Yoga for Scoliosis

(AIS Trial)

Overseen By Gabrielle Reichard, MA

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Non-AIS scoliosis, Surgery, Age, others

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

Compensation: Varies

Number of Visits: 6

Duration: 6 months

500 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether adding yoga to the usual care for adolescents with Adolescent Idiopathic Scoliosis (AIS) can improve their quality of life. AIS involves a spinal curve of more than 10 degrees and can lead to back pain, poor sleep, and depression. Participants will either continue their standard care, with or without a brace, or incorporate yoga sessions into their routine. The trial targets those with scoliosis and a spinal curve over 25 degrees who experience significant back pain. It aims to determine if yoga can reduce the need for medications and improve both physical and mental health. As an unphased trial, this study offers a unique opportunity to explore innovative care options that could enhance 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 focuses on adding yoga to your existing treatment plan, so it's likely you can continue your current medications, but you should confirm with the trial coordinators.

What prior data suggests that this yoga protocol is safe for adolescents with scoliosis?

Research has shown that yoga can be a safe and beneficial activity for people with scoliosis. One study found that individuals with spine issues, including scoliosis, experienced positive results from regular yoga practice. Another study found that yoga reduced the spine's curve by an average of 4.60 degrees compared to traditional treatments.

Yoga is generally well-tolerated, and these studies reported no major safety concerns. The practice involves gentle, controlled movements, making it a low-risk option for many. However, as with any exercise, following advice from qualified instructors is crucial to ensure safety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard scoliosis treatments that mainly involve braces or surgery, yoga offers a non-invasive, holistic approach that focuses on improving flexibility and muscle strength. Researchers are excited about yoga for scoliosis because it may enhance posture and spinal alignment through specific poses, potentially reducing pain and discomfort. This method is also accessible, as it can be done online, making it a convenient option for patients who prefer at-home treatment. Additionally, yoga promotes overall well-being, which can be an added benefit beyond the physical improvements.

What evidence suggests that this yoga protocol is effective for managing adolescent idiopathic scoliosis?

This trial will compare different approaches for managing scoliosis, including yoga and standard care. Research has shown that yoga can help manage scoliosis. One study found that after about 9 months of practicing yoga, certain spine curves improved by an average of 34.2%. Another study showed that yoga reduced the Cobb angle, which measures spine curvature, by an average of 4.60 degrees. A 16-week yoga program also significantly decreased the Cobb angle, leading to better posture and spine alignment. These findings suggest that yoga can help reduce spine curvature and improve posture in people with scoliosis. Participants in this trial will be randomized into different groups, including those practicing yoga with or without a brace, and those continuing with standard care. ^{1 4 5 6 7}

Who Is on the Research Team?

Paul Sponseller, MD

Principal Investigator

Johns Hopkins School of Medicine

Are You a Good Fit for This Trial?

This trial is for adolescents with a pronounced spinal curvature (Cobb angle over 25 degrees) and significant back pain, who are being treated non-surgically for Adolescent Idiopathic Scoliosis at JHH. It includes those undergoing physical therapy, both braced and unbraced patients.

Inclusion Criteria

I am either wearing a brace or not wearing a brace.

I have back pain from AIS and am eligible for physical therapy without surgery.

My spine curve is over 25 degrees and my pain score is more than 4.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized into groups to receive either standard care or standard care with yoga. Yoga sessions are conducted online twice a week for 20 minutes.

6 months

Online sessions twice a week

Follow-up

Participants are monitored for pain, quality of life, and Cobb angle changes at 6 months and 1 year.

6 months

Assessments at 6 months and 1 year

Long-term Follow-up

Participants continue to be monitored for long-term outcomes and engagement.

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Yoga

Trial Overview

The study tests the effectiveness of adding a structured yoga protocol to the standard care for managing AIS. Participants will be randomly assigned to either continue with their usual treatment or incorporate yoga into their regimen.

How Is the Trial Designed?

Group I: Yoga Braced Active Control 1 Intervention

Patients, who are currently wearing a brace, are randomized into the yoga group will partake in an online 20 min yoga class 2 days per week

Group II: Yoga - Not Braced Active Control 1 Intervention

Patients, who are currently not wearing a brace, are randomized into the yoga group will partake in an online 20 min yoga class 2 days per week

Group III: Braced - Standard of care Active Control 1 Intervention

Patients who are braced, will be randomized into a group that will continue with their standard of care current treatment,

Group IV: Non Braced - Standard of care Active Control 1 Intervention

Patients who are not braced, will be randomized into a group that will continue with their standard of care current treatment

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

Published Research Related to This Trial

A review of 12 relevant studies on exercise therapy for adolescent idiopathic scoliosis (AIS) found that while all studies supported its use, the evidence was of poor quality with significant methodological shortcomings.

