European Spine Journal

, Volume 25, Issue 10, pp 3120–3129 | Cite as

Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial

  • Marco MonticoneEmail author
  • Emilia Ambrosini
  • Daniele Cazzaniga
  • Barbara Rocca
  • Lorenzo Motta
  • Cesare Cerri
  • Marco Brayda-Bruno
  • Alessio Lovi
Original Article



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.


Adult 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.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Marco Monticone
    • 1
    Email author
  • Emilia Ambrosini
    • 1
    • 2
  • Daniele Cazzaniga
    • 1
  • Barbara Rocca
    • 1
  • Lorenzo Motta
    • 3
  • Cesare Cerri
    • 3
  • Marco Brayda-Bruno
    • 4
  • Alessio Lovi
    • 4
  1. 1.Physical Medicine and Rehabilitation Unit, Scientific Institute of LissoneSalvatore Maugeri Foundation, Institute of Care and Research (IRCCS)LissoneItaly
  2. 2.Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and BioengineeringPolitecnico di MilanoMilanItaly
  3. 3.School of Physical and Rehabilitation MedicineBicocca University of MilanMilanItaly
  4. 4.Department of Spinal Surgery III, Galeazzi Orthopedic InstituteInstitute of Care and Research (IRCCS)MilanItaly

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