Adolescent idiopathic scoliosis (AIS) is associated with impaired balance, and previous studies have shown that combining balance or hippotherapy training with scoliosis-specific exercises such as Schroth can improve postural control and quality of life. This study aims to evaluate the effect of adding HUBER® 360 neuromuscular balance training to scoliosis-specific exercises on balance outcomes in adolescents with AIS.
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis occurring during the growth period. Previous studies comparing individuals with AIS to healthy controls have demonstrated significant alterations in balance patterns, and several investigations have evaluated balance parameters using posturography in response to exercise-based interventions. For example, Osama et al. (2021) reported that the combination of hippotherapy and Schroth exercises resulted in greater improvements in postural asymmetry and balance compared with Schroth exercises alone. Similarly, Shen et al. (2023) demonstrated that integrating balance training with Schroth therapy in adolescents with idiopathic scoliosis led to significant improvements in trunk rotation angle, Cobb angle, quality of life, and overall balance function. However, to date, no study has investigated the effects of balance training using the HUBER® 360 system on balance outcomes in this population. Therefore, the present study aims to evaluate the effect of adding balance training using the HUBER® 360 system to scoliosis-specific exercises on balance in adolescents with idiopathic scoliosis. The intervention protocol will consist of 12 sessions delivered over 4 weeks, with exercises performed three times per week. Participants will be randomly assigned to two groups. The control group will receive 45 minutes of individualized scoliosis exercises followed by 30 minutes of home-based balance exercises. The intervention group will receive 45 minutes of individualized scoliosis exercises followed by 30 minutes of HUBER-based balance training. Outcome assessments will be performed at baseline, immediately after the 4-week intervention, and at the 3-month follow-up. The primary outcome will be changes in balance parameters measured using the Technobody balance system (static and dynamic balance, sway area, sway velocity, and stability index). Secondary outcomes will include quality of life (SRS-22 questionnaire), postural asymmetry (DIERS 4D Formetric), dynamic balance assessed using the Fukuda stepping test, and static balance performance (unipodal balance test for the right and left legs separately).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Participants complete 30 minutes of balance training using the HUBER® 360 device during each session throughout the study period. The training focuses on postural control, spinal stability, muscle strengthening, and balance control. All sessions are supervised by a physiotherapist.
Participants complete a structured 30-minute home-based balance exercise program regularly throughout the study period. The exercises focus on postural control and balance training. No device-based or feedback-based balance training is used in this intervention.
Ankara Etlik City Hospital, Department of Physical Medicine and Rehabilitation
Ankara, ÇANKAYA, Turkey (Türkiye)
RECRUITINGChange in Stability Index measured by the TecnoBody balance system
Description Postural stability will be evaluated using the TecnoBody ProKin system (multiaxial proprioceptive assessment). The primary outcome is the Stability Index, which reflects overall postural control performance. Lower values indicate better stability. Measurements will be obtained to assess the effect of feedback-based balance training added to conventional scoliosis exercise therapy.
Time frame: Baseline, after 4 weeks of intervention, and at 3-month follow-up.
Change in Postural Asymmetry (DIERS 4D Formetric Analysis)
Postural asymmetry will be assessed using the DIERS 4D Formetric system, a validated rasterstereographic method providing three-dimensional analysis of spinal alignment. Outcome parameters will include trunk imbalance, pelvic tilt, lateral deviation, and surface rotation to determine changes in postural symmetry after intervention.
Time frame: Baseline, after 4 weeks of intervention, and after 3 months
Change in Fukuda Stepping Test Results
Dynamic balance and vestibular function will be assessed using the Fukuda Stepping Test (Unterberger test). The angle and distance of deviation from the starting position will be recorded.
Time frame: Baseline, after 4 weeks of intervention, and after 3 months
Change in Unipodal Balance Test Performance
Static balance will be assessed using the Unipodal Balance Test. The duration (in seconds) that the participant is able to maintain balance on the right and left leg separately will be recorded.
Time frame: Baseline, after 4 weeks of intervention, and after 3 months
Change in Quality of Life (SRS-22 Questionnaire)
Patient-reported outcomes will be assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire, which evaluates function, pain, self-image, mental health.
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Participants perform 45-minute supervised scoliosis exercise sessions throughout the study period. The exercises focus on postural correction, spinal mobility, and muscle balance. All sessions are supervised by a physiotherapist.
Time frame: Baseline, after 4 weeks of intervention, and after 3 months