Adolescent Idiopathic Scoliosis (AIS)NCT07702812
Schroth and Pilates for Adolescent Idiopathic Scoliosis
A study testing Schroth Group and Schroth and Pilates Group in people with Adolescent Idiopathic Scoliosis (AIS), run by Ankara Yildirim Beyazıt University at 1 site in Turkey (Türkiye).
Trial summary
The primary aim of this study is to investigate the effectiveness of Schroth training and the multidimensional effects of adding Pilates-based exercises to Schroth training in individuals with adolescent idiopathic scoliosis. Read more about this study
- Who is it for?
- Ages 10 to 18 years
- Conditions the study is for
- Adolescent Idiopathic Scoliosis (AIS)
- What is being tested?
- Schroth Group and Schroth and Pilates Group
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 34 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jul 2026to 31 Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 10 to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Aged 10-18 years.
- Diagnosed with adolescent idiopathic scoliosis by a physician.
- Cobb angle between 10° and 45°.
- Willingness of both the participant and their parent/legal guardian to participate in the study.
- No additional rheumatologic, neurological, or orthopedic disorders.
- No scoliosis-specific treatment received within the previous 6 months.
Who cannot join
- History of scoliosis or spinal surgery.
- Scoliosis secondary to neurological, congenital, or other non-idiopathic causes.
- Any contraindication to exercise.
- A spinal curve with an apex at T12-L1.
- Presence of cognitive impairment that would interfere with study participation or assessments.
- Current brace treatment. Participants who are eligible for bracing but have not been prescribed a brace by their physician or who decline brace treatment despite being eligible will remain eligible for inclusion.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Ankara Yıldırım Beyazıt University
Ankara
Emine Kübra AY, 03129061000, ekay@aybu.edu.tr
About this study
Official title: Effects of Pilates-Based Exercises Added to Schroth Training on Physical and Clinical Outcomes in Adolescents With Idiopathic Scoliosis
The primary aim of this study is to investigate the effectiveness of Schroth training and the multidimensional effects of adding Pilates-based exercises to Schroth training in individuals with adolescent idiopathic scoliosis. Specifically, the study aims to evaluate the effects of Pilates-based exercises combined with Schroth training on lung capacity, trunk muscle strength, proprioception, trunk rotation, and posture. In addition, it seeks to examine the impact of the intervention on important functional and psychosocial outcomes, including quality of life, perceived cosmetic deformity, and pain threshold.
This study is expected to contribute to the existing evidence on the use of Pilates exercises in combination with Schroth exercises for individuals with adolescent idiopathic scoliosis by providing a comprehensive evaluation of the effects of this combined intervention. The findings are intended to provide guidance for clinicians and researchers regarding the combined use of different exercise approaches in the management of adolescent idiopathic scoliosis. Furthermore, the study aims to explore the potential benefits of integrating the Schroth method with Pilates as a holistic treatment approach for scoliosis management.
Read the detailed description
Scoliosis is a three-dimensional spinal deformity characterized by a lateral curvature greater than 10° measured using the Cobb angle, accompanied by vertebral rotation . Approximately 80% of idiopathic scoliosis cases occur during adolescence . Adolescent idiopathic scoliosis (AIS) typically develops between the ages of 10 and 18 years. Several factors, including the initial curve magnitude, curve location, apical vertebral rotation, and age, have been identified as risk factors for curve progression .
Treatment of AIS depends on the severity of the spinal curvature and may include bracing, exercise-based interventions, or surgical treatment. The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) classifies scoliosis exercise approaches under the category of Physiotherapeutic Scoliosis-Specific Exercises (PSSE). Among these approaches, the Schroth method, which is based on rotational angular breathing, is one of the most widely used and extensively studied treatment methods in the literature . revious research has demonstrated that Schroth therapy may contribute to reductions in Cobb angle and improvements in quality of life in adolescents with idiopathic scoliosis. In addition, Schroth-based exercises have been associated with enhanced thoracic and lumbar proprioception.