Many studies reported small improvements in the curvature of the spine (Cobb angle) after exercise therapy, but these changes were not statistically robust and lacked long-term follow-up, indicating a need for better-designed research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature. Mordecai, SC., Dabke, HV.[2022]

A short-term Schroth exercise camp significantly improved trunk rotation angle, postural symmetry, trunk muscle endurance, and dynamic balance in 45 adolescents with idiopathic scoliosis after just 7 days of intensive corrective exercises.

Participants also reported better perceptions of cosmetic deformity and improved health-related quality of life, indicating that the Schroth method may be an effective intervention for managing symptoms of adolescent idiopathic scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Short-Term 3-Dimensional Schroth Exercises In Adolescent Idiopathic Scoliosis: An Observational Study. Aktan, D., Erdoganoglu, Y.[2022]

A nonrandomized control trial involving 56 adolescents with idiopathic scoliosis showed that specific yoga poses significantly reduced the Cobb angles, indicating improvement in spinal curvature, with a mean change of -9.2 degrees in the treatment group compared to a deterioration of 5.4 degrees in the control group.

Patients receiving yoga treatment in-office experienced greater improvements (1.6 degrees/month) compared to those using telemedicine (0.72 degrees/month), suggesting that while both methods were beneficial, in-person sessions may lead to better adherence and outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis-A Nonrandomized Control Trial. Fishman, LM.[2022]

A study involving 25 patients with idiopathic or degenerative scoliosis showed that practicing the side plank pose asymmetrically for an average of 6.8 months led to a significant reduction in the Cobb angle of the primary scoliotic curve by 32.0%.

Among the 19 patients who consistently practiced the pose, the improvement was even greater at 40.9%, indicating that this non-surgical technique may effectively strengthen muscles on the convex side of the curve and improve spinal alignment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Serial case reporting yoga for idiopathic and degenerative scoliosis. Fishman, LM., Groessl, EJ., Sherman, KJ.[2020]

Both core stabilization exercises combined with bracing and the Scientific Exercises Approach to Scoliosis (SEAS) with bracing were effective in improving spinal curvature and trunk rotation in 30 females with moderate adolescent idiopathic scoliosis over a 4-month period.

While both treatment methods showed similar short-term benefits, only the core stabilization group reported improvements in pain, indicating a potential advantage in pain management with this approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment. Yagci, G., Yakut, Y.[2022]

A systematic review of 15 studies, including six randomized controlled trials, found that exercise therapy positively impacts lung volumes and pulmonary function in patients with Adolescent Idiopathic Scoliosis (AIS).

Despite the positive findings, many studies had only 'fair' quality, indicating a need for more robust clinical trials to confirm these benefits and better understand the effects of exercise therapy on pulmonary function in AIS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does exercise therapy improve pulmonary function in patients with Adolescent Idiopathic Scoliosis? Rafferty, A., Fleming, N., Kiely, P., et al.[2023]

Bracing is a common conservative treatment for idiopathic scoliosis (IS) in adolescents, with evidence supporting its effectiveness, although the quality of this evidence is low; full-time bracing is more effective than part-time, and combining bracing with exercises may yield the best results.

Despite the potential benefits of exercises as an adjunctive treatment for IS, the quality of evidence is also low, and there is a lack of consensus among experts regarding the best types of braces and their effectiveness, highlighting challenges in patient recruitment for clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Actual evidence in the medical approach to adolescents with idiopathic scoliosis. Negrini, S., De Mauroy, JC., Grivas, TB., et al.[2018]

Core-based exercise has been shown to significantly reduce the Cobb angle, a measure of spinal curvature, in individuals with scoliosis, based on a systematic review of nine studies involving 325 participants.

Participants engaging in core-based exercise also reported improved quality of life, as indicated by the Scoliosis Research Society-22 questionnaire, with no serious adverse events noted, suggesting that this intervention is safe.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis. Li, X., Shen, J., Liang, J., et al.[2022]

In a study of 107 patients with idiopathic scoliosis, a 4-6 week inpatient exercise program led to a significant reduction in the average curvature of the spine, from 43.06 degrees to 38.96 degrees as measured by the Cobb technique.

