle between 10˞ and 26˞, regardless of gender. The study will not include any patients with neurological conditions, other orthopedic conditions, surgery histories involving the spine, severe systemic disorders, psychological conditions, or neuromuscular disorders. The experimental group will engage in both routine physical therapy (RPT) and Schroth exercise therapy (SET), while the control group will only receive normal physical treatment. Chest mobility, lumbar extensor endurance, and curve magnitude (Cobb angle) will all be examined. The Sorensen test for lumbar muscle endurance, the X-ray for Cobb angle, and the measuring tape for chest mobility will be the instruments utilized to collect data. The data analysis tool of choice will be SPSS 23.00.

Detailed description: Group A: In addition to regular physical therapy, Group A will engage in Schroth exercises therapy (SET). These regular workouts will include breathing exercises, posture training, spinal flexibility exercises, and stretching activities (especially for the muscles on the concave side of the curve). The intensity of the workout program will progressively rise in line with each participant's improved functional ability. Schroth exercises, which are based on kinesthetic and sensorimotor concepts, will include both passive and active posture autocorrection exercises that are performed frequently. Postural motor control will be enhanced by doing corrective motions repeatedly. Strength and endurance training of the postural muscles is another component of Schroth exercises therapy, which aims to enhance the curve, improve the patient's self-image, and lessen pain. Patients were positioned asymmetrically to optimize trunk rectification. The program will consist of activities designed to increase the curvature, muscle strength, and endurance of postural muscles. These exercises will include spinal elongation, de-flexion, stretching, de-rotation, and strengthening. To provide passive support and correct posture during the SET, long poles, foam blocks, and rice sacks were employed. Depending on how well the patient performs the exercises, the intensity of the Schroth exercises will be gradually raised by modifying the patient's position, varying the number of sets and repetitions of the exercises, and reducing the quantity or degree of passive support. Ten sessions total (30 minutes each, five days a week) will be conducted.

Group B: Group B will engage in independent routine physical therapy (RPT). Stretching exercises (especially for the muscles on the concave side of the curve) will be part of these regular workouts. The patient will be actively taught standard upper extremity range-of-motion exercises. Without using any creams or lotions, myofascial release (MFR) procedures will be applied straight to the skin. To assist avoid back discomfort, pressure will be administered to the restricted area for 90-120 seconds in order to release the tissue. Twice day, perform 10 repetitions of a 5-second hold while supine pelvic tilt, twice. The same protocol will be followed for the cat and camel, double-leg abdominal presses, and superwoman exercises. There will be breathing exercises including thoracic expansion and diaphragmatic breathing.

Eligibility criteria: Inclusion Criteria:

* Ages 9 to 17
* Both genders will be included.
* X-rays will show idiopathic scoliosis with Cobb Angle 10-26.

Exclusion Criteria:

* Any type of cerebral illness
* Any other skeletal issue
* Spine procedure history
* Severe systemic illness

Primary outcomes:
measure: Cobb angle using X-rays to determine curve magnitude
timeFrame: Baseline and 2 weeks
Secondary outcomes:
measure: Sorenson test to measure Lumbar extensor muscle
timeFrame: Baseline and 2 weeks
measure: Measuring tape to measure chest Mobility
timeFrame: Baseline and 2 weeks
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: pakistan Society for the Rehabilitaion of Disables
state: Punjab
Study officials:
affiliation: Riphah International University Lahore
name: Anna Zaheer, MSPT-(NMPT)
role: STUDY_CHAIR
affiliation: Riphah International University, Lahore
name: Mowadat Zahra, MSPT-(PPT)
role: PRINCIPAL_INVESTIGATOR
References:
citation: Strukčinskaitė V, Raistenskis J, Šidlauskienė A, Strukčinskienė B, Griškonis S. EFFECTS OF THE SCHROTH METHOD FOR TRUNK MUSCLES'STATIC ENDURANCE AND SPINE MOBILITY IN GIRLS WITH IDIOPATHIC SCOLIOSIS. Health sciences. 2017;27(5):71-5.
citation: Athawale V, Phansopkar P, Darda P, Chitale N, Chinewar A. Impact of Physical Therapy on Pain and Function in a Patient With Scoliosis. Cureus. 2021 May 26;13(5):e15261. doi: 10.7759/cureus.15261.
citation: Blevins K, Battenberg A, Beck A. Management of Scoliosis. Adv Pediatr. 2018 Aug;65(1):249-266. doi: 10.1016/j.yapd.2018.04.013. Epub 2018 Jun 12. No abstract available.
citation: Kocaman H, Bek N, Kaya MH, Buyukturan B, Yetis M, Buyukturan O. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial. PLoS One. 2021 Apr 15;16(4):e0249492. doi: 10.1371/journal.pone.0249492. eCollection 2021.
citation: Park J, So WY. The Effect of the Schroth Rehabilitation Exercise Program on Spinal and Feet Alignment in Adolescent Patients with Idiopathic Scoliosis: A Pilot Study. Healthcare (Basel). 2022 Feb 20;10(2):398. doi: 10.3390/healthcare10020398.