The literature has associated increases in thoracic curvature, measured by the Cobb angle, with reductions in pulmonary function. Although these reductions have not yet been classified as abnormal by the American Thoracic Society, decreased pulmonary function has been observed even in individuals with mild spinal curvatures. It has been estimated that every 4-5° increase in Cobb angle is associated with approximately a 1% reduction in total lung capacity .
Pilates, originally referred to as "Contrology", was developed by Joseph Pilates and has become widely practiced in both fitness and rehabilitation settings . Although relatively few studies have investigated the effects of Pilates on scoliosis, existing evidence suggests that it may have beneficial effects in this population . Gou et al. reported that Pilates exercises reduced the Cobb angle while improving quality of life and trunk range of motion.
In a 12-week intervention study, Khaledi et al. compared Schroth exercises combined with asymmetric spinal stabilization exercises and found no significant between-group differences in back muscle endurance. Nevertheless, numerical improvements favored the combined exercise group compared with the control group. Similarly, previous studies were compared Schroth exercises with core stabilization exercises in adolescents with idiopathic scoliosis and found that participants receiving Schroth training demonstrated significantly greater improvements in perceived cosmetic appearance than those performing core stabilization exercises. Despite these promising findings, the level of evidence supporting the effectiveness of Pilates exercises in the management of scoliosis-related deformities remains limited. Pilates exercises have been reported to reduce asymmetrical posture in individuals with mild scoliosis and a low risk of progression. Both Schroth and Pilates exercises are considered to have positive effects on lung capacity, trunk proprioception, trunk muscle strength, and quality of life in individuals with AIS. However, previous studies have primarily investigated the effects of these exercise approaches separately. Based on the current literature, no study has evaluated the effects of Pilates-based core stabilization exercises added to Schroth training in individuals with adolescent idiopathic scoliosis. Therefore, further research is needed to investigate the potential benefits of this combined intervention.
- Conditions
- Adolescent Idiopathic Scoliosis (AIS)
- Being tested
- Schroth Group, Schroth and Pilates Group
- Keywords
- adolescent idiopathic scoliosis, Schroth exercise, Pilates exercise, proprioception, quality of life, Perceived cosmetic deformity, Core muscle
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Schroth GroupBehavioural
Participants will be randomly allocated to either the intervention group or the control group.Participants in the control group will receive supervised Schroth exercise training twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will perform only the Schroth home exercise program.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions.
Schroth and Pilates GroupOther
Participants will be randomly allocated to either the intervention group or the control group. Participants in the intervention group will receive supervised Schroth training combined with Pilates-based exercises twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will be prescribed a home exercise program consisting of Schroth home exercises and Pilates-based exercises.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions.
| Study group | Role | What they receive |
|---|---|---|
| Schroth Group | Active comparator | Participants will receive supervised Schroth exercises based on the standardized Schroth method throughout the intervention period. Receives: Behavioral: Schroth Group |
| Schroth Combined with Pilates Group | Experimental | Participants in this group will receive Schroth exercises combined with Pilates-based exercises under the supervision of a physiotherapist throughout the intervention period. Receives: Other: Schroth and Pilates Group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Assessment of Lung Capacity
Vital Capacity (VC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. VC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Measured: Baseline and 2 months
Assessment of Lung Capacity
Forced Vital Capacity (FVC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FVC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Measured: Baseline and 2 months
Assessment of Lung Capacity
Total Lung Capacity (TLC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. TLC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Measured: Baseline and 2 months
Assessment of Lung Capacity
Residual Volume (RV) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. RV values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Measured: Baseline and 2 months
Assessment of Lung Capacity
Forced Expiratory Volume in One Second (FEV₁) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FEV₁ values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Measured: Baseline and 2 months
Assessment of Core Muscle Strength
Core muscle strength will be assessed using The Stabilizer Pressure Biofeedback Unit (Chattanooga Group Inc., USA) with the participant in the prone position. The pressure cuff of the Stabilizer unit will be placed horizontally beneath the abdominal region, with its lower edge aligned with the anterior superior iliac spines (ASIS). Participants will be instructed to take a deep breath, exhale, and gently draw the umbilicus toward the lumbar spine while maintaining normal breathing. After participants have been familiarized with the maneuver, the Stabilizer unit will be inflated to 70 mmHg. Participants will then be asked to repeat the maneuver and maintain the contraction for 10 seconds. The assessment will be performed three times, and the mean value will be recorded.
