Schroth and Pilates for Adolescent Idiopathic Scoliosis

NCT07702812 | Recruiting

• 1 other identifier: 10/1662
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

The primary aim of this study is to investigate the effectiveness of Schroth training and the multidimensional effects of adding Pilates-based exercises to Schroth training in individuals with adolescent idiopathic scoliosis. Specifically, the study aims to evaluate the effects of Pilates-based exercises combined with Schroth training on lung capacity, trunk muscle strength, proprioception, trunk rotation, and posture. In addition, it seeks to examine the impact of the intervention on important functional and psychosocial outcomes, including quality of life, perceived cosmetic deformity, and pain threshold. This study is expected to contribute to the existing evidence on the use of Pilates exercises in combination with Schroth exercises for individuals with adolescent idiopathic scoliosis by providing a comprehensive evaluation of the effects of this combined intervention. The findings are intended to provide guidance for clinicians and researchers regarding the combined use of different exercise approaches in the management of adolescent idiopathic scoliosis. Furthermore, the study aims to explore the potential benefits of integrating the Schroth method with Pilates as a holistic treatment approach for scoliosis management.

Conditions

Adolescent Idiopathic Scoliosis (AIS)

Keywords

adolescent idiopathic scoliosis; Schroth exercise; Pilates exercise; proprioception; quality of life; Perceived cosmetic deformity; Core muscle

Outcome Measures

Primary Outcomes (10)

• Assessment of Lung Capacity

  Vital Capacity (VC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. VC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.

  Baseline and 2 months

• Assessment of Lung Capacity

  Forced Vital Capacity (FVC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FVC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.

  Baseline and 2 months

• Assessment of Lung Capacity

  Total Lung Capacity (TLC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. TLC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.

  Baseline and 2 months

• Assessment of Lung Capacity

  Residual Volume (RV) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. RV values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.

  Baseline and 2 months

• Assessment of Lung Capacity

  Forced Expiratory Volume in One Second (FEV₁) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FEV₁ values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.

  Baseline and 2 months

• Assessment of Core Muscle Strength

  Core muscle strength will be assessed using The Stabilizer Pressure Biofeedback Unit (Chattanooga Group Inc., USA) with the participant in the prone position. The pressure cuff of the Stabilizer unit will be placed horizontally beneath the abdominal region, with its lower edge aligned with the anterior superior iliac spines (ASIS). Participants will be instructed to take a deep breath, exhale, and gently draw the umbilicus toward the lumbar spine while maintaining normal breathing. After participants have been familiarized with the maneuver, the Stabilizer unit will be inflated to 70 mmHg. Participants will then be asked to repeat the maneuver and maintain the contraction for 10 seconds. The assessment will be performed three times, and the mean value will be recorded.

  Baseline and 2 months

• Postural Assessment

  The device projects white light stripes (raster lines) onto the participant's back, and the three-dimensional shape of the back is reconstructed by analyzing the deformation of these projected lines. The resulting curved light patterns are captured by a camera, allowing a radiation-free and non-contact assessment of spinal alignment and posture. During the assessment, participants will be instructed to stand in a relaxed and stationary position facing forward, with their back toward the camera, arms hanging freely at their sides, and feet positioned on the designated markers on the platform. The following postural parameters will be assessed: pelvic symmetry, shoulder and scapular alignment, vertebral rotation, thoracic kyphosis angle, and lumbar lordosis angle.

  Baseline and 2 months

• Assessment of Trunk Proprioception

  Trunk proprioception will be assessed using a dual digital inclinometer (ACUMAR™, Lafayette, IN, USA). Participants will stand barefoot on a firm surface with their feet shoulder-width apart. The inclinometer sensors will be placed over the T1 and S1 spinous processes, identified by palpation. Participants will perform 30° trunk flexion and 15° trunk extension with their eyes open, memorize each target position, return to the starting position, and then reproduce the target angle. Each measurement will be repeated three times. The difference between the target and reproduced angles will be recorded in degrees as the measure of trunk proprioception.

