The Effect of Basic Body Awareness Therapy on Posture, Trunk Proprioception, Clinical Parameters of Scoliosis and Body Awareness in Adolescents With Idiopathic Scoliosis
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Trunk Proprioception
研究概览
简要总结
Adolescent idiopathic scoliosis (AIS) is a complex deformity of the spine, and its cause remains unknown. AIS can have negative physical, psychological, and social effects on an individual's health. There are two main treatment options for AIS: surgical and conservative approaches, including observation, exercise, and bracing. Scoliosis-specific exercises (SSE) refer to globally recognized, evidence-based exercise approaches.
In this study, the Scientific Exercise Approach to Scoliosis (SEAS), one of the SSE methods, will be used. SEAS consists of individualized active self-correction exercises combined with functional movements. Additionally, the Basic Body Awareness Therapy (BBAT) method will also be applied. BBAT is a body-focused, comprehensive approach that incorporates slow, rhythmic movements and breath control.
Both groups will attend supervised sessions in the clinic once a week, and home exercises will be assigned for the remaining days. Participants in the SEAS group will receive only SEAS treatment, while those in the BBAT group will receive both SEAS and additional BBAT exercises.
The goal of this clinical study is to investigate the effects of BBAT in addition to a rehabilitation program including SSE, on posture, spatial orientation, trunk proprioception, scoliosis-specific parameters, quality of life, and body in adolescents with IS aged between 10 and 17 years.
The research hypotheses for this study are as follows:
H1: Basic Body Awareness Therapy has an effect on posture in adolescents with idiopathic scoliosis.
H2: Basic Body Awareness Therapy has an effect on spatial orientation in adolescents with idiopathic scoliosis.
H3: Basic Body Awareness Therapy has an effect on trunk proprioception in adolescents with idiopathic scoliosis.
H4: Basic Body Awareness Therapy has an effect on scoliosis-specific clinical parameters in adolescents with idiopathic scoliosis.
H5: Basic Body Awareness Therapy has an effect on both general and scoliosis-specific quality of life in adolescents with idiopathic scoliosis.
H6: Basic Body Awareness Therapy has an effect on body awareness in adolescents with idiopathic scoliosis.
详细描述
Adolescent idiopathic scoliosis (AIS) is a 3-dimensional complex deformity of the spine, involving lateral curvature, axial rotation, and altered sagittal physiological curves, that occurs in children between the ages of 10 and skeletal maturity. AIS is the most common type, accounting for 84-89% of all types of scoliosis. Although there are many studies in the literature on its aetiopathogenesis, the cause is still unknown. AIS causes chronic back pain, muscle imbalance in the trunk, limited spinal movement, weakening of the para spinal muscles, reduced respiratory capacity, and dissatisfaction with physical appearance due to distorted body image.The main concern about scoliosis is progression of the deformity. In the absence of treatment, scoliosis can lead to negative physical, psychological, and social effects on an individual's health Individuals with idiopathic scoliosis (IS) are known to have a lower quality of life than their healthy peers. The progressive nature of the disease can be considered a factor contributing to the decline in quality of life.
There are two main treatment options for IS: surgical and conservative (observation, exercise, brace) approaches. Because of its complex underlying mechanism, IS requires a comprehensive conservative treatment approach. The current preventive approach to scoliosis rehabilitation is scoliosis-specific exercises (SSE). SSE is the general term for globally recognized evidence-based exercise approaches. In this study, the Scientific Exercise Approach to Scoliosis (SEAS), a school of thought focused on active self-correction, will be used. SEAS is an exercise program designed to enhance spinal stability through individualized, active self-correction without external assistance, integrated into functional exercises.
The three-dimensional deformities in scoliosis lead to musculoskeletal problems such as postural changes, muscle imbalance, sensory disturbances, and deficits in balance and postural stability. As a result, postural control and trunk alignment awareness are impaired. Another factor affecting postural control, vertical perception, is also known to be disrupted in individuals with AIS however, no specific exercise model focuses on this issue.
Basic Body Awareness Therapy (BBAT) is a comprehensive approach that considers the physical, physiological, psychological, and existential aspects of human existence. It includes fundamental functions such as postural stability, relaxed breathing, and awareness. The therapy consists of daily movements like lying, sitting, standing, and walking, aiming to enhance body awareness and develop a more realistic body image by normalizing posture, balance, and muscle tension. The learning process involves gradually increasing awareness of grounding, the vertical axis, breathing, flow, and centering. Individuals are encouraged to focus not only on their movements but also on their experiences while performing them, fostering both physical and mental self-awareness. The slow movements in BBAT integrate postural alignment awareness with breathing, aiming to improve body awareness, movement quality, posture, coordination, balance, postural control, and physical-social functions. It is recommended in the literature that adding BBAT exercises to the rehabilitation program of individuals with AIS may help improve internal body orientation. BBAT's slow and rhythmic movements, which are focused on postural alignment and postural awareness, can help improve the postural control deficits commonly seen in AIS, by improving trunk alignment and proprioception.
The study will include voluntary participants with IS aged between 10 and 17. The individuals will be evaluated twice: at the beginning and at the end of the treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Participant)
盲法说明
Participant's parents.
入排标准
- 年龄范围
- 10 Years 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Being diagnosed with adolescent idiopathic scoliosis
- •Being between the ages of 10 and 17
- •Having scoliosis of 15° or greater
- •Not having received previous treatment for scoliosis and not receiving any other treatment during this study
- •Risser stage 0-4
- •Willing to participate in the study
排除标准
- •Having any spinal/bone deformity in addition to scoliosis (such as hyperkyphosis, pectus, etc.)
- •Wearing a brace
- •Having congenital scoliosis
- •Having any rheumatological, neuromuscular, neurological, cardiovascular, or pulmonary pathology
- •Having a regular history or habit of physical activity
- •Having undergone scoliosis surgery
研究组 & 干预措施
SEAS group
Individuals including this group will only be applied scoliosis specific exercises for treatment. Scientific Exercise Approach to Scoliosis (SEAS) approach will be used. These individuals will be followed in the clinic once a week for 60 minutes. The rest of the week, they will complete their program at home for 40 minutes.
干预措施: Scoliosis Specific Exercise (Other)
BBAT group
Individuals in this group will receive Basic Body Awareness Therapy (BBAT) in addition to scoliosis-specific exercises. Individuals in the BBAT group will be seen in the clinic once a week and will receive 30 minutes of BBAT in addition to 30 minutes of SEAS. They will perform their exercises at home for a total of 40 minutes, consisting of 20 minutes of BBAT and 20 minutes of SEAS. Total treatment duration will be the same for each group.
干预措施: Basic Body Awareness Therapy (Other)
BBAT group
Individuals in this group will receive Basic Body Awareness Therapy (BBAT) in addition to scoliosis-specific exercises. Individuals in the BBAT group will be seen in the clinic once a week and will receive 30 minutes of BBAT in addition to 30 minutes of SEAS. They will perform their exercises at home for a total of 40 minutes, consisting of 20 minutes of BBAT and 20 minutes of SEAS. Total treatment duration will be the same for each group.
干预措施: Scoliosis Specific Exercise (Other)
结局指标
主要结局
Trunk Proprioception
时间窗: 16 weeks
To evaluate trunk proprioception, three tests will be used. Measurements will be repeated three times for each test, and the average value will be calculated. The obtained angle will be recorded in degrees and referred to as the error angle.
Posture ( perception of deformity severity)
时间窗: 16 weeks
For posture assessment, the Spinal Appearance Questionnaire will be used first. It will be completed by the participant, their parent, and the physiotherapist. In this way, the perception of deformity severity will be measured. It is a valid measure for assessing self-image in adolescents with idiopathic scoliosis. This questionnaire includes 11 standardized drawings that represent different severity levels of spinal deformity perception. Additionally, it consists of 22 Likert-scale questions reflecting the patient's impressions and expectations regarding their appearance. Patients select one of five response options for each drawing, with 1 indicating the best and 5 indicating the worst perception. The total score is the sum of all responses, and a higher score indicates a more severe deformity.
Postural Symmetry for Anterior Trunk
时间窗: 16 weeks
Anterior Trunk Symmetry Index (ATSI) is another objective method used to assess postural asymmetry in the anterior trunk. Similar to POTSI, ATSI calculations are based on photographs taken in the optimal standing posture. Although reference values for ATSI are available for different age groups, a definitive normal value has not been established. Higher ATSI values indicate increased asymmetry.
Postural Symmetry for Posterior Trunk
时间窗: 16 weeks
Posterior Trunk Symmetry Index (POTSI) is an objective and comprehensive method used to evaluate an individual's postural asymmetry. For the calculation of POTSI, photographs will be taken in the optimal standing posture for assessment. The ideal value of the POTSI index is 0, indicating that the trunk is symmetric, while values above 0 represent asymmetry.
Scoliosis-specific parameters
时间窗: 16 weeks
For the assessment of scoliosis parameters, curve severity and trunk rotation will be measured. The Cobb angle method, considered the gold standard, will be used to assess the severity of the curve, measured from the individual's antero-posterior X-ray image. The Cobb angle is defined as the angle between the superior endplate of the uppermost vertebra and the inferior endplate of the lowermost vertebra involved in the curve in the coronal plane. A Cobb angle greater than 10° is required for a diagnosis of AIS. The scoliometer will be use to assess axial trunk rotation. It is a type of inclinometer that measures the symmetry of both sides of the trunk and records it in degrees. The value of 0 observed on the scoliometer indicates that the trunk is symmetric, while values above 0 indicate asymmetry. A 5° threshold on the scoliometer is considered significant, with values above it being regarded as meaningful.
Spatial Orientation
时间窗: 16 weeks
The Fukuda stepping test will be used to assess spatial orientation. Measurements will be taken between the marked points at the start and end of the test, with displacement distance recorded in centimeters and displacement angle in degrees. A decrease in angle or distance will be considered an improvement. Although there are no reference values for individuals with AIS, it has been emphasized in the literature that this test is effective in demonstrating proprioceptive deficits in this group. This test will provide information about individuals' dynamic proprioception.
Body awareness (Awareness of body responses)
时间窗: 16 weeks
The Body Awareness Questionnaire (BAQ) is used to assess individuals' body awareness by exploring body responses, predictions about bodily processes, the disease process, and the sleep-wake cycle. It consists of 18 items and 4 subgroups in a Likert scale format. Participants rate statements from 1 (Not true for me) to 7 (Completely true for me). The total score is calculated by summing the ratings, and an increase in the score indicates improved body awareness.
Body awareness and perception
时间窗: 16 weeks
The Awareness Body Chart (ABC) is another tool used to assess body awareness. It includes simple front and back drawings of male and female bodies, divided into 51 regions and 14 body parts. Participants are asked to color these body parts according to awareness levels represented by specific colors. The total score is calculated by summing the points corresponding to the colors, and an increase in the score indicates an improvement in awareness.
次要结局
- Quality of life related to scoliosis(16 weeks)
- General quality of life(16 weeks)
- Evaluation of treatment compliance(16 weeks)
研究者
Gözde Yagci (Gür)
Prof. Dr.
Hacettepe University