Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training for Adolescent Spinal Curvature Abnormalities

NCT07319702 | Completed

• 1 other identifier: NNU202410016
• Study Type: interventional
• Target: 189
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to evaluate the clinical effectiveness of proprioceptive neuromuscular facilitation (PNF) combined with spiral muscle chain training in improving spinal function and posture in adolescents aged 13 to 18 years with spinal curvature abnormalities. The main questions it aims to answer are: Does exercise-based intervention improve trunk inclination angle, kyphotic angle, and body balance parameters in adolescents with spinal curvature abnormalities? Does the combined intervention improve spinal mobility and paraspinal muscle endurance compared with single-intervention approaches? Does the combined intervention lead to favorable changes in surface electromyography (sEMG) indicators of the paraspinal muscles? Researchers will compare a PNF therapy group, a spiral muscle chain training group, and a combined PNF plus spiral muscle chain training group to assess differences in trunk inclination angle, kyphotic angle, spinal mobility, paraspinal muscle endurance, and neuromuscular activation outcomes. Body mass index, fat-to-muscle ratio, and other body-composition-related indicators will be analyzed as exploratory post hoc outcomes. Participants will: Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training. Participate in supervised exercise training sessions three times per week for 12 weeks. Undergo pre- and post-intervention assessments, including body composition testing, electronic spinal measurements, and surface electromyography testing.

Conditions

Kyphosis; Flat Back; Spinal Curvature Abnormalities; Adolescent Idiopathic Scoliosis (AIS)

Keywords

Adolescent Idiopathic Scoliosis; Proprioceptive Neuromuscular Facilitation; Spiral Muscle Chain Training; Exercise Therapy; Rehabilitation; Spinal Curvature Abnormalities

Outcome Measures

Primary Outcomes (3)

• Change in Trunk Tilt Angle (ATI)

  Trunk tilt angle (Angle of Trunk Rotation, ATI) measured using an electronic spine assessment device to evaluate changes in spinal asymmetry and trunk alignment.

  Baseline and after 12 weeks of intervention

• Change in Kyphotic Angle (KA)

  Kyphotic angle will be measured using an electronic spinal assessment device to evaluate changes in sagittal spinal curvature.

  Baseline and after 12 weeks of intervention

• Change in Body Balance Parameters

  Body balance parameters assessed by electronic spine measurement, including head lateral deviation, shoulder asymmetry, and pelvic tilt.

  Baseline and after 12 weeks of intervention

Secondary Outcomes (6)

• Change in Body Mass Index (BMI)

  Baseline and after 12 weeks of intervention

• Change in Fat-to-Muscle Ratio (FMR)

  Baseline and after 12 weeks of intervention

• Change in Spinal Mobility

  Baseline and after 12 weeks of intervention

• Change in Surface Electromyography Parameters

  Baseline and after 12 weeks of intervention

• Change in Trunk Muscle Activation Patterns

  Baseline and after 12 weeks of intervention

Study Arms (3)

Proprioceptive Neuromuscular Facilitation (PNF) Therapy

EXPERIMENTAL

Participants receive proprioceptive neuromuscular facilitation (PNF) therapy as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The PNF protocol includes resisted scapular-pelvic patterns, cervical flexion/extension, trunk chopping/lifting patterns, bilateral upper-limb patterns, and bridge exercises (per PNF schedule).

Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) Therapy

Spiral Muscle Chain (SPS) Training

EXPERIMENTAL

Participants receive spiral stabilizing muscle chain (SPS) training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The SPS program follows the SPS training schedule (Training 1A-6A, 7C-10C, and stretching component), with planned repetitions/sets and practice time as listed in the protocol schedule.

Behavioral: Spiral Muscle Chain (SPS) Training

Combined Exercise Therapy

EXPERIMENTAL

Participants receive a combined program consisting of PNF therapy plus SPS spiral muscle chain training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks.