Approximately 44% of patients experienced an improvement of 5 degrees or more in their spinal curvature, demonstrating that targeted physiotherapy can effectively reduce curvature even in severe cases of scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of an in-patient exercise program on scoliotic curve. Weiss, HR.[2022]

A hypopressive gymnastics (HG) program applied to three children aged 8 to 15 with idiopathic scoliosis showed a trend towards stabilization of vertebral tilt and rotation after three months of daily exercises.

The program also indicated potential improvements in rib cage deformation (gibbosity) and respiratory function, suggesting that HG exercises may help control the progression of dorsal idiopathic scoliosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Preliminary study on the action of hypopressive gymnastics in the treatment of idiopathic scoliosis]. Caufriez, M., Fernández-Domínguez, JC., Brynhildsvoll, N.[2022]

In a study involving 18 females with adolescent idiopathic scoliosis, prior muscle stretching negatively impacted their ability to maintain proper lower trunk alignment during posture exercises, with a significant change in alignment observed after stretching.

The results suggest that practitioners should avoid incorporating stretching immediately before posture maintenance exercises, as it may hinder performance without affecting perceived effort.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute muscle stretching and the ability to maintain posture in females with adolescent idiopathic scoliosis. Levi, D., Springer, S., Parmet, Y., et al.[2019]

A study involving 36 patients with idiopathic scoliosis showed that adding a new exercise program focused on correcting sagittal profiles (physio-logic exercises) significantly reduced lateral trunk deviation compared to standard Scoliosis Intensive Rehabilitation (SIR) alone.

While the physio-logic exercises improved lateral deviation and surface rotation, they did not lead to significant changes in kyphosis angle, indicating that while beneficial, further research is needed to assess long-term effects and overall effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Weiss, HR., Klein, R.[2022]

In a study of 74 adolescents with idiopathic scoliosis, those who participated in the Scientific Exercises Approach to Scoliosis (SEAS) had a significantly lower rate of brace prescriptions (6.1%) compared to those receiving usual care (25.0%).

The SEAS exercises not only reduced the need for bracing but also led to improvements in Cobb angle measurements, with 23.5% of patients improving, while the usual physiotherapy group saw a worsening in their Cobb angles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis. Negrini, S., Zaina, F., Romano, M., et al.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11185438/

Exploring the Effectiveness of Hatha Yoga as a ...

The results showed that after an average of 9.4 months of practice, there was an average improvement of 34.2% in the lumbar/thoracolumbar curves and 20.3% in ...

2.

josr-online.biomedcentral.com

josr-online.biomedcentral.com/articles/10.1186/s13018-023-04137-1

The effect of an exercise intervention on adolescent idiopathic ...

Compared with conventional therapy, yoga reduced the average Cobb angle by 4.60 degrees and ranked first in the cumulative probability of ...

3.

ajkinesiol.org

ajkinesiol.org/m/journal/view.php?number=534

Effect of a 16-Week Yoga Program on Cobb's Angle in ...

The current study suggests that a 16-week yoga exercise program can improve postural imbalances based on Cobb's angle in the spine, shoulder ...

4.

researchgate.net

researchgate.net/publication/362380318_Effect_of_a_16-Week_Yoga_Program_on_Cobb's_Angle_in_Female_Patients_with_Scoliosis

(PDF) Effect of a 16-Week Yoga Program on Cobb's Angle ...

RESULTS Following the 16-week program, Cobb's angle had significantly decreased from 10.50±4.26 to 7.05±3.37 (p<0.001). However, there were no ...

5.

withpower.com

withpower.com/trial/yoga-for-scoliosis-31242

Yoga for Scoliosis (AIS Trial)

A nonrandomized control trial involving 56 adolescents with idiopathic scoliosis showed that specific yoga poses significantly reduced the Cobb angles, ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC2697577/

Is physical activity contraindicated for individuals with ...

Nonsurgically treated scoliosis is not a contraindication to sports participation (grade D recommendation [3 level 5 studies8,19,28]).

7.

frontiersin.org

frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1685627/epub

Mental and physical outcomes of yoga participation in ...

Likewise, participants with structural spinal conditions like lordosis, kyphosis, and scoliosis reported positive outcomes from regular yoga ...