Outcomes of 12 Weeks of Schroth and Asymmetric Spinal Stabilization Exercises on Cobb Angle, Angle of Trunk Rotation, and Quality of Life in Adolescent Boys with Idiopathic Scoliosis: A Randomized-controlled Trial

Document Type : RESEARCH PAPER

Authors

1 Department of Sport Sciences, Kish International Campus, University of Tehran, Kish, Iran

2 Department of Sports injury and biomechanics, Faculty of Sport Sciences and health, university of Tehran, Tehran, Iran

3 Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran

4 Department of Health & Sport Rehabilitation, Faculty of Sport Science & Health, University of Shahid Beheshti, Tehran, Iran

10.22038/abjs.2023.71875.3356

Abstract

Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for 
correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric 
spinal stabilization exercises (ASSE) method. Therefore, we hypothesized that, first, there is no 
difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb 
angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in 
the efficiency of SE and no intervention on corresponding variables in treating AIS.
Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) 
divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three 
days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the 
control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam’s test), 
and QoL (Scoliosis Research Society-22 questionnaire).
Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group 
(Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed 
significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the 
control group (P<.001), whereas the control group remained almost unchanged.
Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE 
alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis 
and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer 
treatment periods in future.
 Level of evidence: I

Keywords

Main Subjects

References

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24.              Kuru T, Yeldan İ, Dereli EE, Özdinçler AR, Dikici F, Çolak İ. The efficacy of three-dimensional Schroth exercises in adolescent 

  1. Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M. The Effectiveness of Schroth vs SEAS Exercise Methods for Correcting Idiopathic Scoliosis in Adolescents: A Systematic Review. Physical Treatments-Specific Physical Therapy Journal. 2022; 12(1):1-12. doi: 10.32598/ptj.12.1.517.3.
  2. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013; 7(1):3-9. doi: 10.1007/s11832-012-0457-4.
  3. Tome-Bermejo F, R. Piñera A, Alvarez L. Osteoporosis and the Management of Spinal Degenerative Disease (II). Arch Bone Jt Surg. 2017; 5(6):363-374. doi:10.22038/abjs.2017.19349.1498.
  4. Peng Y, Wang S-R, Qiu G-X, Zhang J-G, Zhuang Q-Y. Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis. Chin Med J (Engl). 2020; 133(04):483-493. doi: 10.1097/CM9.0000000000000652.
  5. Refsum HE, Næss-Andresen CF, Lange JE. Pulmonary function and gas exchange at rest and exercise in adolescent girls with mild idiopathic scoliosis during treatment with Boston thoracic brace. Spine. 1990; 15(5):420-423. doi: 10.1097/00007632-199005000-00014.
  6. Nikouei F, Ghandhari H, Ameri E, Mokarami F. Shoulder Imbalance in Adolescent Idiopathic Scoliosis: A Systematic Review of the Current State of the Art. Arch Bone Jt Surg. 2022; 10(12):992-1003. doi:10.22038/abjs.2022.64282.3086.
  7. Balagué F, Pellisé F. Adolescent idiopathic scoliosis and back pain. Scoliosis Spinal Disord. 2016; 11(1):1-15. doi: 10.1186/s13013-016-0086-7.
  8. Tan K-J, Moe MM, Vaithinathan R, Wong H-K. Curve progression in idiopathic scoliosis: follow-up study to skeletal maturity. Spine. 2009; 34(7):697-700. doi: 10.1097/BRS.0b013e31819c9431.
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  12. Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M. Is Core Stability Exercise Effective in Correcting Idiopathic Scoliosis in Adolescents? A Systematic Review. Review. Journal of Mazandaran University of Medical Sciences. 2023; 32(216):179-191.
  13. Khaledi, A., Minoonejad, H., Daneshmandi, H., Akoochakian, M., Gheitasi, M. Effectiveness of the Schroth Method in Improving Cobb Angle, Trunk Rotation, and Quality of Life in Adolescents With Idiopathic Scoliosis: A Systematic Review. The Scientific Journal of Rehabilitation Medicine.2023; 12(2): 202-217. doi: 10.32598/SJRM.12.2.15.
  14. Van Rooyen C, Du Plessis LZ, Geldenhuys L, et al. The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis. S Afr J Physiother. 2019; 75(1):1-9. doi: 10.4102/sajp.v75i1.904.
  15. Ceballos-Laita L, Carrasco-Uribarren A, Cabanillas-Barea S, Pérez-Guillén S, Pardos-Aguilella P, Jiménez Del Barrio S. The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2023; 59(2):228-236. doi: 10.23736/S1973-9087.23.07654-2.
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  19. Kim MJ, Park DS. The effect of Schroth's three-dimensional exercises in combination with respiratory muscle exercise on Cobb's angle and pulmonary function in patients with idiopathic scoliosis. Physical Therapy Rehabilitation Science. 2017; 6(3):113-119. doi: 10.14474/ptrs.2017.6.3.113.
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  22. Avikainen VJ, Rezasoltani A, Kauhanen HA. Asymmetry of paraspinal EMG-time characteristics in idiopathic scoliosis. J Spinal Disord. 1999; 12(1):61-67.
  23. Rrecaj-Malaj S, Beqaj S, Krasniqi V, Qorolli M, Tufekcievski A. Outcome of 24 weeks of combined schroth and pilates exercises on cobb angle, angle of trunk rotation, chest expansion, flexibility and quality of life in adolescents with idiopathic scoliosis. Med Sci Monit Basic Res. 2020; 26:e920449-1. doi: 10.12659/MSMBR.920449.
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10.1177/0269215515575745.

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The Archives of Bone and Joint Surgery
Volume 12, Issue 1
January 2024
Pages 26-35

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History

  • Receive Date: 24 April 2023
  • Revise Date: 17 November 2023
  • Accept Date: 02 November 2023

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