Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial

Introduction Scoliosis-specific exercises require specialist supervision, frequent clinical visits, and high costs, limiting accessibility. Additionally, females with idiopathic scoliosis (IS) engage in less physical activity (PA) than sex- and age-matched peers, leading to poorer bone and muscle h...

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Main Authors: Tunyalux Wannakon, Patraporn Sitilertpisan, Montree Tungjai, Nuanlaor Thawinchai
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/8/e103899.full
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author Tunyalux Wannakon
Patraporn Sitilertpisan
Montree Tungjai
Nuanlaor Thawinchai
author_facet Tunyalux Wannakon
Patraporn Sitilertpisan
Montree Tungjai
Nuanlaor Thawinchai
author_sort Tunyalux Wannakon
collection DOAJ
description Introduction Scoliosis-specific exercises require specialist supervision, frequent clinical visits, and high costs, limiting accessibility. Additionally, females with idiopathic scoliosis (IS) engage in less physical activity (PA) than sex- and age-matched peers, leading to poorer bone and muscle health. These challenges underscore the need for accessible, home-based interventions targeting both musculoskeletal health and spinal alignment.Methods and analysis This single-blinded, randomised controlled trial aims to investigate the efficacy of a 16-week home-based exercise intervention on bone mineral density (BMD), Cobb angle, spinal flexibility, core muscle endurance, lean body mass, and quality of life (QoL) in females with IS. 28 participants will be randomly assigned (1:1) to either an intervention group (IG) or a control group (CG). Both groups will perform Schroth and core stabilisation exercises three times per week, while the IG will additionally perform impact-loading exercises. The primary outcome is BMD. Secondary outcomes include Cobb angle, lean body mass, cosmetic trunk deformity, spinal flexibility, core muscle endurance, and QoL. All outcomes will be assessed at baseline and post-intervention, with interim evaluations (excluding BMD, Cobb angle, and lean body mass) conducted at weeks 4, 8, and 12. All assessors, radiologists, and statisticians will remain blinded to group allocation. Treatment effects between groups over time will be analysed using two-way mixed-design analysis of variance (ANOVA).Discussion This study addresses a critical gap in IS management by integrating a preventive and therapeutic home-based programme. The approach aims to improve musculoskeletal health, spinal alignment, and overall QoL. Its accessible format may inform future guidelines for conservative treatment and early intervention. Such interventions could significantly enhance bone health, reduce the risk of progression, and improve long-term musculoskeletal outcomes in young females with mild to moderate IS.Ethics and dissemination This study has received ethical approval from the Research Ethics Committee, Faculty of Associated Medical Sciences, Chiang Mai University (No. AMSEC-67EX-045). The findings will be disseminated through a peer-reviewed publication.Trial registration number TCTR20241001001.
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spelling doaj-art-b6bef8e3632e4d3db99769046bfbc3cf2025-08-20T03:41:36ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-103899Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trialTunyalux Wannakon0Patraporn Sitilertpisan1Montree Tungjai2Nuanlaor Thawinchai3Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, ThailandDepartment of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, ThailandDepartment of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, ThailandDepartment of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, ThailandIntroduction Scoliosis-specific exercises require specialist supervision, frequent clinical visits, and high costs, limiting accessibility. Additionally, females with idiopathic scoliosis (IS) engage in less physical activity (PA) than sex- and age-matched peers, leading to poorer bone and muscle health. These challenges underscore the need for accessible, home-based interventions targeting both musculoskeletal health and spinal alignment.Methods and analysis This single-blinded, randomised controlled trial aims to investigate the efficacy of a 16-week home-based exercise intervention on bone mineral density (BMD), Cobb angle, spinal flexibility, core muscle endurance, lean body mass, and quality of life (QoL) in females with IS. 28 participants will be randomly assigned (1:1) to either an intervention group (IG) or a control group (CG). Both groups will perform Schroth and core stabilisation exercises three times per week, while the IG will additionally perform impact-loading exercises. The primary outcome is BMD. Secondary outcomes include Cobb angle, lean body mass, cosmetic trunk deformity, spinal flexibility, core muscle endurance, and QoL. All outcomes will be assessed at baseline and post-intervention, with interim evaluations (excluding BMD, Cobb angle, and lean body mass) conducted at weeks 4, 8, and 12. All assessors, radiologists, and statisticians will remain blinded to group allocation. Treatment effects between groups over time will be analysed using two-way mixed-design analysis of variance (ANOVA).Discussion This study addresses a critical gap in IS management by integrating a preventive and therapeutic home-based programme. The approach aims to improve musculoskeletal health, spinal alignment, and overall QoL. Its accessible format may inform future guidelines for conservative treatment and early intervention. Such interventions could significantly enhance bone health, reduce the risk of progression, and improve long-term musculoskeletal outcomes in young females with mild to moderate IS.Ethics and dissemination This study has received ethical approval from the Research Ethics Committee, Faculty of Associated Medical Sciences, Chiang Mai University (No. AMSEC-67EX-045). The findings will be disseminated through a peer-reviewed publication.Trial registration number TCTR20241001001.https://bmjopen.bmj.com/content/15/8/e103899.full
spellingShingle Tunyalux Wannakon
Patraporn Sitilertpisan
Montree Tungjai
Nuanlaor Thawinchai
Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
BMJ Open
title Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
title_full Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
title_fullStr Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
title_full_unstemmed Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
title_short Outcomes of 16 weeks of combined exercises on Cobb angle, bone and muscle health, and quality of life in females with idiopathic scoliosis: a study protocol for a single-blinded randomised controlled trial
title_sort outcomes of 16 weeks of combined exercises on cobb angle bone and muscle health and quality of life in females with idiopathic scoliosis a study protocol for a single blinded randomised controlled trial
url https://bmjopen.bmj.com/content/15/8/e103899.full
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