Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial
To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression.
130 adults with idiopathic scoliosis (main curve <35°) were randomly assigned to a 20-week rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive–behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome.
Significant effects of time, group, and time by group interaction were found for all outcome measures (P < 0.001). After training, the primary outcome showed a clinically significant between-group change (12 % points), which was preserved at follow-up. At follow-up, the radiological deformities showed a significant, although not clinically meaningful, between-group difference of 4° in favour of the experimental group.
The experimental programme was superior to general physiotherapy in reducing disability of adults with idiopathic scoliosis. Motor and cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.
KeywordsAdult scoliosis Self-correction Task-oriented exercises Cognitive–behavioural therapy Randomised controlled trial
Compliance with ethical standard
Conflicts of interest
There are no conflicts of interest to declare.
Source of funding
The study was not grant funded.
- 7.Bridwell KH, Glassman S, Horton W et al (2009) Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine 34:2171–2178. doi: 10.1097/BRS.0b013e3181a8fdc8 CrossRefPubMedGoogle Scholar
- 16.Cooper G, Lutz GE, Boachie-Adjei O, Lin J (2004) Effectiveness of transforaminal epidural steroid injections in patients with degenerative lumbar scoliotic stenosis and radiculopathy. Pain Phys 7:311–317Google Scholar
- 33.Monticone M, Ambrosini E, Cazzaniga D et al (2014) Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 23:1204–1214. doi: 10.1007/s00586-014-3241-y CrossRefGoogle Scholar
- 37.Monticone M, Baiardi P, Ferrari S et al (2012) Development of the Italian version of the Pain Catastrophising Scale (PCS-I): cross-cultural adaptation, factor analysis, reliability, validity and sensitivity to change. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 21:1045–1050. doi: 10.1007/s11136-011-0007-4 CrossRefGoogle Scholar
- 38.Monticone M, Baiardi P, Calabrò D et al (2010) Development of the Italian version of the revised Scoliosis Research Society-22 Patient Questionnaire, SRS-22r-I: cross-cultural adaptation, factor analysis, reliability, and validity. Spine 35:E1412–E1417. doi: 10.1097/BRS.0b013e3181e88981 CrossRefPubMedGoogle Scholar
- 41.Monticone M, Baiardi P, Vanti C et al (2012) Responsiveness of the Oswestry Disability Index and the Roland Morris Disability Questionnaire in Italian subjects with sub-acute and chronic low back pain. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 21:122–129. doi: 10.1007/s00586-011-1959-3 CrossRefGoogle Scholar
- 45.van Middelkoop M, Rubinstein SM, Kuijpers T et al (2011) A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 20:19–39. doi: 10.1007/s00586-010-1518-3 CrossRefGoogle Scholar