Efficacy of a Three-dimensionally Corrective Exercise Therapy for Scoliosis
Efficacy of a Three-dimensionally Corrective Exercise Therapy for Scoliosis
Idiopathic scoliosis (AIS) is one of the most prevalent spinal deformity that may progress
 sharply during growth. It is recommended that the physiotherapeutic scoliosis-specific
 exercises should be the first step to treat idiopathic scoliosis to prevent/limit progression
 of the deformity. Three-dimensionally corrective exercise for scoliosis is based the theory
 of physiotherapeutic scoliosis specific exercises, which focuses on 3-dimension
 self-correction and consists of two parts:1)outpatient treatment including stretching,
 three-dimensional self-correction, balance and stability training, combined with manual
 fascia relaxation therapy, and and breathing training; 2)family rehabilitation: combines
 self-correcting gymnastics with daily posture management, etc., forming the individual
 exercise approach for each patient. Nevertheless, the evidence concerning three-dimensionally
 corrective exercise for scoliosis is inadequate. Therefore, the objective of this study is to
 determine the effect of three-dimensionally corrective exercise intervention on the change of
 Cobb angle, trunk rotation, sagittal profile, lung function, exercise endurance and health
 related quality-of-life, compared to conventional exercise therapy for patients with mild and
 moderate AIS.

 Informed consent will be obtained from each patient and one of their parents prior to
 inclusion. Eligible subjects will be divided into two groups(experimental group or control
 group) according to their wishes. Subjects in experimental group will perform
 three-dimensionally corrective exercise for scoliosis (moderate patients combined with a
 brace) and those in the control group will receive conventional exercise therapy (moderate
 patients combined with a brace).

 Blinded assessments at baseline and immediately post 12-month intervention will include
 radiographic measurement, trunk rotation, sagittal profile, lung function, exercise endurance
 and health related quality-of-life.
Idiopathic scoliosis (AIS) is one of the most prevalent spinal deformity that may progress
 sharply during growth. According to the severity of the curve, the major treatment approaches
 for patient with AIS include exercises, bracing and surgery, to correct, prevent or stop the
 progression of the deformity.In North America, Scoliosis Research Society (SRS) has been
 published the standard of care for AIS: patients with curves between 10 and 25° should be
 observation who are still growing. While in the Europe, the International Scientific Society
 on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) has recommended that the
 physiotherapeutic scoliosis-specific exercises should be the first step to treat idiopathic
 scoliosis to prevent/limit progression of the deformity. Three-dimensionally corrective
 exercise for scoliosis is based the theory of physiotherapeutic scoliosis specific exercises,
 which focuses on 3-dimension self-correction and consists of two parts:1)outpatient treatment
 including stretching, three-dimensional self-correction, balance and stability training,
 combined with manual fascia relaxation therapy, and and breathing training; 2)family
 rehabilitation: combines self-correcting gymnastics with daily posture management, etc.,
 forming the individual exercise approach for each patient. Nevertheless, the evidence
 concerning three-dimensionally corrective exercise for scoliosis is inadequate. Therefore,
 the objective of this study is to determine the effect of three-dimensionally corrective
 exercise intervention on the change of Cobb angle, trunk rotation, sagittal profile, lung
 function, exercise endurance and health related quality-of-life, compared to conventional
 exercise therapy for patients with mild and moderate AIS.

 The present study is a single-center prospective non-randomised controlled trial conducted at
 the department of rehabilitation medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong
 University School of Medicine. The demographic data (height, weight), menarche status for the
 girls, family history, will be recorded by the physician.

 Informed consent will be obtained from each patient and one of their parents prior to
 inclusion. Eligible subjects will be assigned by a 1:1 allocation ratio either to the
 experimental group, in which they will perform three-dimensionally integrated exercise for
 scoliosis, or the control group, in which they will receive the standard of care with
 observation according to the Scoliosis Research Society criteria. Blinded assessments at
 baseline and immediately post 12-month intervention will include radiographic measurement,
 trunk rotation, sagittal profile, lung function, exercise endurance and health related
 quality-of-life.
Inclusion Criteria(meet all the following conditions):

 1. Age between 8-16;

 2. Definitely diagnosed as IS;

 3. Patients with Cobb angle greater than or equal to 10° and less than 45°.

 Exclusion Criteria(at least meet one of the following conditions):

 1. Scoliosis caused by congenital, postural, neuromuscular or other diseases (such as
 neurofibromatosis, Marfan syndrome, bone dysplasia, metabolic or endocrine diseases,
 etc.);

 2. Patients suffering from mental illness or rheumatic disease;

 3. Patients with insufficient understanding ability to understand and complete the
 treatment plan;

 4. Patients with exercise contraindications who cannot tolerate exercise therapy;

 5. Patients with poor treatment compliance or refusal to treat;

 6. Patients with a history of rehabilitation or surgery before the first visit;

 7. Patients with apical vertebrae at T7 and above, or patients with mature bones.