To evaluate the efficacy of core stability (CS) exercises on curve magnitude, posture, trunk deformity and quality of life in adolescent females with idiopathic scoliosis.
Scoliosis is a disease in which the spine deviates or rotates laterally from its normal vertical line, and it can cause decreased spinal movement, weakening of muscles near the spine, reduced pulmonary function, respiratory dysfunction, chronic pain, and psychological suffering. Scoliosis can be classified as idiopathic, congenital, neurofibromatosis, and neuromuscular. Among these types of scoliosis, approximately 80% of patients with scoliosis have AIS, which typically occurs around 10 years of age when healthy bone maturation occurs during adolescence. IS is diagnosed when there are no known causes besides spinal deformity involving a lateral curvature with a Cobb angle ≥10°. Therapeutic approaches for IS include surgical and conservative treatments. Exercise therapy for IS is considered important for maintaining spinal function when the Cobb angle is \<20°. Moreover, the effects of core stabilization exercise have been demonstrated recently for alleviating chronic lower back pain in patients, improving performance in athletes, and preventing sports injuries in athletes. Based on this information, core stabilization exercise may be used effectively to improve neuromuscular imbalance, which is the cause of IS. However, studies on the therapeutic effects of using core stabilization exercise in patients with AIS are still lacking. Accordingly, the objective of this study is to evaluate the efficacy of core stability exercises on curve magnitude, posture, trunk deformity, and quality of life in adolescent females with idiopathic scoliosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Traditional exercises for scoliosis include breathing exercises, posture training, spinal flexibility exercises, stretching exercises for the involved muscles (especially for the concave side of the curve), and general strengthening exercises for the main muscle groups of trunk, pelvis, and shoulder girdle muscles (especially for the convex side of the curve).
The CS training program includes local muscle stability training (transverses abdominis, multifidus, and diaphragm), global muscle stability training (oblique abdominal muscles, psoas major, quadratus lumborum, and pelvic floor muscles), global muscle mobility training (rectus abdominis, back extensors, and hamstring muscles), and strength training of the core muscles through the thoracolumbar fascia by maintaining the neutral spine position. Diaphragmatic breathing technique will be used during exercises.
Al Azhar University
Cairo, Egypt
Measurement of Cobb angles
Cobb angles on anterior and posterior spine radiographs taken in standing position. The Cobb angle is the angle between two lines, drawn perpendicular to the upper endplate of the uppermost vertebra involved and the lower endplate of the lowest vertebra involved. Once a patient's Cobb angle is determined, the condition can be further classified on its severity scale of mild, moderate, or severe. Cobb angles will be assessed for all adolescent females in both groups A \& B before and after treatment.
Time frame: 3 months
Measurement of trunk asymmetry in scoliosis
A scoliometer is an instrument that measures trunk asymmetry in scoliosis, or angle of trunk rotation (ATR). It is a small, non-invasive device (essentially a mini-level) that is placed over the spine while a person is in a forward bending position. The scoliometer reading indicates degree of trunk asymmetry (rotation). Generally, an angle of trunk rotation that is less than 5 degrees is insignificant and may not require follow-up. A measurement of 5 to 9 degrees at least warrants reexamination in six months. A measurement of 10 degrees or greater requires radiologic evaluation for Cobb angle measurement.
Time frame: 3 months
Trunk appearance perception scale (TAPS)
TAPS includes 3 sets of figures that depict the trunk from 3 viewpoints: looking toward the back, looking toward the head with the patient bending over (Adam's test), and looking toward the front. This last view has two sets of drawings, one for males and one for females. Each drawing is scored from 1 (greatest deformity) to 5 (smallest deformity) and a mean score is obtained by adding the scores for the 3 drawings and dividing by 3.
Time frame: 3 months
The Scoliosis research society-22 questionnaire (SRS-22)
The SRS-22 contains 22 questions covering 5 domains: function/activity, 5 items; pain, 5 items; self-perceived body image, 5 items; mental health, 5 items; and satisfaction with treatment, 2 items. The satisfaction scale was not used in the present study. Each item is scored from 1 (worst) to 5 (best). In the present study, the results are expressed as the mean for each domain (total sum of the domain divided by the number of items answered) and the total score.
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Time frame: 3 months