  Baseline and 2 months

• Assessment of Trunk Rotation

  Trunk rotation will be assessed using a Baseline Scoliometer (Fabrication Enterprises, White Plains, NY, USA). Participants will stand upright with their feet together and parallel, facing forward. They will then be instructed to place their hands together and bend forward until the trunk is parallel to the floor while keeping the arms relaxed. Angle of trunk rotation (ATR) will be measured at the cervical, thoracic, and lumbar regions, and the values will be recorded

  Baseline and 2 months

• Assessment of Pain Threshold

  Pressure pain threshold will be assessed using a Baseline algometer (White Plains, NY, USA). The device applies pressure through a 1 cm² rubber tip, and the pressure at which pain is first perceived will be recorded in kg/cm² . Measurements will be performed bilaterally at points 2-3 cm lateral to the paravertebral muscles at the level of the participant's primary spinal curve. Before testing, pressure will be applied to a non-test area to familiarize participants with the procedure. Pressure will then be gradually increased until the participant indicates that the sensation has become painful by raising a hand. Three consecutive measurements, separated by 5-second intervals, will be obtained, and the mean value will be recorded.

  Baseline and 2 months

Secondary Outcomes (2)

• Assessment of Quality of Life

  Baseline and 2 months

• Assessment of Perceived Cosmetic Deformity

  Baseline and 2 months

Study Arms (2)

Schroth Group

ACTIVE COMPARATOR

Participants will receive supervised Schroth exercises based on the standardized Schroth method throughout the intervention period.

Behavioral: Schroth Group

Schroth Combined with Pilates Group

EXPERIMENTAL

Participants in this group will receive Schroth exercises combined with Pilates-based exercises under the supervision of a physiotherapist throughout the intervention period.

Other: Schroth and Pilates Group

Interventions

Schroth Group BEHAVIORAL

Participants will be randomly allocated to either the intervention group or the control group.Participants in the control group will receive supervised Schroth exercise training twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will perform only the Schroth home exercise program.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions.

Schroth Group

Schroth and Pilates Group OTHER

Participants will be randomly allocated to either the intervention group or the control group. Participants in the intervention group will receive supervised Schroth training combined with Pilates-based exercises twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will be prescribed a home exercise program consisting of Schroth home exercises and Pilates-based exercises.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions.

Schroth Combined with Pilates Group

Eligibility Criteria

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

You may qualify if:

• Aged 10-18 years.
• Diagnosed with adolescent idiopathic scoliosis by a physician.
• Cobb angle between 10° and 45°.
• Willingness of both the participant and their parent/legal guardian to participate in the study.
• No additional rheumatologic, neurological, or orthopedic disorders.
• No scoliosis-specific treatment received within the previous 6 months.

You may not qualify if:

• History of scoliosis or spinal surgery.
• Scoliosis secondary to neurological, congenital, or other non-idiopathic causes.
• Any contraindication to exercise.
• A spinal curve with an apex at T12-L1.
• Presence of cognitive impairment that would interfere with study participation or assessments.

Sponsors & Collaborators

• Ankara Yildirim Beyazıt University: lead

Study Sites (1)

Ankara Yıldırım Beyazıt University

Ankara, Turkey (Türkiye)

RECRUITING

Related Publications (20)

• Manzak Dursun AS, Ozyilmaz S, Ucgun H, Elmadag NM. The effect of Pilates-based exercise applied with hybrid telerehabilitation method in children with adolescent idiopathic scoliosis: A randomized clinical trial. Eur J Pediatr. 2024 Feb;183(2):759-767. doi: 10.1007/s00431-023-05340-2. Epub 2023 Nov 23.

  PMID: 37993666 BACKGROUND

• Langensiepen S, Semler O, Sobottke R, Fricke O, Franklin J, Schonau E, Eysel P. Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review. Eur Spine J. 2013 Nov;22(11):2360-71. doi: 10.1007/s00586-013-2693-9. Epub 2013 Feb 27.

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• Kocaman H, Bek N, Kaya MH, Buyukturan B, Yetis M, Buyukturan O. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial. PLoS One. 2021 Apr 15;16(4):e0249492. doi: 10.1371/journal.pone.0249492. eCollection 2021.

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• Kim, B. S., & Lee, M. M. (2020). A study on the clinical usefulness, validity, and test-retest reliability of the Spirokit, a device that combines the pulmonary function test and respiratory muscle strength test. Physical therapy rehabilitation science, 9(2), 120-130.