Measured: Baseline and 2 months
Postural Assessment
The device projects white light stripes (raster lines) onto the participant's back, and the three-dimensional shape of the back is reconstructed by analyzing the deformation of these projected lines. The resulting curved light patterns are captured by a camera, allowing a radiation-free and non-contact assessment of spinal alignment and posture.
During the assessment, participants will be instructed to stand in a relaxed and stationary position facing forward, with their back toward the camera, arms hanging freely at their sides, and feet positioned on the designated markers on the platform. The following postural parameters will be assessed: pelvic symmetry, shoulder and scapular alignment, vertebral rotation, thoracic kyphosis angle, and lumbar lordosis angle.
Measured: Baseline and 2 months
Assessment of Trunk Proprioception
Trunk proprioception will be assessed using a dual digital inclinometer (ACUMAR™, Lafayette, IN, USA). Participants will stand barefoot on a firm surface with their feet shoulder-width apart. The inclinometer sensors will be placed over the T1 and S1 spinous processes, identified by palpation. Participants will perform 30° trunk flexion and 15° trunk extension with their eyes open, memorize each target position, return to the starting position, and then reproduce the target angle. Each measurement will be repeated three times. The difference between the target and reproduced angles will be recorded in degrees as the measure of trunk proprioception.
Measured: Baseline and 2 months
Assessment of Trunk Rotation
Trunk rotation will be assessed using a Baseline Scoliometer (Fabrication Enterprises, White Plains, NY, USA). Participants will stand upright with their feet together and parallel, facing forward. They will then be instructed to place their hands together and bend forward until the trunk is parallel to the floor while keeping the arms relaxed. Angle of trunk rotation (ATR) will be measured at the cervical, thoracic, and lumbar regions, and the values will be recorded
Measured: Baseline and 2 months
Assessment of Pain Threshold
Pressure pain threshold will be assessed using a Baseline algometer (White Plains, NY, USA). The device applies pressure through a 1 cm² rubber tip, and the pressure at which pain is first perceived will be recorded in kg/cm² . Measurements will be performed bilaterally at points 2-3 cm lateral to the paravertebral muscles at the level of the participant's primary spinal curve. Before testing, pressure will be applied to a non-test area to familiarize participants with the procedure. Pressure will then be gradually increased until the participant indicates that the sensation has become painful by raising a hand. Three consecutive measurements, separated by 5-second intervals, will be obtained, and the mean value will be recorded.
Measured: Baseline and 2 months
Secondary outcomes (2)
Assessment of Quality of Life
Quality of life will be assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire. The Turkish validity and reliability of the questionnaire were established by Alanay et al. (2005). The SRS-22 consists of 22 items organized into five domains: pain, self-image/appearance, function/activity, mental health, and satisfaction with treatment. Each item is scored on a 5-point Likert scale, with higher scores indicating better quality of life. Permission to use the questionnaire will be obtained following ethics committee approval.
Measured: Baseline and 2 months
Assessment of Perceived Cosmetic Deformity
Perceived cosmetic deformity will be assessed using the Walter Reed Visual Assessment Scale (WRVAS). The Turkish validity and reliability of the scale were established by Çolak et al. (2020). The WRVAS is a visual instrument developed to evaluate how individuals with adolescent idiopathic scoliosis perceive their own deformity. It consists of seven items assessing spinal deformity, rib prominence, lumbar prominence, thoracic deformity, trunk imbalance, shoulder asymmetry, and scapular asymmetry. Each item includes five illustrations representing increasing deformity severity and is scored from 1 to 5, with higher scores indicating greater perceived deformity. The questionnaire will be completed separately by the physiotherapist, the participant, and a parent before and after the intervention. Permission to use the scale will be obtained following ethics committee approval.
