Volume 8 Supplement 1

9th International Conference on Conservative Management of Spinal Deformities - SOSORT 2012 Annual Meeting

Open Access

Feasibility and three months preliminary results of an RCT on the effect of Schroth exercises in adolescent idiopathic scoliosis (AIS)

  • S Schreiber1,
  • EC Parent2, 4,
  • DM Hedden3,
  • EM Watkins1,
  • DL Hill3, 4,
  • M Moreau3,
  • S Southon5 and
  • JK Mahood3
Scoliosis20138(Suppl 1):O21

https://doi.org/10.1186/1748-7161-8-S1-O21

Published: 3 June 2013

Background

Schroth exercises are scoliosis-specific postural exercises aimed at improving appearance, postural control, and prevention of curve progression. An RCT on the effect of Schroth exercises for scoliosis is needed.

Aim

To determine the recruitment, eligibility, attendance, and compliance rates for an RCT, and estimate the effect size for the selected outcomes.

Methods

Fifteen patients with AIS, aged 10-18, with curves 10 – 45 degrees, braced or not, were randomized into Schroth, or standard care, groups. The six-month Schroth intervention consists of weekly one-hour long group exercise sessions, combined with a daily 45-minute long home program, consisting of 3-4 exercises prescribed using an algorithm. Compliance was monitored with a logbook. SRS-22r, Spinal Appearance Questionnaire, Sorensen back endurance, and Self-efficacy and Global Rating of Change (GRC) outcomes were measured. The effect sizes of the Schroth exercise treatment on key outcomes were estimated using Cohen’s d (≥0.8=large, 0.5-0.8=moderate, 0.2-0.5=small). Cohen’s d is defined as the difference in change between the group means, Schroth – Standard care, observed from baseline to 3 months, divided by the pooled standard deviation at baseline.

Results

Of 122 eligible patients, fifteen (12.3%) were enrolled between April and August 2011. Recruitment was 3 per month. Exercise subjects attended 89±9% of the prescribed weekly exercise sessions, and completed 76±8% of the prescribed home exercises. Only one Standard-care subject dropped out due to relocation. For SRS-22r domains, Cohen’s d effect sizes favored standard care: -0.31 for Self-image, -0.72 for Function, and -0.38 for Pain. For SAQ domains, some effect sizes favored standard care: 0.50 for General, 0.46 for Curve, 1.36 for Prominence, 0.57 for Shoulders and 0.35 for Chest. Other SAQ effect sizes favored Schroth: -0.14 for Trunk Shift, -0.31 for waist. The Sorensen test’s effect size was -0.14, and Self-efficacy’s was 0.5, both favoring standard care. The mean difference between groups in GRC was 3.4±1.7 in favor of the Schroth group.

Conclusion

RCT feasibility was demonstrated by high therapy session attendance and home-exercises compliance. At 3-months, in a small sample, without adjustment for severity, effect sizes favoring Schroth exercises were smaller than anticipated, or favored standard care. We will assess whether our Schroth education, with curve and posture analysis, might have sensitized patients as to how they perceive their scoliosis.

Authors’ Affiliations

(1)
Faculty of Rehabilitation Medicine, Rehabilitation Science, University of Alberta
(2)
Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta
(3)
Faculty of Medicine and Dentistry, Department of Surgery, University of Alberta
(4)
Glenrose Rehabilitation Hospital
(5)
University of Alberta Hospital

References

  1. Fusco C, Zaina F, Atanasio S, Romano M, Negrini A, Negrini S: Physical exercises in the treatment of adolescent idiopathic scoliosis: an updated systematic review. Physiother Theory Pract. 2011, 27 (1): 80-114. 10.3109/09593985.2010.533342.View ArticlePubMedGoogle Scholar
  2. Negrini S, Fusco C, Minozzi S, Atanasio S, Zaina F, Romano M: Exercises reduce the progression rate of adolescent idiopathic scoliosis: results of a comprehensive systematic review of the literature. Disabil Rehabil. 2008, 30 (10): 772-785. 10.1080/09638280801889568.View ArticlePubMedGoogle Scholar

Copyright

© Schreiber et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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