Effect of a Postural Re-education Intervention Compared to Standard Care on Scoliosis Progression in Adolescent (RCT-RPG)

Effect of a Postural Re-education Intervention Compared to Standard Care on Scoliosis Progression in Adolescent

Randomized Controlled Trial to Evaluate the Effect of a Postural Re-education Intervention Compared to Standard Care on Scoliosis Progression in Adolescent

The aim of this project is to verify the effect of the global postural reeducation (GPR) intervention used in physiotherapy on scoliosis progression (scoliosis angle), back pain, quality of life, respiratory function, trunk posture and trunk muscle functioning and walking endurance. To do so, we will recruit 144 participants at three scoliosis specialized Centers. Participants will be randomly allocated to the standard of care (SC) group (observation or brace plus home video of exercises for 12 months) or to the GPR group (SC plus individual sessions once a week for 6 months and individual sessions alternating with telerehabilitation sessions once per two weeks between 6 and 12 months). At initial, 6, 12- and 24-months evaluation, participants will have x-ray, complete self-report questionnaires to document back pain and quality of life. Thereafter, measurement of trunk posture, electromyography activity of the back muscles, excursion of the diaphragm muscle using echography and respiratory function as well as distance covered using the 6-minute walk test for walking endurance will be done. We believe that GPR intervention may prevent scoliosis progression and improve physical health and quality of life in adolescence.

adolescent idiopathic scoliosis, Global postural re-education, back pain, quality of life, trunk imbalance, inter muscular coherence, respiratory function, functional performance

GPR consists of active treatment posture and sensorimotor control exercises to regain back muscle symmetry and correct posture in daily activities

Intensity of back pain on the Numerical Pain Rating Scale (0-10, where 0 indicates no pain et 10 the worst imaginable pain)

Measure of the association between right and left paraspinal muscle activity at each frequency on a scale from 0 to 1, where 0 indicates independent processes and 1 indicates correlated processes.

Inclusion Criteria: aged between 10 and 16 years old, Cobb angle between 15º and 45º, Risser sign ≤3 (skeletal growth incomplete), with a risk of progression index > 1.3, having recent x-rays (4-6 weeks), ability to travel weekly to attend GPR intervention Exclusion Criteria: patients with diagnosis other than AIS, patients who are planned for surgery, have had surgery, worn a brace for at least three months prior to GPR intervention