Measured: Baseline and 2 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2026
- Study start1 Jul 2026
- Primary completion31 Dec 2027 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (20)Papers the sponsor has linked to this study.
- Other trials for Adolescent Idiopathic Scoliosis (AIS)Studies of the same condition, open and under way.
- More trials run by Ankara Yildirim Beyazıt UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 34 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ankara Yildirim Beyazıt University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Emine Kübra AY, Principal investigator, Ankara Yildirim Beyazıt UniversityBahar ANAFOROĞLU, Study chair, Ankara Yildirim Beyazıt University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07702812
- Sponsor's protocol ID
- 10/1662
- Status last verified
- Jul 2026
- First submitted
- 3 Jul 2026
- Last updated
- 14 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Manzak Dursun AS, Ozyilmaz S, Ucgun H, Elmadag NM. The effect of Pilates-based exercise applied with hybrid telerehabilitation method in children with adolescent idiopathic scoliosis: A randomized clinical trial. Eur J Pediatr. 2024 Feb;183(2):759-767. doi: 10.1007/s00431-023-05340-2. Epub 2023 Nov 23.
PubMed 37993666Langensiepen S, Semler O, Sobottke R, Fricke O, Franklin J, Schonau E, Eysel P. Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review. Eur Spine J. 2013 Nov;22(11):2360-71. doi: 10.1007/s00586-013-2693-9. Epub 2013 Feb 27.
PubMed 23443679Kocaman H, Bek N, Kaya MH, Buyukturan B, Yetis M, Buyukturan O. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial. PLoS One. 2021 Apr 15;16(4):e0249492. doi: 10.1371/journal.pone.0249492. eCollection 2021.
PubMed 33857180Kim, B. S., & Lee, M. M. (2020). A study on the clinical usefulness, validity, and test-retest reliability of the Spirokit, a device that combines the pulmonary function test and respiratory muscle strength test. Physical therapy rehabilitation science, 9(2), 120-130.
Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M. Schroth and Asymmetric Spinal Stabilization Exercises' Effectiveness on Back Pain and Trunk Muscle Endurance in Adolescents' Idiopathic Scoliosis: A Randomized Controlled Trial. Med J Islam Repub Iran. 2024 Aug 6;38:90. doi: 10.47176/mjiri.38.90. eCollection 2024.
PubMed 39678764Kempen DHR, Heemskerk JL, Kacmaz G, Altena MC, Reesink HJ, Vanhommerig JW, Willigenburg NW. Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J. 2022 Jul;22(7):1178-1190. doi: 10.1016/j.spinee.2021.12.011. Epub 2021 Dec 25.
PubMed 34963629HwangBo, P. N. (2018). The effects of Pilates exercise using the three dimensional Schroth breathing technique on the physical factors of scoliosis patients. The Journal of Korean Physical Therapy, 30(6), 229-233.
Güneş, G., & Çolak, T. K. (2023). Adölesan İdiyopatik Skolyozda Emekleme (KLAPP) Egzersizleri (KLAPP). Journal of Health Sciences and Management, 3(3), 66-70.
Grooms DR, Grindstaff TL, Croy T, Hart JM, Saliba SA. Clinimetric analysis of pressure biofeedback and transversus abdominis function in individuals with stabilization classification low back pain. J Orthop Sports Phys Ther. 2013 Mar;43(3):184-93. doi: 10.2519/jospt.2013.4397. Epub 2012 Nov 16.
PubMed 23160344Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, Hallstrand TS, Kaminsky DA, McCarthy K, McCormack MC, Oropez CE, Rosenfeld M, Stanojevic S, Swanney MP, Thompson BR. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019 Oct 15;200(8):e70-e88. doi: 10.1164/rccm.201908-1590ST.
