Authors (including presenting author) :
Chan NC(1), Yeung KC(1), Chan CY(1), Leung KH(1),Hui WH(1), Lau SM(1), See KH(1), Mak HL(1), Lee CC(1), Tsui YC(1), Lau AYC(2), Hung ALH(2), Lam TP(2), Cheng JCY, Leung A(3), & Tsang SMH (4)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital, Hong Kong. (2) The Department of Orthopedic & Traumatology, Prince of Wales Hospital, Hong Kong. (3) International Schroth Three Dimensional Scoliosis Therapy, Sobernheim, Germany, (4) Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Keyword 1: :
Physiotherapeutic scoliosis-specific exercises (PSSE)
Keyword 2: :
Adolescent idiopathic scoliosis
Keyword 3: :
Angle of trunk rotation
Keyword 4: :
Postural correction
Keyword 5: :
Schroth method
Keyword 6: :
Exercise adherence
Introduction :
Physiotherapeutic scoliosis-specific exercises (PSSE), including the Schroth method, demonstrate efficacy in adolescent idiopathic scoliosis (AIS) management; however exercise adherence remains challenging for its complexity and time commitment. This single-group, pre-post pilot trial evaluated immediate angle-of-trunk-rotation (ATR) changes from three simplified Schroth techniques quantified by scoliometer measurements and through "Patient-Reported-Ease" of self posture correction, aiming to evaluate optimization of spine posture and feasibility for simplified, compliance-enhancing protocols in this cohort.
Objectives :
To evaluate the immediate efficacy (ATR reduction) and feasibility (perceived ease) of a simplified Schroth protocol for AIS.
Methodology :
Adolescents with scoliosis presenting a single or double-curve involving the thoracic spine were first assessed to establish a baseline (ATR) and immediately after each of the three simplified Schroth exercises using the Adams-forward-bend-test. Each participant 1) performed a seated rib hump derotation maneuver for 30 seconds, 2) adopted and maintained a relaxed posture by lying on the concave side of the curve for two minutes, and 3) assumed a side-lying position on the convex side (T side) with support while performing a stretching protocol for the concave side (weak side) (1 set of 6 repetitions). The ATR measured baseline and immediately after each respective exercise, and the patient reported ease (0-100%) of re-attempting the self-posture correction after completing all three exercises was analyzed using a repeated-measures ANOVA.
Result & Outcome :
A total of 23 adolescents with AIS (11 thoracic, 12 double-major-curves; Risser 0-5) were recruited (males:females 5:18; age mean 13.3 years ±2.4 ). All three simplified Schroth techniques led to significant immediate reductions in ATR compared to baseline (mean 11° ± 4.4 SD, *p* = 0.005). The initial seated rib hump derotation alone reduced the mean ATR to 8.3° (±3.7 SD). The complete, sequenced intervention (combining derotation, concave-side relaxation, and targeted stretching) elicited the greatest effect, further reducing the mean ATR to 7.6° (±3.6 SD). The "Patient-Reported Ease" of 12 cases reported a mean 60% (±18 SD) reduction. This pilot study demonstrates that a simplified Schroth protocol provides a resource-efficient model for managing adolescent idiopathic scoliosis. The brief, single-session sequence produced significant reductions in trunk rotation and substantially easier self postural correction, indicating efficacy and improved patient mastery. The present protocol saves clinical instruction time and reduces patient burden, directly addressing key adherence barriers. These findings support this practical, time-efficient approach for broadly applicable clinical and home-based management.
