Diaphragm Mobilization in Adolescent Idiopathic Scoliosis

NCT07482748 | Not Yet Recruiting

• 1 other identifier: 09.2025/303
• Study Type: interventional
• Target: 42
• Locations: 0 countries
• Sites: N/A

Brief Summary

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that can affect posture, trunk movement, and respiratory function. Changes in the shape of the rib cage may influence diaphragm function and breathing mechanics in individuals with scoliosis. The Schroth Best Practice (SBP) exercise program is commonly used in the conservative treatment of scoliosis and focuses on posture correction and scoliosis-specific exercises. However, the additional benefits of manual diaphragm mobilization combined with this exercise program are not well known. The aim of this randomized controlled trial is to investigate the effect of diaphragm mobilization added to the Schroth Best Practice program in adolescents with idiopathic scoliosis. Participants will be randomly assigned to two groups: one group will perform the SBP exercise program alone, and the other group will receive SBP exercises combined with diaphragm mobilization. The intervention will be performed three times per week for six weeks. Assessments will be conducted at baseline, at the end of the 6-week intervention, and at a 12-week follow-up. Outcomes will include respiratory function measured by spirometry, trunk rotation, thoracic mobility, trunk flexibility, quality of life, and body image. The results of this study may help determine whether adding diaphragm mobilization to scoliosis-specific exercise programs improves clinical outcomes in adolescents with idiopathic scoliosis.

Conditions

Adolescent Idiopathic Scoliosis

Keywords

Adolescent Idiopathic Scoliosis; Diaphragm Mobilization; Scoliosis-Specific Exercise; Respiratory Function; Physiotherapy

Outcome Measures

Primary Outcomes (4)

• Forced Vital Capacity

  Forced vital capacity (FVC), expressed in liters, will be measured by spirometry to assess pulmonary function.

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Forced Expiratory Volume in One Second

  Forced expiratory volume in one second (FEV1), expressed in liters, will be measured by spirometry to assess pulmonary function.

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• FEV1/FVC Ratio

  The FEV1/FVC ratio, expressed as a percentage, will be calculated from spirometry measurements to assess pulmonary function.

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Peak Expiratory Flow

  Peak expiratory flow (PEF), expressed in liters per minute, will be measured by spirometry to assess pulmonary function.

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

Secondary Outcomes (5)

• Trunk rotation angle measured by scoliometer

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Thoracic mobility measured by thoracic circumference difference

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Trunk lateral flexion flexibility

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Quality of life measured by Scoliosis Research Society-22 questionnaire

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

• Body image measured by Walter Reed Visual Assessment Scale

  Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)

Study Arms (2)

Schroth Best Practice Program + Diaphragm Mobilization

EXPERIMENTAL

Participants in this group will receive the Schroth Best Practice exercise program combined with diaphragm mobilization. The intervention will be performed three times per week for six weeks.

Procedure: Diaphragm Mobilization; Behavioral: Schroth Best Practice Exercise Program

Schroth Best Practice Program

ACTIVE COMPARATOR

Participants in this group will receive the Schroth Best Practice exercise program three times per week for six weeks.

Behavioral: Schroth Best Practice Exercise Program

Interventions

Diaphragm Mobilization PROCEDURE

Manual diaphragm mobilization will be performed with the participant in the supine position. The therapist will place both hands along the inferior costal margin and apply a gentle mobilization in coordination with the participant's breathing cycle. During inspiration and expiration, the inferior costal margin will be mobilized in a cranial and lateral direction. The technique will be performed for 20 breathing cycles and repeated twice during each treatment session with short rest periods between repetitions. The intervention will be applied at the end of each treatment session throughout the 6-week treatment period.

Also known as: Manual Diaphragm Release, Diaphragmatic Mobilization

Schroth Best Practice Program + Diaphragm Mobilization

Schroth Best Practice Exercise Program BEHAVIORAL

The Schroth Best Practice (SBP) program is a physiotherapeutic scoliosis-specific exercise approach that includes curve-specific corrective exercises and postural education. Participants will perform exercises tailored to their scoliosis curve pattern under the supervision of a physiotherapist. The program will be applied three times per week for six weeks.

Also known as: Schroth Exercises

Schroth Best Practice Program; Schroth Best Practice Program + Diaphragm Mobilization

Eligibility Criteria

• Age: 10 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Adolescents aged between 10 and 18 years
• Diagnosis of adolescent idiopathic scoliosis
• Cobb angle ≥ 10°
• Ability to participate in exercise sessions
• Written informed consent from the participant and their parent or legal guardian

You may not qualify if:

• Non-idiopathic scoliosis (e.g., neuromuscular, congenital, or syndromic scoliosis)
• Presence of congenital anomalies affecting the musculoskeletal system
• Previous scoliosis treatment within the last 6 months
• Participation in another physiotherapy or rehabilitation program during the study period
• Current use of a scoliosis brace
• History of spinal surgery
• Presence of neurological, rheumatological, or cardiopulmonary diseases that may affect participation in the intervention
• Cognitive impairment, communication disorders, or any condition that may limit the ability to follow instructions or complete assessments

Sponsors & Collaborators

• Marmara University: lead

MeSH Terms

Conditions

Respiratory Aspiration

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Tuğba KURU ÇOLAK, PT, PhD

  Marmara University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Eray Yüceel, PT, MSc(c)

CONTACT

+90(538)8861539; eryuceel@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessments will be performed by a physiotherapist who is blinded to group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Department of Physiotherapy and Rehabilitation

Model Details: Participants will be randomly allocated into two parallel groups: (1) Schroth Best Practice exercise program and (2) Schroth Best Practice exercise program combined with diaphragm mobilization.

Study Record Dates

• First Submitted: March 6, 2026
• First Posted: March 19, 2026
• Study Start: March 15, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): January 1, 2027
• Last Updated: March 19, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share