PubMed 31613151Gou Y, Lei H, Zeng Y, Tao J, Kong W, Wu J. The effect of Pilates exercise training for scoliosis on improving spinal deformity and quality of life: Meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021 Oct 1;100(39):e27254. doi: 10.1097/MD.0000000000027254.
PubMed 34596121Goldberg A, Hernandez ME, Alexander NB. Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci. 2005 Oct;60(10):1310-4. doi: 10.1093/gerona/60.10.1310.
PubMed 16282565Dimitrijevic V, Viduka D, Scepanovic T, Maksimovic N, Giustino V, Bianco A, Drid P. Effects of Schroth method and core stabilization exercises on idiopathic scoliosis: a systematic review and meta-analysis. Eur Spine J. 2022 Dec;31(12):3500-3511. doi: 10.1007/s00586-022-07407-4. Epub 2022 Oct 14.
PubMed 36229615Degenhardt BF, Starks Z, Bhatia S. Reliability of the DIERS Formetric 4D Spine Shape Parameters in Adults without Postural Deformities. Biomed Res Int. 2020 Feb 13;2020:1796247. doi: 10.1155/2020/1796247. eCollection 2020.
PubMed 32104678Çolak İ, Çolak TK. A study of the reliability and validity of the Turkish version of the Walter Reed Visual Assessment Scale in adolescents with idiopathic scoliosis. J Turk Spinal Surg. 2020;31(3):125-9.
Study at a glance
From the registry record, last updated by the sponsor on 14 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Pilates-Based Exercises Added to Schroth Training on Physical and Clinical Outcomes in Adolescents With Idiopathic Scoliosis
- ClinicalTrials.gov ID
- NCT07702812
- Acronym / sponsor ID
- 10/1662
- Conditions
- Adolescent Idiopathic Scoliosis (AIS)
- Keywords
- adolescent idiopathic scoliosis, Schroth exercise, Pilates exercise, proprioception, quality of life, Perceived cosmetic deformity, Core muscle
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 34 participants (estimated)
- Lead sponsor
- Ankara Yildirim Beyazıt UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (actual)
- Primary completion
- 31 Dec 2027 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 14 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary aim of this study is to investigate the effectiveness of Schroth training and the multidimensional effects of adding Pilates-based exercises to Schroth training in individuals with adolescent idiopathic scoliosis. Specifically, the study aims to evaluate the effects of Pilates-based exercises combined with Schroth training on lung capacity, trunk muscle strength, proprioception, trunk rotation, and posture. In addition, it seeks to examine the impact of the intervention on important functional and psychosocial outcomes, including quality of life, perceived cosmetic deformity, and pain threshold.
This study is expected to contribute to the existing evidence on the use of Pilates exercises in combination with Schroth exercises for individuals with adolescent idiopathic scoliosis by providing a comprehensive evaluation of the effects of this combined intervention. The findings are intended to provide guidance for clinicians and researchers regarding the combined use of different exercise approaches in the management of adolescent idiopathic scoliosis. Furthermore, the study aims to explore the potential benefits of integrating the Schroth method with Pilates as a holistic treatment approach for scoliosis management.
Detailed description
Scoliosis is a three-dimensional spinal deformity characterized by a lateral curvature greater than 10° measured using the Cobb angle, accompanied by vertebral rotation . Approximately 80% of idiopathic scoliosis cases occur during adolescence . Adolescent idiopathic scoliosis (AIS) typically develops between the ages of 10 and 18 years. Several factors, including the initial curve magnitude, curve location, apical vertebral rotation, and age, have been identified as risk factors for curve progression .
Treatment of AIS depends on the severity of the spinal curvature and may include bracing, exercise-based interventions, or surgical treatment. The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) classifies scoliosis exercise approaches under the category of Physiotherapeutic Scoliosis-Specific Exercises (PSSE). Among these approaches, the Schroth method, which is based on rotational angular breathing, is one of the most widely used and extensively studied treatment methods in the literature . revious research has demonstrated that Schroth therapy may contribute to reductions in Cobb angle and improvements in quality of life in adolescents with idiopathic scoliosis. In addition, Schroth-based exercises have been associated with enhanced thoracic and lumbar proprioception.
