title: Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial.
abstract: To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression.
  
  
  
  130 adults with idiopathic scoliosis (main curve <35°) were randomly assigned to a 20-week rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive-behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome.
  
  
  
  Significant effects of time, group, and time by group interaction were found for all outcome measures (P < 0.001). After training, the primary outcome showed a clinically significant between-group change (12 % points), which was preserved at follow-up. At follow-up, the radiological deformities showed a significant, although not clinically meaningful, between-group difference of 4° in favour of the experimental group.
  
  
  
  The experimental programme was superior to general physiotherapy in reducing disability of adults with idiopathic scoliosis. Motor and cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Via Monsignor Bernasconi, 16, 20851, Lissone, Monza Brianza, Italy. marco.monticone@fsm.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Monticone
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Via Monsignor Bernasconi, 16, 20851, Lissone, Monza Brianza, Italy.|Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Ambrosini
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Via Monsignor Bernasconi, 16, 20851, Lissone, Monza Brianza, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Cazzaniga
authors.affiliation: Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Salvatore Maugeri Foundation, Institute of Care and Research (IRCCS), Via Monsignor Bernasconi, 16, 20851, Lissone, Monza Brianza, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Rocca
authors.affiliation: School of Physical and Rehabilitation Medicine, Bicocca University of Milan, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Motta
authors.affiliation: School of Physical and Rehabilitation Medicine, Bicocca University of Milan, Milan, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cerri
authors.affiliation: Department of Spinal Surgery III, Galeazzi Orthopedic Institute, Institute of Care and Research (IRCCS), Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Brayda-Bruno
authors.affiliation: Department of Spinal Surgery III, Galeazzi Orthopedic Institute, Institute of Care and Research (IRCCS), Milan, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Lovi
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012600:Scoliosis / Q000534:rehabilitation*
keywords: Adult scoliosis; Cognitive–behavioural therapy; Randomised controlled trial; Self-correction; Task-oriented exercises