  BACKGROUND

• Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M. Schroth and Asymmetric Spinal Stabilization Exercises' Effectiveness on Back Pain and Trunk Muscle Endurance in Adolescents' Idiopathic Scoliosis: A Randomized Controlled Trial. Med J Islam Repub Iran. 2024 Aug 6;38:90. doi: 10.47176/mjiri.38.90. eCollection 2024.

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• Kempen DHR, Heemskerk JL, Kacmaz G, Altena MC, Reesink HJ, Vanhommerig JW, Willigenburg NW. Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J. 2022 Jul;22(7):1178-1190. doi: 10.1016/j.spinee.2021.12.011. Epub 2021 Dec 25.

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• HwangBo, P. N. (2018). The effects of Pilates exercise using the three dimensional Schroth breathing technique on the physical factors of scoliosis patients. The Journal of Korean Physical Therapy, 30(6), 229-233.

  BACKGROUND

• Güneş, G., & Çolak, T. K. (2023). Adölesan İdiyopatik Skolyozda Emekleme (KLAPP) Egzersizleri (KLAPP). Journal of Health Sciences and Management, 3(3), 66-70.

  BACKGROUND

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  PMID: 31613151 BACKGROUND

• Gou Y, Lei H, Zeng Y, Tao J, Kong W, Wu J. The effect of Pilates exercise training for scoliosis on improving spinal deformity and quality of life: Meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021 Oct 1;100(39):e27254. doi: 10.1097/MD.0000000000027254.

  PMID: 34596121 BACKGROUND

• Goldberg A, Hernandez ME, Alexander NB. Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci. 2005 Oct;60(10):1310-4. doi: 10.1093/gerona/60.10.1310.

  PMID: 16282565 BACKGROUND

• Dimitrijevic V, Viduka D, Scepanovic T, Maksimovic N, Giustino V, Bianco A, Drid P. Effects of Schroth method and core stabilization exercises on idiopathic scoliosis: a systematic review and meta-analysis. Eur Spine J. 2022 Dec;31(12):3500-3511. doi: 10.1007/s00586-022-07407-4. Epub 2022 Oct 14.

  PMID: 36229615 BACKGROUND

• Degenhardt BF, Starks Z, Bhatia S. Reliability of the DIERS Formetric 4D Spine Shape Parameters in Adults without Postural Deformities. Biomed Res Int. 2020 Feb 13;2020:1796247. doi: 10.1155/2020/1796247. eCollection 2020.

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• Çolak İ, Çolak TK. A study of the reliability and validity of the Turkish version of the Walter Reed Visual Assessment Scale in adolescents with idiopathic scoliosis. J Turk Spinal Surg. 2020;31(3):125-9.

  BACKGROUND

• Coelho DM, Bonagamba GH, Oliveira AS. Scoliometer measurements of patients with idiopathic scoliosis. Braz J Phys Ther. 2013 Mar-Apr;17(2):179-84. doi: 10.1590/S1413-35552012005000081.

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  BACKGROUND

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• Alanay A, Cil A, Berk H, Acaroglu RE, Yazici M, Akcali O, Kosay C, Genc Y, Surat A. Reliability and validity of adapted Turkish Version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine (Phila Pa 1976). 2005 Nov 1;30(21):2464-8. doi: 10.1097/01.brs.0000184366.71761.84.

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• Akyurek E, Zengin Alpozgen A, Akgul T. The preliminary results of physiotherapy scoliosis-specific exercises on spine joint position sense in adolescent idiopathic scoliosis: A randomized controlled trial. Prosthet Orthot Int. 2022 Oct 1;46(5):510-517. doi: 10.1097/PXR.0000000000000136. Epub 2022 Jun 7.

  PMID: 36215059 BACKGROUND

Study Officials

• Emine Kübra AY

  Ankara Yildirim Beyazıt University

  PRINCIPAL INVESTIGATOR

• Bahar ANAFOROĞLU

  Ankara Yildirim Beyazıt University

  STUDY CHAIR

Central Study Contacts

Emine Kübra AY

CONTACT

+90 312 906 10 00; ekay@aybu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 3, 2026
• First Posted: July 14, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)