The literature has associated increases in thoracic curvature, measured by the Cobb angle, with reductions in pulmonary function. Although these reductions have not yet been classified as abnormal by the American Thoracic Society, decreased pulmonary function has been observed even in individuals with mild spinal curvatures. It has been estimated that every 4-5° increase in Cobb angle is associated with approximately a 1% reduction in total lung capacity .
Pilates, originally referred to as "Contrology", was developed by Joseph Pilates and has become widely practiced in both fitness and rehabilitation settings . Although relatively few studies have investigated the effects of Pilates on scoliosis, existing evidence suggests that it may have beneficial effects in this population . Gou et al. reported that Pilates exercises reduced the Cobb angle while improving quality of life and trunk range of motion.
In a 12-week intervention study, Khaledi et al. compared Schroth exercises combined with asymmetric spinal stabilization exercises and found no significant between-group differences in back muscle endurance. Nevertheless, numerical improvements favored the combined exercise group compared with the control group. Similarly, previous studies were compared Schroth exercises with core stabilization exercises in adolescents with idiopathic scoliosis and found that participants receiving Schroth training demonstrated significantly greater improvements in perceived cosmetic appearance than those performing core stabilization exercises. Despite these promising findings, the level of evidence supporting the effectiveness of Pilates exercises in the management of scoliosis-related deformities remains limited. Pilates exercises have been reported to reduce asymmetrical posture in individuals with mild scoliosis and a low risk of progression. Both Schroth and Pilates exercises are considered to have positive effects on lung capacity, trunk proprioception, trunk muscle strength, and quality of life in individuals with AIS. However, previous studies have primarily investigated the effects of these exercise approaches separately. Based on the current literature, no study has evaluated the effects of Pilates-based core stabilization exercises added to Schroth training in individuals with adolescent idiopathic scoliosis. Therefore, further research is needed to investigate the potential benefits of this combined intervention.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Schroth Group | Active comparator | Behavioral: Schroth GroupParticipants will receive supervised Schroth exercises based on the standardized Schroth method throughout the intervention period. |
| Schroth Combined with Pilates Group | Experimental | Other: Schroth and Pilates GroupParticipants in this group will receive Schroth exercises combined with Pilates-based exercises under the supervision of a physiotherapist throughout the intervention period. |
Who may qualify
- Ages
- 10 to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (6 listed)
- Aged 10-18 years.
- Diagnosed with adolescent idiopathic scoliosis by a physician.
- Cobb angle between 10° and 45°.
- Willingness of both the participant and their parent/legal guardian to participate in the study.
- No additional rheumatologic, neurological, or orthopedic disorders.
Key exclusion criteria (6 listed)
- History of scoliosis or spinal surgery.
- Scoliosis secondary to neurological, congenital, or other non-idiopathic causes.
- Any contraindication to exercise.
- A spinal curve with an apex at T12-L1.