Behavioral: Combined Exercise Therapy

Interventions

Spiral Muscle Chain (SPS) Training BEHAVIORAL

Spiral muscle chain (SPS) training is applied as an exercise-based intervention aimed at improving spinal alignment, postural control, and neuromuscular coordination in children with adolescent idiopathic scoliosis. The SPS program consists of spiral stabilization exercises performed with elastic resistance, body positioning control, and stretching components according to a standardized training protocol. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Also known as: Spiral Stabilization Training

Spiral Muscle Chain (SPS) Training

Combined Exercise Therapy BEHAVIORAL

The combined intervention integrates proprioceptive neuromuscular facilitation (PNF) therapy and spiral muscle chain (SPS) training as a comprehensive exercise program for children with adolescent idiopathic scoliosis. Participants perform both PNF and SPS exercise components within each training cycle to target spinal alignment, muscle endurance, and neuromuscular activation. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Combined Exercise Therapy

Proprioceptive Neuromuscular Facilitation (PNF) Therapy BEHAVIORAL

Proprioceptive neuromuscular facilitation (PNF) therapy is used as an exercise-based intervention to address abnormal spinal curvature in children with adolescent idiopathic scoliosis. The PNF program includes resisted scapular-pelvic patterns, cervical flexion and extension, trunk diagonal patterns (chopping and lifting), bilateral upper-limb diagonal patterns, and bridge exercises. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Also known as: Proprioceptive Neuromuscular Facilitation

Proprioceptive Neuromuscular Facilitation (PNF) Therapy

Eligibility Criteria

• Age: 13 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Aged 13 to 18 years
• Newly diagnosed with no prior treatment and meeting the diagnostic criteria for spinal curvature abnormalities
• Scoliosis or coronal spinal curvature abnormality determined by poor posture and angle of trunk inclination or angle of trunk rotation of 5° or greater
• Anterior-posterior spinal curvature abnormality determined by poor posture or abnormal spinal side-view assessment, including kyphotic angle less than 20° or greater than 40°
• No prior brace treatment
• No history of spinal surgery
• Able to complete proprioceptive neuromuscular facilitation therapy, spiral muscle chain training, or combined exercise training as required
• Written informed consent obtained from participants and their parents or legal guardians

You may not qualify if:

• Menstruating females at the time of assessment
• Metal implants
• History of brace use or prior treatment for spinal curvature abnormalities
• Severe scoliosis, defined as angle of trunk inclination or angle of trunk rotation greater than 13°
• Congenital spinal curvature abnormality
• Neuromuscular disorders
• Respiratory dysfunction
• Any contraindication to exercise
• Any trauma within the previous 6 months
• Any accompanying neurological, rheumatological, or mental health problems

Sponsors & Collaborators

• Nie danning: lead

Study Sites (1)

The Affiliated High School of Nanjing Normal University

Nanjing, Jiangsu, 210023, China

Location

Related Publications (3)

• Xu Y, Feng M, Wu R, Wang Y, Yang Z, Wang Z, Kang Z, Xie L, Liu H. Effect of adding proprioceptive neuromuscular facilitation to conventional physiotherapy on scapular balance and shoulder proprioception in adolescents with idiopathic scoliosis: a randomised controlled trial protocol. BMJ Open. 2025 Nov 19;15(11):e106848. doi: 10.1136/bmjopen-2025-106848.

  PMID: 41263915 RESULT

• Nechvatal P, Hitrik T, Kendrova LD, Macej M. Comparison of the effect of the McKenzie method and spiral stabilization in patients with low back pain: A prospective, randomized clinical trial. J Back Musculoskelet Rehabil. 2022;35(3):641-647. doi: 10.3233/BMR-210055.

  PMID: 34657873 RESULT

• Maruyama T, Kitagawa T, Takeshita K, Mochizuki K, Nakamura K. Conservative treatment for adolescent idiopathic scoliosis: can it reduce the incidence of surgical treatment? Pediatr Rehabil. 2003 Jul-Dec;6(3-4):215-9. doi: 10.1080/13638490310001642748.

  PMID: 14713588 RESULT

MeSH Terms

Conditions

Kyphosis

Interventions

Muscle Stretching Exercises; Therapeutics

Condition Hierarchy (Ancestors)

Spinal Curvatures; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: PhD Candidate

Study Record Dates

• First Submitted: December 20, 2025
• First Posted: January 6, 2026
• Study Start: March 5, 2024
• Primary Completion: December 30, 2024
• Study Completion: December 30, 2024
• Last Updated: May 14, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)