Conservative Management for Adolescent Idiopathic Scoliosis

Official title

Orthotic Management for Controlling Scoliotic Curve Progression in Adolescent Idiopathic Scoliosis

Overview

Idiopathic scoliosis is a living problem that resists correction. The underlying cause of the such disorder is unknown but directed more toward muscular disorders. However recent clinical observation showed a possible neuromuscular compromise early in those patients. The main purpose of this study is to develop a treatment procedure to correct the degree of bony curvature in patients with Idiopathic scoliosis through developing a neuromuscular corrective approach that might be a more effective conservative treatment protocol for such disorder.

Detailed description

Scoliosis is one of the most common spinal deformities occurring in school-going children during the growth spurts of adolescents. It is an abnormal curvature of the spine. Failure of early management of idiopathic scoliosis could lead to multiple problems related to postural malalignment, pulmonary and physical dysfunctions, and surgical interventions. These problems could lead to health-related quality-of-life issues such as psychological and social problems that are represented in social isolation, depression, loss of self-confidence, limited job opportunities, and hospital stays \& days off school and university as a result of undergoing corrective surgeries. Treatment methods for adolescent idiopathic Scoliosis (AIS) vary between surgical intervention and conservative treatment, in mild and moderate cases. Conservative treatment includes physical therapy in addition to rigid splints and braces, which may cause pain, tightness, restriction of movement, and a bad psychological status for adolescents which may lead them to the irregular wearing of these splints and braces. A type of soft, lightweight, breathable orthosis which is TheraTogs orthotic undergarment with the strapping system has been fabricated to provide gentle, passive compression to correct spinal deformities. Therefore, the objective of this study is to evaluate the effectiveness of TheraTogs orthotic undergarment with the strapping system on controlling and modulating the degree of scoliosis in Saudi adolescents with idiopathic scoliosis.

Interventions

• Other Scoliosis-Specific Exercise Program
  Adolescents in the control group will receive a scoliosis-specific exercise program which will be prescribed to control the progression of the scoliotic curve. This exercise program will include frontal plane active or passive correction exercises for scoliotic posture. The exercise program for every participant will be three sessions per week for 12 successive weeks. Every treatment session was applied for one hour.The exercise program for every participant will be three sessions per week for 1
• Other Soft orthoses with external strapping.
  Adolescents in the experimental group will receive a scoliosis-specific exercises program which will be prescribed to control the progression of the scoliotic curve in addition to wearing the soft orthoses with external strapping. The wearing schedule of the soft orthosis with the external strapping for every participant in this group will be 12 hours daily for 12 successive weeks.

Primary outcome measures

• Change in the scoliotic cobb's angle (°) [Time frame: [Data was collected at baseline, and 12 weeks after intervention commencement.]]
• Changes in the Pelvic Obliquity (mm) [Time frame: [Data was collected at baseline, and 12 weeks after intervention commencement.]]
• Change in the vertebral rotation (Angle) [Time frame: [Data was collected at baseline, and 12 weeks after intervention commencement.]]
• Change in the Coronal imbalance (mm) [Time frame: [Data was collected at baseline, and 12 weeks after intervention commencement.]]

Eligibility criteria

The inclusion criteria will be:

• Adolescents of both sexes with an age range between 10-17 years.
• They were diagnosed with Adolescent idiopathic scoliosis by an orthopedic specialist, confirmed through (loaded) X- rays.
• They have mild non-structural scoliosis with Cobb's angle measurement of between 10 and 25 degrees
• They have Single major thoracolumbar curve located between T6-7 to L1-2, apex at T12 or L1.
• They have good health conditions except for scoliosis.
• They can understand and communicate with no mental abnormalities.

The exclusion criteria will be:

• Adolescents with cerebral palsy or other degenerative neurological disorders;
• Participants with nutritional disorders e.g. diabetes or vascular disorders.
• Participants with a scoliotic curve with angle > 25° will be excluded.
• Participants will be excluded from this study if they have inflexible spinal deformities interfering with spinal mobility,
• Participants who were subjected to any corrective surgery to their spine within the previous two years.
• Participants will be also excluded if their skin were sensitive or inflamed to any materials used.
• Participants who have seizures, perceptual disorders, visual problems, and auditory deficits
• Participants who have leg length discrepancy
• Participants who have scoliosis developed as a consequence of traumatic scoliosis.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Saudi Arabia · 1 center

• Umm Al Qura University — Mecca

Identifiers

NCT: NCT05819034 · DSR02

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