Schroth Exercises for Degenerative Scoliosis

(ADSET Trial)

Overseen By Eric Parent, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Trial Phase: Academic

Sponsor: University of Alberta

Disqualifiers: Curves over 50°, fractures, cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

Duration: 12 weeks

20 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether Schroth exercises, a type of scoliosis-specific exercise, can benefit adults with degenerative scoliosis, a condition where the spine curves and rotates, causing pain and other issues. The study compares patients performing Schroth exercises to those who are either observed or continue their usual pain medication. It aims to determine if these exercises can reduce pain and improve quality of life without surgery. The trial seeks adults over 50 with scoliosis curves between 15° and 45° who experience pain. As an unphased trial, it offers a unique opportunity to explore non-surgical options for improving quality of life.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

What prior data suggests that Schroth exercises are safe for adults with degenerative scoliosis?

Research has shown that Schroth exercises, a type of physical therapy for scoliosis, yield promising results in improving spine curves and reducing trunk rotation. These exercises are customized for each individual's spine and have proven helpful for age-related scoliosis. Studies suggest they can enhance quality of life and may aid in managing pain and disability related to scoliosis.

In terms of safety, these exercises are non-invasive, involving neither surgery nor medications, and are generally well-tolerated. No significant reports of harmful side effects have emerged. The exercises focus on body posture and movement, which most people can safely perform with guidance from a trained therapist. Participants must follow instructions closely to avoid any potential strain. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Schroth exercises for degenerative scoliosis because they offer a personalized and active approach to managing the condition, unlike the usual observation or reliance on pain medication. This method focuses on teaching patients specific exercises tailored to their abilities, progressively challenging them to improve posture and spinal alignment. By using a certified Schroth therapist and an algorithm to guide exercise progression, patients receive a structured and dynamic treatment plan, which could lead to better long-term outcomes in managing scoliosis compared to passive treatments.

What evidence suggests that Schroth exercises might be an effective treatment for degenerative scoliosis?

Research has shown that Schroth exercises, which participants in this trial may receive, might help treat adult degenerative scoliosis. One study found that these exercises can improve the curve of the spine, reduce trunk twisting, and enhance quality of life. Another study observed that these exercises help maintain spinal alignment by strengthening muscles. Although factors like age and spine stiffness might affect results, these exercises have shown promise in reducing pain and improving function. Overall, early findings suggest Schroth exercises could be a helpful non-surgical option for managing scoliosis symptoms. ^{1 2 6 7 8}

Who Is on the Research Team?

Eric Parent, PT PhD

Principal Investigator

University of Alberta

Are You a Good Fit for This Trial?

This trial is for adults over 50 with degenerative scoliosis, experiencing pain and having a spinal curve between 15°-45°. It's not for those who've had recent injections, surgery, or have conditions like fractures, cancer, severe heart issues, or weak bones.

Inclusion Criteria

I am over 50 with degenerative scoliosis and experience pain greater than 2 out of 10.

My spinal curve is between 15° and 45°.

Exclusion Criteria

I haven't had cortisone or anesthetic injections, surgery, and don't have exercise restrictions due to severe health issues in the last 3 months.

My spinal curve is less than 50 degrees.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants in the Schroth exercise group will attend 5 individual sessions to learn exercises and participate in weekly group classes for 3 months.

12 weeks

5 individual sessions, weekly group classes

Control

Participants in the control group will be under observation without treatment or with previously prescribed pain medication for 3 months.

12 weeks

Follow-up

Participants are monitored for longer-term effects 3 months after the exercise program.

12 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Schroth exercises

Trial Overview

The study tests Schroth exercises—a specialized physical therapy—against no treatment in managing adult degenerative scoliosis. The focus is on the feasibility of a larger trial by looking at recruitment capability and participants' adherence to the exercise regimen.

How Is the Trial Designed?

Group I: Schroth exercise group Experimental Treatment 1 Intervention

Will attend 5 1-hr long individual sessions to learn Schroth exercises and the home program. A 30-min. daily home program of 3 to 4 exercises will be progressed by the certified Schroth therapist using an algorithm. Patients will attend weekly 1-hr long group therapist-led exercise classes for 3 months. At each group class, adequate exercise performance will be assessed using the checklist. An algorithm guides the prescription of exercises intensity and progression from static to dynamic depending on the participant's ability. Prescription begins with Sitting on a Ball. If performed adequately, a more challenging exercise is attempted. The 3 most challenging exercises performed adequately as per the checklist will be prescribed with a detailed handout.

