title: Effect of Schroth exercises on curve characteristics and clinical outcomes in adolescent idiopathic scoliosis: protocol for a multicentre randomised controlled trial.
abstract: BACKGROUND
  The promising results of Schroth scoliosis-specific exercises for adolescent idiopathic scoliosis found in low-quality studies will be strengthened by confirmation in a randomised controlled trial.
  
  
  OBJECTIVE
  1. Are Schroth exercises combined with standard care for 6 months more effective than standard care alone in improving radiographic and clinical outcomes for adolescents with idiopathic scoliosis? 2. Will the outcomes of the control group (who will be offered Schroth therapy delayed by 6 months) improve after 6 months of Schroth therapy? 3. Are the effects maintained 6 months after discontinuing the supervised intervention?
  
  
  METHODS
  This is an assessor-blinded and statistician-blinded randomised controlled trial with transfer of the controls to the exercise group after 6 months.
  
  
  METHODS
  Two hundred and fifty-eight consecutive adolescents with idiopathic scoliosis, aged 10 to 16 years, treated with or without a brace, with curves between 10 and 45 deg Cobb and Risser sign ≤ 3 will be recruited from three scoliosis clinics.
  
  
  METHODS
  Combined with standard care, the Schroth group will receive five individual training sessions, followed by weekly group classes and daily home exercises for 6 months.
  
  
  METHODS
  Controls will only receive standard care consisting of observation or bracing, and will be offered Schroth therapy 6 months later.
  
  
  METHODS
  Curve severity (Cobb angle) and vertebral rotation will be assessed from radiographs at baseline, 6 and 12 months. Secondary clinical outcomes (back muscle endurance, surface topography measures of posture, and self-reported perceived spinal appearance and quality of life) will be assessed at baseline, and every 3 months until 1-year follow-up.
  
  
  METHODS
  Data will be analysed using intention-to-treat linear mixed models.
  
  
  CONCLUSIONS
  The results will demonstrate whether Schroth exercises combined with standard of care can improve outcomes in adolescents with idiopathic scoliosis. This study has potential to influence clinical practice worldwide, where exercises are not routinely prescribed for adolescents with idiopathic scoliosis.
authors.affiliation: University of Alberta.
authors.forename: Sanja
authors.initials: S
authors.lastname: Schreiber
authors.affiliation: University of Alberta; Alberta Health Services, Alberta, Canada.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Parent
authors.affiliation: University of Alberta; Alberta Health Services, Alberta, Canada.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Hedden
authors.affiliation: University of Alberta; Alberta Health Services, Alberta, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Moreau
authors.affiliation: University of Alberta; Alberta Health Services, Alberta, Canada.
authors.forename: Doug
authors.initials: D
authors.lastname: Hill
authors.affiliation: University of Alberta; Alberta Health Services, Alberta, Canada.
authors.forename: Edmond
authors.initials: E
authors.lastname: Lou
mesh_terms: D000293:Adolescent; D001915:Braces; D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D011187:Posture; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000628:therapy*; D013131:Spine / Q000000981:diagnostic imaging*; D016896:Treatment Outcome