Clinical efficacy of Schroth scoliosis-specific exercises combined with three-dimensional traction therapy in spinal-pelvic remodeling for adolescents with idiopathic scoliosis

English Keywords:Schroth scoliosis-specific exercises  Three-dimensional traction  Adolescent idiopathic scoliosis  Spinal-pelvic remodeling

English Abstract:

  【Abstract】 Objectives: To investigate the clinical efficacy of Schroth scoliosis-specific exercises combined with three-dimensional traction therapy in spinal-pelvic remodeling for adolescents idiopathic scoliosis(AIS). Methods: 80 AIS patients who received treatment at our hospital from June 2021 to June 2024 were enrolled. They were randomly divided into a control group(n=40, received Schroth spinal scoliosis-specific correction exercises alone) and a research group(n=40, underwent a combination of Schroth spinal scoliosis-specific correction exercises and three-dimensional traction therapy) using a random number table method. The general demographic data of the two groups were well-balanced(P>0.05). The clinical overall response rates of the two groups were compared, and spinal-pelvic remodeling indicators, including Cobb angle, angle of trunk inclination(ATI), angle of trunk rotation(ATR), C7 plumb line to the center sacral vertical line(C7-CSVL), apical vertebral translation(AVT), as well as median frequency(MF), mean power frequency(MPF), and average electromyography(AEMG) of the surface electromyography of the erector spinae muscles on the concave and convex sides, pelvic tilt(PT), pelvic incidence(PI), and sacral slope(SS), were assessed before treatment, at 1 month and 3 months after treatment. Repeated measures analysis of variance was conducted to test the main effects of spinal-pelvic remodeling indicators during the treatment period for both groups. Pearson correlation analysis was performed to examine the relationship between the Oswestry disability index(ODI) score and spinal-pelvic remodeling indicators. Results: The total effective treatment rate was significantly higher in the research group than in the control group(97.50% vs 67.50%, P<0.001). Compared with the pre-treatment values, the Cobb angle, ATI, and ATR of both groups decreased at 1 month and 3 months post-treatment(P<0.05). Moreover, when compared with the control group, the research group showed a more pronounced decrease in Cobb angle, ATI, and ATR at 1 month and 3 months post-treatment(P<0.05). Both groups exhibited a decrease in PI and SS, along with an increase in PT at 1 month and 3 months post-treatment(P<0.05). In comparison with the control group, the research group demonstrated a more significant decrease in PI and SS, and a more pronounced increase in PT at 1 month and 3 months post-treatment(P<0.05). The C7-CSVL and AVT of both groups decreased at 1 month and 3 months post-treatment(P<0.05), and the research group showed a more significant decrease in C7-CSVL and AVT compared with the control group at 1 month and 3 months post-treatment(P<0.05). Both groups experienced an increase in MF, MPF, and AEMG of the surface electromyography of the erector spinae muscles at 1 month and 3 months post-treatment(P<0.05), with the research group showing a more significant increase compared with the control group at 1 month and 3 months post-treatment(P<0.05). The main effect tests revealed statistically significant time effects, inter-group effects, and interaction effects for the spinal-pelvic remodeling indicators during the treatment period(P<0.05). The Cobb angle, ATI, ATR, C7-CSVL, AVT, MF, AEMG, MPF, PI, PT, and SS were all found to be correlated with the ODI score before and after treatment(P<0.05). The decrease in the ODI score of study group after treatment was significantly better than that of control group(β=-6.178, P<0.001). Conclusions: Schroth scoliosis-specific exercises combined with three-dimensional traction therapy significantly improve spinal-pelvic remodeling in AIS patients, effectively reducing spinal curvature and enhancing pelvic symmetry.