Group II: Control group Active Control 1 Intervention

Observation without treatment or with previously prescribed pain medication is the current standard for adults with degenerative scoliosis not planning surgery.

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Published Research Related to This Trial

The Schroth scoliosis-specific exercises significantly reduce the Cobb angle and angle of trunk rotation in children with idiopathic scoliosis, with effect sizes indicating moderate to large improvements.

The Schroth method also positively impacts the quality of life for these patients, suggesting it is an effective non-surgical intervention for managing idiopathic scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Application of the Schroth Method in the Treatment of Idiopathic Scoliosis: A Systematic Review and Meta-Analysis. Dimitrijević, V., Šćepanović, T., Jevtić, N., et al.[2023]

A six-week physiotherapy program using the Schroth method, modified by H.R. Weiss, was evaluated in 21 patients with idiopathic scoliosis, showing improvements in their musculoskeletal system.

Instrumental diagnostic techniques, including computer optical topography and electromyography, confirmed that the modified Schroth exercises enhance the effectiveness of treatment for children with scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Corrective exercises in multimodality therapy of idiopathic scoliosis in children - analysis of six weeks efficiency - pilot study. Pugacheva, N.[2022]

The Schroth method, focusing on active holding exercises, was applied to three patients with scoliosis three times a week for 15 weeks, resulting in decreased pain and improved Cobb's angle.

This study suggests that the Schroth exercise program can effectively reduce pain and improve spinal alignment in patients with idiopathic scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of the Schroth method of emphasis of active holding on Cobb's angle in patients with scoliosis: a case report. Lee, HJ., Seong, HD., Bae, YH., et al.[2020]

This study will evaluate the effectiveness of Schroth scoliosis-specific exercises combined with standard care over 6 months in 258 adolescents with idiopathic scoliosis, aiming to improve both radiographic and clinical outcomes.

The trial will also assess whether the benefits of Schroth therapy are maintained 6 months after the intervention ends, potentially influencing future clinical practices regarding exercise prescriptions for scoliosis treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Schroth exercises on curve characteristics and clinical outcomes in adolescent idiopathic scoliosis: protocol for a multicentre randomised controlled trial. Schreiber, S., Parent, EC., Hedden, DM., et al.[2022]

The Schroth method, a physiotherapeutic exercise for adolescent idiopathic scoliosis (AIS), significantly improved the Cobb angle, trunk rotation angle, and quality of life in 144 patients compared to no intervention or other conservative treatments.

While the Schroth method showed positive short-term effects, the reduction in Cobb angle did not surpass the minimum clinically important difference, indicating that while beneficial, the changes may not be substantial enough to be considered clinically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis. Ceballos-Laita, L., Carrasco-Uribarren, A., Cabanillas-Barea, S., et al.[2023]

In a study of 51 patients with adolescent idiopathic scoliosis, supervised three-dimensional (3D) Schroth exercises in a clinic setting led to significant improvements in scoliosis angles and waist asymmetry compared to home exercises and a control group.

The clinic group showed a decrease in the Cobb angle by 2.53° and rotation angle by 4.23°, while the control group experienced worsening of their condition, highlighting the efficacy of supervised exercise in managing scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Kuru, T., Yeldan, İ., Dereli, EE., et al.[2022]

The Schroth exercise significantly improves paraspinal muscle symmetry in patients with adolescent idiopathic scoliosis (AIS), as indicated by a reduction in the paraspinal muscle symmetry index (PMSI) after the exercise.

Different types of Schroth exercises affect muscle activity differently, with symmetric exercises leading to lower PMSI and asymmetric exercises increasing it, suggesting that targeted exercises can enhance muscle performance on both sides of the scoliotic curve.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How do Paraspinal Muscles Contract during the Schroth Exercise Treatment in Patients with Adolescent Idiopathic Scoliosis (AIS)? He, C., Yang, JT., Zheng, Q., et al.[2023]

In a randomized controlled trial involving 50 adolescents with idiopathic scoliosis, those who participated in supervised Schroth exercises alongside standard care showed a significant improvement in back muscle endurance, increasing by 32.3 seconds compared to just 4.8 seconds in the control group after 3 months.

The Schroth exercise group also experienced a notable enhancement in self-image and pain scores from 3 to 6 months, indicating that these exercises can provide additional benefits beyond standard treatment for quality of life in adolescents with scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". Schreiber, S., Parent, EC., Moez, EK., et al.[2022]

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Schroth Exercises for Degenerative Scoliosis (ADSET Trial)

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The Adult Degenerative Scoliosis Exercise Trial (Pilot Study)

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