NCT04922983

Brief Summary

The study uses a yoga-like isometric posture and botulinum injections to reduce the curves in adolescent idiopathic lumbar scoliosis. Three previous studies show that the yoga pose is effective for reversing scoliotic curves; Botulinum toxin has been approved by the FDA for teenagers. However, no studies using the two of them together have been done until this one.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
42

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Jul 2021

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 3, 2021

Completed
2 months until next milestone

First Posted

Study publicly available on registry

June 11, 2021

Completed
20 days until next milestone

Study Start

First participant enrolled

July 1, 2021

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2025

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2026

Completed
Last Updated

October 19, 2023

Status Verified

August 1, 2023

Enrollment Period

4 years

First QC Date

April 3, 2021

Last Update Submit

October 17, 2023

Conditions

Keywords

Adolescent idiopathic scoliosisscoliosisyogaisometricbotulinum

Outcome Measures

Primary Outcomes (5)

  • Reduction in lumbar and thoracic scoliotic curve

    Measured by the Cobb angle in coronal X-rays

    At study onset

  • Reduction in lumbar and thoracic scoliotic curve

    Measured by the Cobb angle in coronal X-rays

    3 weeks after study onset

  • Reduction in lumbar and thoracic scoliotic curve

    Measured by the Cobb angle in coronal X-rays

    3 months after study onset

  • Reduction in lumbar and thoracic scoliotic curve

    Measured by the Cobb angle in coronal X-rays

    3 weeks after crossover group injections

  • Reduction in lumbar and thoracic scoliotic curve

    Measured by the Cobb angle in coronal X-rays

    3 months after crossover group injections

Study Arms (4)

Group I: Placebo isometric measure, no injection

SHAM COMPARATOR

Group I: no isometric yoga-like exercise, no injection given.

Behavioral: Placebo

Group II Isometric yoga-like exercise, placebo injection given

PLACEBO COMPARATOR

Group II isometric yoga-like exercise, injection of preservative-free normal saline.

Behavioral: Isometric Yoga-like exercise

Group III: True isometric exercise, botulinum injection

ACTIVE COMPARATOR

Group III: Isometric yoga-like exercise, botulinum injection given

Drug: Botulinum toxin type ABehavioral: Isometric Yoga-like exercise

Crossover

ACTIVE COMPARATOR

After the three months, Arm I and Arm II patients will be given botulinum injections, and Group I will be given the proper yoga-like exercise. These two arms will constitute a further comparator with their own performances in the first 3 months of the study.

Drug: Botulinum toxin type ABehavioral: Isometric Yoga-like exercise

Interventions

A position similar to the side-plank (Vasisthasana) held for maximal time at least once daily (usual duration: 30 - 90 seconds).

Also known as: Incobotulinumtoxin A
CrossoverGroup III: True isometric exercise, botulinum injection

Extended torso and legs held diagonally by one straight arm, back against wall if necessary

Also known as: Side-Plank, Vasisthasana
CrossoverGroup II Isometric yoga-like exercise, placebo injection givenGroup III: True isometric exercise, botulinum injection
PlaceboBEHAVIORAL

Used as placebo

Also known as: no active intervention by drug or yoga-like exercise
Group I: Placebo isometric measure, no injection

Eligibility Criteria

Age14 Years - 18 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • \. Fourteen - 18 years of age, 2. Scoliotic curve greater than 25 degrees, less than 45 degrees, 3. Stated willingness to do the yoga and yoga-like poses daily, 4. Written, signed consent by patient and parent/guardian 5. Pre-test Cobb films no less than 3 months old read by independent radiologists.

You may not qualify if:

  • Neurological, muscular or neuromuscular disease, (e.gs., cerebral palsy, myopathy, stroke),
  • Genetic abnormalities that affect limb growth, proportionality or metabolism, (e.gs., mucopolysaccharidoses, Marfan's syndrome, Refsums disease).
  • Pregnancy and other conditions prohibiting X-rays or minute(s)-long exertion (e.gs., congestive heart failure, great weakness, COPD).
  • Previous exposure to botulinum neurotoxin Type A. Sexually active female subjects must present a recent negative pregnancy test.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Manhattan Physical Medicine and Rehabilitation, PLLC

Manhattan, New York, 10022, United States

RECRUITING

Related Publications (3)

  • Fishman LM, Groessl EJ, Sherman KJ. Serial case reporting yoga for idiopathic and degenerative scoliosis. Glob Adv Health Med. 2014 Sep;3(5):16-21. doi: 10.7453/gahmj.2013.064.

  • Fishman LM. Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis-A Nonrandomized Control Trial. Glob Adv Health Med. 2021 Feb 24;10:2164956120988259. doi: 10.1177/2164956120988259. eCollection 2021.

  • Fishman LM, Groessl EJ, Bernstein P.Two Isometric Yoga Poses Reduce the Curves in Degenerative and Adolescent Idiopathic Scoliosis. Topics in Geriatric Rehabilitation. 33(4):231-237, October/December, 2017.

    RESULT

Related Links

MeSH Terms

Conditions

Scoliosis

Interventions

Botulinum Toxins, Type A

Condition Hierarchy (Ancestors)

Spinal CurvaturesSpinal DiseasesBone DiseasesMusculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Botulinum ToxinsMetalloendopeptidasesEndopeptidasesPeptide HydrolasesHydrolasesEnzymesEnzymes and CoenzymesMetalloproteasesBacterial ProteinsProteinsAmino Acids, Peptides, and ProteinsBacterial ToxinsToxins, BiologicalBiological Factors

Study Officials

  • Loren M Fishman

    Columbia University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Cara M Cipriano, BA

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Participants will understand they may receive placebo, and that they will not be told Investigators will know whether they give injections or not, but will not know if injection is placebo. Outcomes assessors will be blinded to the entire procedure (radiologists reading X-rays).
Purpose
TREATMENT
Intervention Model
CROSSOVER
Model Details: Three groups: Group I: Placebo isometric measure, no injection Group II True isometric exercise, placebo injection Group III: True isometric exercise, botulinum injection
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 3, 2021

First Posted

June 11, 2021

Study Start

July 1, 2021

Primary Completion

July 1, 2025

Study Completion

January 1, 2026

Last Updated

October 19, 2023

Record last verified: 2023-08

Data Sharing

IPD Sharing
Will not share

Locations