Effects of Core Stabilization Exercises and Rotation Angular Breathing Exercises Among Idiopathic Scoliosis Patients (CSE RAB IS)

Lahore University of Biological and Applied Sciences

Status: Not yet enrolling

Conditions: Scoliosis Idiopathic; Idiopathic Adolescent Scoliosis

Treatments: Other: Core Stabilization Exercises; Other: Standard Care (in control arm)

Study type: Interventional

Funder types: Other

Identifiers

NCT07601893

UBAS/ERB/26/04/035

U1111-1339-6644 (Registry Identifier)

Details and patient eligibility

About

This study is a single-blind, two-arm parallel-group randomized controlled trial designed to evaluate the effects of core stabilization exercises combined with rotational angular breathing exercises on adolescents with idiopathic scoliosis. Participants aged 10-18 years with a Cobb angle between 10° and 25° will be randomly assigned to either an experimental group receiving a structured exercise program or a control group receiving standard care.

The intervention will be conducted over 12 weeks, with outcomes assessed at baseline, post-intervention, and follow-up periods. Primary outcomes include Cobb angle, angle of trunk rotation, inspiratory capacity, and spinal appearance. The study aims to determine whether the combined exercise approach is more effective than standard care in improving spinal alignment, respiratory function, and physical appearance.

Full description

Adolescent idiopathic scoliosis is a three-dimensional spinal deformity characterized by lateral curvature and vertebral rotation, commonly developing during adolescence. It is associated with postural asymmetry, trunk deformity, reduced pulmonary function, and decreased quality of life. Conservative management strategies, particularly exercise-based interventions, are widely used to prevent progression and improve functional outcomes.

Core stabilization exercises focus on strengthening the muscles surrounding the spine, including abdominal, paraspinal, and pelvic muscles. These exercises enhance spinal stability, improve postural control, and reduce compensatory movement patterns. However, core stabilization alone may not fully address thoracic asymmetry and respiratory limitations associated with scoliosis.

Rotational angular breathing exercises are scoliosis-specific techniques aimed at improving thoracic expansion, promoting spinal de-rotation, and enhancing pulmonary function. These exercises involve controlled breathing patterns that target the concave side of the rib cage, facilitating improved ventilation and postural correction.

Although both interventions have shown individual effectiveness, limited evidence exists regarding their combined effects on structural, functional, and patient-reported outcomes in adolescents with idiopathic scoliosis. Therefore, this study aims to evaluate the combined impact of core stabilization and rotational angular breathing exercises on multiple clinical outcomes.

This study will be conducted as a single-blind, randomized controlled trial with two parallel groups. A total of 32 participants meeting eligibility criteria will be recruited and randomly assigned in a 1:1 ratio to either the experimental group or the control group.

Participants in the experimental group will undergo a supervised exercise program consisting of core stabilization exercises (planks, bridges, bird dog, and dead bug) combined with rotational angular breathing exercises. The program will be performed 3-4 times per week for 12 weeks, with gradual progression in intensity and duration. The control group will receive standard care without a structured exercise program.

Outcome measures will be assessed at baseline, immediately after the 12-week intervention, and at 3-month and 6-month follow-up periods. Primary outcomes include Cobb angle measured via radiographs, angle of trunk rotation assessed using a scoliometer, inspiratory capacity measured using spirometry, and spinal appearance evaluated using the Spinal Appearance Questionnaire. Secondary outcomes include quality of life assessed using the Scoliosis Research Society-22 questionnaire.

Blinding will be applied at the level of outcome assessors to reduce measurement bias. Statistical analysis will be conducted to compare within-group and between-group differences over time.

The results of this study are expected to provide evidence on the effectiveness of a combined exercise approach targeting both biomechanical and respiratory components of scoliosis. This may support the development of comprehensive rehabilitation protocols for adolescents with idiopathic scoliosis.

Enrollment: 32 estimated patients

Sex: All

Ages: 10 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adolescents aged 10-17 years
• Both male and female participants
• Diagnosed cases of idiopathic scoliosis
• Cobb's angle between 10° and 25°
• Both thoracic and lumbar spine scoliosis patients
• Both C-shaped or S-shaped curve scoliosis patients

Exclusion criteria

• Previous spinal surgery
• Significant neuromuscular disorders (e.g, muscular dystrophy, cerebral palsy)
• Other medical conditions affecting participation (e.g, respiratory or cardiac)
• Any contraindication to exercise program

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Core stabilization and rotational angular breathing exercises

Experimental group

Description:

Planks involve maintaining a straight body position from head to heels while resting on the forearms and toes, effectively strengthening the abdominal muscles and lower back. Bridges require participants to lie on their backs with knees bent and feet flat, lifting their hips to create a straight line from shoulders to knees, targeting the glutes and hamstrings for enhanced pelvic stability. The bird dog exercise is performed on hands and knees, where participants extend one arm and the opposite leg, promoting balance and coordination while engaging the core. Lastly, dead bugs involve lying on the back with arms and legs raised, lowering one arm and the opposite leg while keeping the lower back pressed into the floor, which effectively engages deep core muscles. Additionally, the program will incorporate rotational angular breathing exercises, focusing on enhancing thoracic expansion and postural control through specific breathing techniques.

Treatment:

Other: Core Stabilization Exercises

Standard care

Active Comparator group

Description:

Participants in the active comparator group will receive conventional physiotherapy routinely provided for individuals with idiopathic scoliosis. The program will focus on general posture correction, flexibility, spinal mobility, and basic strengthening exercises without specialized core stabilization or rotational angular breathing techniques. Standard Care Intervention: General stretching exercises for trunk and lower limb muscles Active range of motion exercises for spinal mobility Conventional postural correction exercises Basic strengthening exercises for back and abdominal muscles Breathing awareness exercises without rotational angular emphasis Education regarding posture maintenance and ergonomic advice Frequency: 3 sessions per week Total Duration: 12 weeks Session Duration: 40 minutes Session Structure 5 minutes warm-up 25 minutes conventional physiotherapy exercises 5 minutes breathing and relaxation exercises 5 minutes cool-down and posture education

Treatment:

Other: Standard Care (in control arm)