Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity associated with impaired respiratory muscle strength, balance, postural control, body image, and health-related quality of life. Core stabilization exercises are widely used in the conservative management of AIS. Horse riding simulator training reproduces the multidirectional rhythmic movements of horseback riding while eliminating the potential risks associated with conventional hippotherapy and may provide additional benefits for postural control and trunk muscle activation.
The aim of this randomized controlled trial is to investigate the effects of adding horse riding simulator training to a core stabilization exercise program on respiratory muscle strength, balance, health-related quality of life, and perceived cosmetic deformity in adolescents with idiopathic scoliosis. Participants will be randomly assigned to either an experimental group receiving horse riding simulator training combined with core stabilization exercises or a control group receiving core stabilization exercises alone. Outcomes will be assessed before and after the 12-week intervention.
Diagnosis of adolescent idiopathic scoliosis
Age between 10 and 19 years
Cobb angle between 10° and 40°, measured on standing spinal radiographs
Willingness of the participant and, when applicable, the parent or legal guardian to participate in the study
Scoliosis of a non-idiopathic etiology
History of surgery within the previous 3 months
Presence of an orthopedic, neurological, or systemic condition that may prevent participation in the exercise program
Cognitive, communication, or behavioral disorders that may interfere with understanding instructions, answering questions, or performing the exercises
Parallel
Horse Riding Simulator
DeviceParticipants will receive 30-minute horse riding simulator training twice weekly for 12 weeks in addition to supervised core stabilization exercises. Each session consists of 5 minutes of warm-up at low speed, 20 minutes of training at the highest speed tolerated by the participant, and 5 minutes of cool-down at low speed.
Core Stabilization Exercises
BehavioralParticipants will perform supervised 60-minute core stabilization exercises twice weekly for 12 weeks. Home-based core stabilization exercises will be prescribed for the remaining days of the week.
Balance
Balance will be assessed using the Biodex Balance System.
Respiratory Muscle Strength
Respiratory muscle strength will be assessed by measuring maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) using a portable mouth pressure device.
Health-Related Quality of Life
Health-related quality of life will be evaluated using the Scoliosis Research Society-22 (SRS-22) questionnaire.
Perceived Cosmetic Deformity
Perceived cosmetic deformity will be assessed using the Walter Reed Visual Assessment Scale (WRVAS).
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