Diaphragm Mobilization in Adolescent Idiopathic Scoliosis
ConditionAdolescent Idiopathic Scoliosis
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age10-18
SponsorMarmara University
About this trial
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that can affect posture, trunk movement, and respiratory function. Changes in the shape of the rib cage may influence diaphragm function and breathing mechanics in individuals with scoliosis. The Schroth Best Practice (SBP) exercise program is commonly used in the conservative treatment of scoliosis and focuses on posture correction and scoliosis-specific exercises. However, the additional benefits of manual diaphragm mobilization combined with this exercise program are not well known.
The aim of this randomized controlled trial is to investigate the effect of diaphragm mobilization added to the Schroth Best Practice program in adolescents with idiopathic scoliosis. Participants will be randomly assigned to two groups: one group will perform the SBP exercise program alone, and the other group will receive SBP exercises combined with diaphragm mobilization. The intervention will be performed three times per week for six weeks.
Assessments will be conducted at baseline, at the end of the 6-week intervention, and at a 12-week follow-up. Outcomes will include respiratory function measured by spirometry, trunk rotation, thoracic mobility, trunk flexibility, quality of life, and body image. The results of this study may help determine whether adding diaphragm mobilization to scoliosis-specific exercise programs improves clinical outcomes in adolescents with idiopathic scoliosis.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adolescents aged between 10 and 18 years
Diagnosis of adolescent idiopathic scoliosis
Cobb angle ≥ 10°
Ability to participate in exercise sessions
Disqualifiers
Non-idiopathic scoliosis (e.g., neuromuscular, congenital, or syndromic scoliosis)
Presence of congenital anomalies affecting the musculoskeletal system
Previous scoliosis treatment within the last 6 months
Participation in another physiotherapy or rehabilitation program during the study period
Trial design
Design model
Parallel
Treatments tested in this trial
Diaphragm Mobilization
Procedure/SurgeryManual diaphragm mobilization will be performed with the participant in the supine position. The therapist will place both hands along the inferior costal margin and apply a gentle mobilization in coordination with the participant's breathing cycle. During inspiration and expiration, the inferior costal margin will be mobilized in a cranial and lateral direction. The technique will be performed for 20 breathing cycles and repeated twice during each treatment session with short rest periods between repetitions. The intervention will be applied at the end of each treatment session throughout the 6-week treatment period.
Schroth Best Practice Exercise Program
BehavioralThe Schroth Best Practice (SBP) program is a physiotherapeutic scoliosis-specific exercise approach that includes curve-specific corrective exercises and postural education. Participants will perform exercises tailored to their scoliosis curve pattern under the supervision of a physiotherapist. The program will be applied three times per week for six weeks.
Treatment groups
42 Participants
are divided into 2 treatment groupsGroup A: Schroth Best Practice Program + Diaphragm MobilizationExperimental treatment 2 interventions
Group B: Schroth Best Practice ProgramActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Forced Vital Capacity
Forced vital capacity (FVC), expressed in liters, will be measured by spirometry to assess pulmonary function.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)2
Forced Expiratory Volume in One Second
Forced expiratory volume in one second (FEV1), expressed in liters, will be measured by spirometry to assess pulmonary function.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)3
FEV1/FVC Ratio
The FEV1/FVC ratio, expressed as a percentage, will be calculated from spirometry measurements to assess pulmonary function.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)4
Peak Expiratory Flow
Peak expiratory flow (PEF), expressed in liters per minute, will be measured by spirometry to assess pulmonary function.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)Secondary outcomes
1
Trunk rotation angle measured by scoliometer
Angle of trunk rotation will be measured using a scoliometer during the forward Adam's bending test to assess spinal rotation.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)2
Thoracic mobility measured by thoracic circumference difference
Thoracic mobility will be assessed by measuring chest circumference at the xiphoid process level during maximal inspiration and maximal expiration using a measuring tape. The difference between the two measurements will be recorded in centimeters.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)3
Trunk lateral flexion flexibility
Trunk lateral flexion flexibility will be assessed by measuring the distance between the fingertips and the floor during lateral bending. Measurements will be performed bilaterally, and the distance between the fingertips and the floor will be recorded in centimeters.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)4
Quality of life measured by Scoliosis Research Society-22 questionnaire
Health-related quality of life will be evaluated using the Scoliosis Research Society-22 (SRS-22) questionnaire. This questionnaire assesses multiple domains including function/activity, pain, self-image, mental health, and satisfaction with management. The total score ranges from 22 to 110, higher scores indicate better health-related quality of life.
Time frame
Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)Sponsors and contacts
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Source ClinicalTrials.gov