- Presence of cognitive impairment that would interfere with study participation or assessments.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Schroth GroupParticipants will be randomly allocated to either the intervention group or the control group.Participants in the control group will receive supervised Schroth exercise training twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will perform only the Schroth home exercise program.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions. | Behavioural | Schroth Group |
| Schroth and Pilates GroupParticipants will be randomly allocated to either the intervention group or the control group. Participants in the intervention group will receive supervised Schroth training combined with Pilates-based exercises twice weekly for 8 weeks in face-to-face sessions conducted by a physiotherapist. In addition, they will be prescribed a home exercise program consisting of Schroth home exercises and Pilates-based exercises.All participants will perform their home exercises twice daily, in the morning and evening. Before prescribing the home exercise program, the physiotherapist will provide detailed instructions and demonstrate each exercise during the clinical sessions. The home exercises will be performed twice daily, with each exercise consisting of 3 sets of 10 repetitions. | Other | Schroth Combined with Pilates Group |
Primary outcome
Assessment of Lung Capacity
Time frame: Baseline and 2 months
Vital Capacity (VC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. VC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Assessment of Lung Capacity
Time frame: Baseline and 2 months
Forced Vital Capacity (FVC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FVC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Assessment of Lung Capacity
Time frame: Baseline and 2 months
Total Lung Capacity (TLC) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. TLC values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Assessment of Lung Capacity
Time frame: Baseline and 2 months
Residual Volume (RV) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. RV values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Assessment of Lung Capacity
Time frame: Baseline and 2 months
Forced Expiratory Volume in One Second (FEV₁) will be assessed using a COSMED microQuark PC spirometer (Rome, Italy). During the assessment, participants will be seated comfortably in an upright position. A nose clip will be applied to prevent airflow through the nose during the test. FEV₁ values will be interpreted by comparing the measured values with the predicted reference values obtained from healthy individuals.
Assessment of Core Muscle Strength
Time frame: Baseline and 2 months
Core muscle strength will be assessed using The Stabilizer Pressure Biofeedback Unit (Chattanooga Group Inc., USA) with the participant in the prone position. The pressure cuff of the Stabilizer unit will be placed horizontally beneath the abdominal region, with its lower edge aligned with the anterior superior iliac spines (ASIS). Participants will be instructed to take a deep breath, exhale, and gently draw the umbilicus toward the lumbar spine while maintaining normal breathing. After participants have been familiarized with the maneuver, the Stabilizer unit will be inflated to 70 mmHg. Participants will then be asked to repeat the maneuver and maintain the contraction for 10 seconds. The assessment will be performed three times, and the mean value will be recorded.
Postural Assessment
Time frame: Baseline and 2 months
The device projects white light stripes (raster lines) onto the participant's back, and the three-dimensional shape of the back is reconstructed by analyzing the deformation of these projected lines. The resulting curved light patterns are captured by a camera, allowing a radiation-free and non-contact assessment of spinal alignment and posture. During the assessment, participants will be instructed to stand in a relaxed and stationary position facing forward, with their back toward the camera, arms hanging freely at their sides, and feet positioned on the designated markers on the platform. The following postural parameters will be assessed: pelvic symmetry, shoulder and scapular alignment, vertebral rotation, thoracic kyphosis angle, and lumbar lordosis angle.
Assessment of Trunk Proprioception
Time frame: Baseline and 2 months
Trunk proprioception will be assessed using a dual digital inclinometer (ACUMAR™, Lafayette, IN, USA). Participants will stand barefoot on a firm surface with their feet shoulder-width apart. The inclinometer sensors will be placed over the T1 and S1 spinous processes, identified by palpation. Participants will perform 30° trunk flexion and 15° trunk extension with their eyes open, memorize each target position, return to the starting position, and then reproduce the target angle. Each measurement will be repeated three times. The difference between the target and reproduced angles will be recorded in degrees as the measure of trunk proprioception.
Assessment of Trunk Rotation
Time frame: Baseline and 2 months
Trunk rotation will be assessed using a Baseline Scoliometer (Fabrication Enterprises, White Plains, NY, USA). Participants will stand upright with their feet together and parallel, facing forward. They will then be instructed to place their hands together and bend forward until the trunk is parallel to the floor while keeping the arms relaxed. Angle of trunk rotation (ATR) will be measured at the cervical, thoracic, and lumbar regions, and the values will be recorded
Assessment of Pain Threshold
Time frame: Baseline and 2 months
Pressure pain threshold will be assessed using a Baseline algometer (White Plains, NY, USA). The device applies pressure through a 1 cm² rubber tip, and the pressure at which pain is first perceived will be recorded in kg/cm² . Measurements will be performed bilaterally at points 2-3 cm lateral to the paravertebral muscles at the level of the participant's primary spinal curve. Before testing, pressure will be applied to a non-test area to familiarize participants with the procedure. Pressure will then be gradually increased until the participant indicates that the sensation has become painful by raising a hand. Three consecutive measurements, separated by 5-second intervals, will be obtained, and the mean value will be recorded.
