Effect of Global Postural Re-education in Idiopathic Scoliosis
Effect of Global Postural Re-education in Idiopathic Scoliosis
In North America, children and adolescents with idiopathic scoliosis (IS) are rarely referred
 for a rehabilitation program whereas the European guidelines stated that scientific evidences
 concerning scoliosis specific physiotherapy exercises were strong enough to recommend the use
 of these exercises at an early stage. The objectives of this pilot study is to assess
 feasibility of conducting a larger randomized control trial (RCT) on the effect of global
 postural re-education (GPR) on scoliosis progression (Cobb angle) and posture, back pain and
 participation and to assess the equivalence of two groups of GPR interventions. A convenience
 sample of 60 adolescents with IS (Cobb angle 15º-50º, Risser sign ≤3) will be recruited at
 CHU Sainte-Justine. Participants will be randomly allocated to GPR-A (individual sessions
 once a week) or GPR-B (individual sessions once per two weeks alternately with class
 exercises once per two weeks) for 6 months. After 6 months, groups will be interchanged for
 another 6 months. Feasibility outcomes will be recruitment rate, consent rate, completion
 rate and adherence to treatment at 12 months. The primary outcome of the effect of GPR will
 be the Cobb angle. Secondary outcomes will be: posture, back pain and participation at 6 and
 12 months. Statistical analyses: For feasibility, percentage of eligible patients recruited,
 percentage of recruited patients who completed the trial and adherence to treatment will be
 calculated. For the preliminary effects of GPR, linear mixed-models will be used to assess
 differences in groups' changes from baseline, to 6 and 12-month while adjusting for
 covariates (age, Risser, adherence). Separate analyses will be conducted for each outcome.
Inclusion Criteria:

 -  aged between 8 and 16 years old,

 -  Cobb angle between 15º and 50º,

 -  a Risser sign ≤3 (skeletal growth incomplete),

 -  having recent x-rays (4-6 weeks),

 -  ability to travel weekly to attend GPR interventions

 Exclusion Criteria:

 -  patients who are planning surgery or have had surgery,

 -  previous regular physiotherapy or other conservative treatment (chiro, osteopathy),

 -  worn a brace for at least three months prior to GPR interventions,

 -  scheduled for clinic follow-up later than in 6±2 months,

 -  or to be discharged before 12 months.