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De-Rotation Breathing Exercises for Idiopathic Kyphoscoliosis Among Adolescents.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03779581
Recruitment Status : Completed
First Posted : December 19, 2018
Last Update Posted : December 20, 2018
Sponsor:
Information provided by (Responsible Party):
faizan kashoo, PT, Majmaah University

Brief Summary:
De-rotation Breathing Exercises are the group of spinal extension, lateral spinal flexion and rotational exercises performed in synchrony with deep breathing. Exercises are performed in a sitting position with feet firmly placed on the ground. The therapist will stand behind the patient with a medicine ball or a small Swiss ball for the patient to receive while the patient rotates and laterally bend the trunk towards the convexity of scoliosis curvature. The patient is instructed to breathe in deeply during lateral bend and rotation in order to maximally expand the chest wall. Expiration involves relaxation while returning to the neutral position. Later, patients are instructed to extend their back along with former maneuver. The backrest of the chair is adjustable and aligned with the apex of thoracic curvatures. Side flexion and rotation towards the convexity of the scoliotic curvature is to correct scoliosis and to increase the chest wall compliance and extension of spinal is used to correct the kyphosis of the spine with an intention to also increase chest wall compliance.

Condition or disease Intervention/treatment Phase
Khyphosis Scoliosis Idiopathic Rehabilitation Other: De-Rotation breathing Exercises Not Applicable

Detailed Description:

Kyphoscoliosis (KS) is the dual spinal deformity characterized by exaggerated thoracic kyphosis and lateral displacement of the spine in the frontal plane. Scoliosis is often associated with vertebral rotation. Scoliosis is the term used by Hippocrates, which means "crooked". Depending on the presence of lateral displacement scoliosis is classified into thoracic, lumbar or thoracolumbar. Idiopathic KS in adolescents is characterized by wedging of vertebral bodies in X-Ray and cardio-respiratory compromise.

Scoliosis is clinically diagnosed with 'Adam's test' by observing a posterior rib hump towards the convexity of scoliosis while bending forward in standing.

The severity of scoliosis is quantified by Cobb angle, which is calculated by drawing a line parallel to the end plates of the vertebral bodies at the starting and end of scoliotic curvature. The Second line is drawn a perpendicular to the first lines, the angle made between the intersection second lines is known as Cobb angle.

Clinical signs and symptoms of scoliosis become evident during the phase of rapid skeletal growth in children. The prevalence of scoliosis in the general population ranges from 0.3% to 15.3%.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 17 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Six of the 17 subjects visiting out-patient Department of our hospital met the inclusion criteria. All the subjects diagnosed with kyphoscoliosis signed the informed consent approved by the ethical committee of the hospital. The diagnosis was based on the diagnosis by an experienced radiologist. Subjects with idiopathic kyphoscoliosis and Cobb's angle greater than 60 degree and normal pulmonary function were included. The subjects with other cardiovascular pathologies, congenital disorders and inability to commute were excluded from this study.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: De-Rotation Breathing Exercises for Idiopathic Kyphoscoliosis Among Adolescents.
Actual Study Start Date : January 1, 2018
Actual Primary Completion Date : December 1, 2018
Actual Study Completion Date : December 1, 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Exercise Group
postural correction exercise on the wall and in front of the mirror, Exercise on a Swiss ball, Hanging on wall ladder for 1-2 minutes five times and side bending and extension exercises of the spine with theraband in standing and sitting. In addition, 7 of the randomly selected patients received De-rotation Breathing Exercises.
Other: De-Rotation breathing Exercises
De-rotation Breathing Exercises are the group of spinal extension, lateral spinal flexion and rotational exercises performed in synchrony with deep breathing. Exercises are performed in a sitting position with feet firmly placed on the ground. The therapist will stand behind the patient with a medicine ball or a small Swiss ball for the patient to receive while the patient rotates and laterally bend the trunk towards the convexity of scoliosis curvature. The patient is instructed to breathe in deeply during lateral bend and rotation in order to maximally expand the chest wall. Expiration involves relaxation while returning to the neutral position. Later, patients are instructed to extend their back along with former maneuver.

Active Comparator: Control Group
postural correction exercise on the wall and in front of the mirror, Exercise on a Swiss ball, Hanging on wall ladder for 1-2 minutes five times and side bending and extension exercises of the spine with theraband in standing and sitting.
Other: De-Rotation breathing Exercises
De-rotation Breathing Exercises are the group of spinal extension, lateral spinal flexion and rotational exercises performed in synchrony with deep breathing. Exercises are performed in a sitting position with feet firmly placed on the ground. The therapist will stand behind the patient with a medicine ball or a small Swiss ball for the patient to receive while the patient rotates and laterally bend the trunk towards the convexity of scoliosis curvature. The patient is instructed to breathe in deeply during lateral bend and rotation in order to maximally expand the chest wall. Expiration involves relaxation while returning to the neutral position. Later, patients are instructed to extend their back along with former maneuver.

Active Comparator: Age Matched Normal Group
The Group consisted of age-matched normal subjects. Following exercises were performed, Postural correction exercise on the wall and in front of the mirror, Exercise on a Swiss ball, Hanging on wall ladder for 1-2 minutes five times and side bending and extension exercises of the spine with theraband in standing and sitting.
Other: De-Rotation breathing Exercises
De-rotation Breathing Exercises are the group of spinal extension, lateral spinal flexion and rotational exercises performed in synchrony with deep breathing. Exercises are performed in a sitting position with feet firmly placed on the ground. The therapist will stand behind the patient with a medicine ball or a small Swiss ball for the patient to receive while the patient rotates and laterally bend the trunk towards the convexity of scoliosis curvature. The patient is instructed to breathe in deeply during lateral bend and rotation in order to maximally expand the chest wall. Expiration involves relaxation while returning to the neutral position. Later, patients are instructed to extend their back along with former maneuver.




Primary Outcome Measures :
  1. Cobb angle [ Time Frame: 1-2 hours ]
    Angulation calculated on X-ray

  2. Chest wall compliance [ Time Frame: 1-2 hours ]
    Measured with Inch Tape at three different levels of chest

  3. VO2 Max [ Time Frame: 1-2 hours ]
    Amount of oxygen consumption by an individual doing exercises on treadmill.



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Ages Eligible for Study:   Child, Adult, Older Adult
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Subjects with idiopathic kyphoscoliosis and Cobb's angle greater than 60 degree and normal pulmonary function were included.

Exclusion Criteria:

  • The subjects with other cardiovascular pathologies, congenital disorders and inability to commute were excluded from this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03779581


Locations
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Saudi Arabia
Faizan Kashoo
Riyadh, Saudi Arabia, 11952
Sponsors and Collaborators
Majmaah University
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Responsible Party: faizan kashoo, PT, Lecturer, Department of physical Therapy and Health Rehabilitation, Majmaah University
ClinicalTrials.gov Identifier: NCT03779581    
Other Study ID Numbers: MajmaahUniversity
First Posted: December 19, 2018    Key Record Dates
Last Update Posted: December 20, 2018
Last Verified: December 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Scoliosis
Spinal Curvatures
Spinal Diseases
Bone Diseases
Musculoskeletal Diseases