Diaphragm Mobilization in Adolescent Idiopathic Scoliosis

Condition(s) studied

Investigational drug(s) / intervention(s)

Diaphragm Mobilization: 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.

Schroth Best Practice Exercise Program: 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.

Study 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.

Eligibility

Primary outcome measure(s)

• Forced Vital Capacity — Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)
  Forced vital capacity (FVC), expressed in liters, will be measured by spirometry to assess pulmonary function.
• Forced Expiratory Volume in One Second — Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)
  Forced expiratory volume in one second (FEV1), expressed in liters, will be measured by spirometry to assess pulmonary function.
• FEV1/FVC Ratio — Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)
  The FEV1/FVC ratio, expressed as a percentage, will be calculated from spirometry measurements to assess pulmonary function.
• Peak Expiratory Flow — Baseline, 6 weeks (post-intervention), and 12 weeks (follow-up)
  Peak expiratory flow (PEF), expressed in liters per minute, will be measured by spirometry to assess pulmonary function.

Trial sites (1)

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