Comparison of the Efficiency of Schroth Method and Virtual Reality Exercises in Individuals With AIS

Summary

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine of unknown etiology, in the treatment of which physiotherapy-specific scoliosis-specific exercise (PSSE), corset and surgical treatment approaches are used depending on the severity of the curvature \[8, 9\]. The Schroth method, one of the PSSE methods, has been shown to reduce the severity of the curvature, Cobb angles and the need for surgery, especially in curvatures between 10-30 degrees, slow down the progression of the curvature, increase back muscle strength and improve respiratory functions \[10-12\]. In the Schroth method, mental imagery, exteroceptive, proprioceptive stimulations and mirror control, which follow motor learning principles and include internal focus, are used to increase body awareness and facilitate the individual's self-posture corrections with postural, sensorimotor and rotational breathing exercises specific to scoliosis \[5, 10\]. In cases that require long-term treatment, such as scoliosis, the motivation and participation of the child and adolescent population in particular decreases and negatively affects the success of treatment \[1, 2\]. Additionally, it has been reported in the literature that patients have difficulty in performing Schroth exercises at home and adapting the corrected posture to daily life\[5\]. For this reason, in order to maintain the corrected posture and make it permanent, motor learning-based approaches must be used \[6\]. Virtual reality rehabilitation (VR) creates an external focus on the individual, allows for a large number of repetitions, and thus encourages motor learning. It is also known that VR increases motivation, participation and exercise performance in children and adolescents\[7\]. When the literature was examined, no studies were found regarding VR in individuals with AIS.

The study will show that Schroth-based VR will be effective on spinal parameters, trunk rotation and spinal mobility parameters in cases with AIS. Our aim is to examine the effects of Schroth-based VR in comparison with Schroth exercises in cases with AIS.

Conditions

• Scoliosis; Adolescence
• Scoliosis
• Scoliosis Lumbar Region
• Adolescent Idiopathic Scoliosis

Interventions

OTHER

Schroth Exercise Group

Exercises will be given in lying, sitting and standing positions. In each exercise, elongation of the spine will be ensured and the person will be positioned according to the type of scoliosis. Exercises will be given progressively in supine, prone, side sitting, sitting and standing positions. In each exercise, elongation of the spine will be ensured and the person will be positioned according to the upper and lower extremities. The exercise program will be divided into 4 phases: 0-4, 5-8, 9-12, 12-24. Progress in the exercises will be made positionally by increasing the number of repetitions and the number of rotational breathing during the exercise.

OTHER

Schroth Method Based Virtual Reality Group

During Schroth method-based virtual reality exercises, continuity in stabilization will be ensured by using external focus and muscular activation in positions appropriate to the Schroth method and in corrected posture. Sessions will last 40 minutes in total, including 5 minutes of warm-up, 30 minutes of balance and sports games, and 5 minutes of cool-down. Warm-up and cool-down will consist of aerobic games available in Nitendo wii. Balance games will consist of Penguin Slide, Soccer Heading, Table Tilt, Balance Bubble, Ski Slalom, Ski Jump, Tilt City and Snowboard Slalom. Among the sports games, Bowling, Boxing, Tennis and Baseball will be included in the program. Progression will be made by difficulty level and positional in all games. The exercises will be made more difficult by side sitting, side sitting on a stool, sitting position, knight position, standing, sitting on a balance ball, standing on a soft floor, on a bosu ball and moving towards the balance board.

OTHER

Control Group

Participants in the control group will be placed on a waiting list for 24 weeks. Participants will not receive any exercise intervention for 24 weeks and will be able to continue their routine physical activities.

Sponsors & Collaborators

• Istanbul University - Cerrahpasa

  lead OTHER

Principal Investigators

• İrem KURT ULUSOY, PhD(C) · Istanbul University - Cerrahpasa

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

10 Years

Max Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-06-01

Primary Completion

2025-06-01

Completion

2025-11-01

Countries

• Turkey (Türkiye)

Study Locations