title: CONTRAIS: CONservative TReatment for Adolescent Idiopathic Scoliosis: a randomised controlled trial protocol.
abstract: BACKGROUND
  Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis.
  
  
  METHODS
  
  
  
  METHODS
  Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25-40 degrees will be included. A total of 135 participants will be randomly allocated in groups of 45 patients each to receive one of the three interventions.
  
  
  METHODS
  All three groups will receive a physical activity prescription according to the World Health Organisation recommendations. One group will additionally wear a hyper-corrective night-time brace. One group will additionally perform postural scoliosis-specific exercises.
  
  
  RESULTS
  Participation in the study will last until the curve has progressed, or until cessation of skeletal growth. OUTCOME variables will be measured every 6 months. The primary outcome variable, failure of treatment, is defined as progression of the Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity Questionnaire (IPAQ) short form, and Cobb angle at end of the study.
  
  
  CONCLUSIONS
  This trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis.
  
  
  BACKGROUND
  NCT01761305.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. allan.abbott@karolinska.se.
authors.forename: Allan
authors.initials: A
authors.lastname: Abbott
authors.forename: Hans
authors.initials: H
authors.lastname: Möller
authors.forename: Paul
authors.initials: P
authors.lastname: Gerdhem
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001915:Braces; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D012107:Research Design; D012600:Scoliosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000254:growth & development; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome