Feasibility and three months preliminary results of an RCT on the effect of Schroth exercises in adolescent idiopathic scoliosis (AIS)

Methods Fifteen patients with AIS, aged 10-18, with curves 10 – 45 degrees, braced or not, were randomized into Schroth, or standard care, groups. The six-month Schroth intervention consists of weekly one-hour long group exercise sessions, combined with a daily 45-minute long home program, consisting of 3-4 exercises prescribed using an algorithm. Compliance was monitored with a logbook. SRS-22r, Spinal Appearance Questionnaire, Sorensen back endurance, and Self-efficacy and Global Rating of Change (GRC) outcomes were measured. The effect sizes of the Schroth exercise treatment on key outcomes were estimated using Cohen’s d (≥0.8=large, 0.5-0.8=moderate, 0.2-0.5=small). Cohen’s d is defined as the difference in change between the group means, Schroth – Standard care, observed from baseline to 3 months, divided by the pooled standard deviation at baseline. Results Of 122 eligible patients, fifteen (12.3%) were enrolled between April and August 2011. Recruitment was 3 per month. Exercise subjects attended 89±9% of the prescribed weekly exercise sessions, and completed 76±8% of the prescribed home exercises. Only one Standardcare subject dropped out due to relocation. For SRS-22r domains, Cohen’s d effect sizes favored standard care: -0.31 for Self-image, -0.72 for Function, and -0.38 for Pain. For SAQ domains, some effect sizes favored standard care: 0.50 for General, 0.46 for Curve, 1.36 for Prominence, 0.57 for Shoulders and 0.35 for Chest. Other SAQ effect sizes favored Schroth: -0.14 for Trunk Shift, -0.31 for waist. The Sorensen test’s effect size was -0.14, and Self-efficacy’s was 0.5, both favoring standard care. The mean difference between groups in GRC was 3.4±1.7 in favor of the Schroth group.