Basic Body Awareness Therapy Added to Scoliosis-Specific Exercise in Adolescents With Scoliosis

Official title

Effects of Integrating Basic Body Awareness Therapy Into Scoliosis-Specific Exercises on Body Awareness, Quality of Life, and Scoliosis-Related Outcomes in Adolescents With Idiopathic Scoliosis: A Randomized Controlled Trial

Overview

The goal of this randomised clinical trial is to evaluate whether adding Basic Body Awareness Therapy (BBAT) to scoliosis-specific exercises can improve body awareness, quality of life and scoliosis-speficic outcomes in adolescents aged 10-17 years with adolescent idiopathic scoliosis (AIS). The main questions it aims to answer are: Does the addition of BBAT to scoliosis-specific exercises lead to greater improvements in body awareness compared to scoliosis-specific exercises alone? Does adding BBAT improve trunk proprioception, scoliosis-related parameters, and health-related quality of life in adolescents with AIS? H1: Adolescents with idiopathic scoliosis who receive Basic Body Awareness Therapy in addition to scoliosis-specific exercises will demonstrate greater improvements in body awareness compared to those receiving scoliosis-specific exercises alone. H2: Adolescents receiving Basic Body Awareness Therapy in addition to scoliosis-specific exercises will demonstrate greater improvements in scoliosis-related clinical parameters compared to those receiving scoliosis-specific exercises alone. H3: Adolescents receiving Basic Body Awareness Therapy in addition to scoliosis-specific exercises will demonstrate greater improvements in both general and scoliosis-specific quality of life compared to those receiving scoliosis-specific exercises alone.

Detailed description

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that may affect not only spinal alignment but also postural control and body perception. Recent evidence suggests that, beyond structural deformity, alterations in sensory integration and body awareness may contribute to postural asymmetry in individuals with AIS. These findings highlight the importance of addressing both structural and perceptual components in rehabilitation.

Physiotherapeutic scoliosis-specific exercises (PSSE) are widely used in the conservative management of AIS and aim to improve spinal alignment through active self-correction and functional stabilization. While PSSE has demonstrated positive effects on scoliosis-related clinical outcomes, its effects on perceptual aspects such as body awareness remain less explored. Therefore, integrating interventions that specifically target body awareness may enhance rehabilitation outcomes.

Basic Body Awareness Therapy (BBAT) is a movement-based approach that focuses on posture, movement quality, breathing, and awareness of bodily sensations. By promoting conscious perception of body alignment and movement, BBAT may support improvements in postural control and functional organization in individuals with AIS. For this reason, BBAT was incorporated as a complementary intervention alongside PSSE.

This study is designed as a randomized controlled trial to investigate the effects of adding BBAT to a PSSE-based rehabilitation program. Participants will be randomly assigned to either a control group receiving PSSE alone or an intervention group receiving PSSE combined with BBAT. Both groups will participate in supervised sessions once per week for 6 months and perform home-based exercises on the remaining days.

Outcome measures will include body awareness, health-related quality of life, and scoliosis-specific clinical parameters. Assessments will be conducted at baseline and after 6 months.

This study aims to determine whether the addition of BBAT to conventional exercise-based rehabilitation provides additional benefits in adolescents with AIS.

Interventions

• Other Scoliosis-specific exercises
  This approach aims to improve spinal stabilization and postural control through active self-correction. Exercises are performed in basic positions and progressively advance to more complex functional tasks according to individual ability. The program follows a structured yet individualized approach tailored to each participant's needs. All exercises are administered and supervised by an experienced, certified physiotherapist.
• Other Awareness therapy
  BBAT sessions include movements performed in basic and functional positions such as lying, sitting, standing, and walking, integrated with breathing and awareness of bodily sensations. The program aims to improve body awareness, movement quality, and postural control through slow, rhythmic, and coordinated movements. Movements emphasize grounding, alignment of body segments, weight transfer, and coordinated breathing. Participants are instructed to perform movements slowly and with attention to

Primary outcome measures

• Body Awareness Questionnaire (BAQ) [Time frame: 6 months]
• Awareness Body Chart (ABC) [Time frame: 6 months]
• The Pediatric Quality of Life Inventory (PedsQL) [Time frame: 6 months]
• The Japanese Scoliosis Questionnaire-27 (JSQ-27) [Time frame: 6 months]

Secondary outcome measures (5)

• Curve magnitude- Cobb angle method [Time frame: 6 months]
• Axial Trunk Rotation (ATR) [Time frame: 6 months]
• Posterior Trunk Symmetry Index [Time frame: 6 months]
• Anterior Trunk Symmetry Index [Time frame: 6 months]
• Exercise Adherence [Time frame: 6 months]

Eligibility criteria

Inclusion criteria

• Diagnosed of adolescent idiopathic scoliosis
• Age between 10 and 17 years
• Cobb angle ≥15°
• No previous or concurrent scoliosis treatment
• Risser sign between 0 and 4

Exclusion criteria

• Evidence of congenital scoliosis or other spinal deformities (e.g., hyperkyphosis, pectus deformities)
• Diagnosis of neuromuscular, rheumatologic, neurological, cardiovascular, pulmonary disorders
• Regular participation in sports
• History of spinal orthosis use or scoliosis surgery.

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

Double blind

Primary purpose

Other

Study locations

Turkey (Türkiye) · 1 center

• Hacettepe University Faculty of Physical Therapy and Rehabilitation, Orthotics and Biomech — Ankara

Identifiers

NCT: NCT07500883 · HU-SNYaylaci-002

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