2 secondary outcomes
Assessment of Quality of Life
Time frame: Baseline and 2 months
Assessment of Perceived Cosmetic Deformity
Time frame: Baseline and 2 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jul 2026.
- Background: PubMed 37993666Manzak Dursun AS, Ozyilmaz S, Ucgun H, Elmadag NM. The effect of Pilates-based exercise applied with hybrid telerehabilitation method in children with adolescent idiopathic scoliosis: A randomized clinical trial. Eur J Pediatr. 2024 Feb;183(2):759-767. doi: 10.1007/s00431-023-05340-2. Epub 2023 Nov 23.
- Background: PubMed 23443679Langensiepen S, Semler O, Sobottke R, Fricke O, Franklin J, Schonau E, Eysel P. Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review. Eur Spine J. 2013 Nov;22(11):2360-71. doi: 10.1007/s00586-013-2693-9. Epub 2013 Feb 27.
- Background: PubMed 33857180Kocaman H, Bek N, Kaya MH, Buyukturan B, Yetis M, Buyukturan O. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial. PLoS One. 2021 Apr 15;16(4):e0249492. doi: 10.1371/journal.pone.0249492. eCollection 2021.
- BackgroundKim, B. S., & Lee, M. M. (2020). A study on the clinical usefulness, validity, and test-retest reliability of the Spirokit, a device that combines the pulmonary function test and respiratory muscle strength test. Physical therapy rehabilitation science, 9(2), 120-130.
- Background: PubMed 39678764Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M. Schroth and Asymmetric Spinal Stabilization Exercises' Effectiveness on Back Pain and Trunk Muscle Endurance in Adolescents' Idiopathic Scoliosis: A Randomized Controlled Trial. Med J Islam Repub Iran. 2024 Aug 6;38:90. doi: 10.47176/mjiri.38.90. eCollection 2024.
- Background: PubMed 34963629Kempen DHR, Heemskerk JL, Kacmaz G, Altena MC, Reesink HJ, Vanhommerig JW, Willigenburg NW. Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J. 2022 Jul;22(7):1178-1190. doi: 10.1016/j.spinee.2021.12.011. Epub 2021 Dec 25.
- BackgroundHwangBo, P. N. (2018). The effects of Pilates exercise using the three dimensional Schroth breathing technique on the physical factors of scoliosis patients. The Journal of Korean Physical Therapy, 30(6), 229-233.
- BackgroundGüneş, G., & Çolak, T. K. (2023). Adölesan İdiyopatik Skolyozda Emekleme (KLAPP) Egzersizleri (KLAPP). Journal of Health Sciences and Management, 3(3), 66-70.
- Background: PubMed 23160344Grooms DR, Grindstaff TL, Croy T, Hart JM, Saliba SA. Clinimetric analysis of pressure biofeedback and transversus abdominis function in individuals with stabilization classification low back pain. J Orthop Sports Phys Ther. 2013 Mar;43(3):184-93. doi: 10.2519/jospt.2013.4397. Epub 2012 Nov 16.
- Background: PubMed 31613151Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, Hallstrand TS, Kaminsky DA, McCarthy K, McCormack MC, Oropez CE, Rosenfeld M, Stanojevic S, Swanney MP, Thompson BR. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019 Oct 15;200(8):e70-e88. doi: 10.1164/rccm.201908-1590ST.
- Background: PubMed 34596121Gou Y, Lei H, Zeng Y, Tao J, Kong W, Wu J. The effect of Pilates exercise training for scoliosis on improving spinal deformity and quality of life: Meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021 Oct 1;100(39):e27254. doi: 10.1097/MD.0000000000027254.
- Background: PubMed 16282565Goldberg A, Hernandez ME, Alexander NB. Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci. 2005 Oct;60(10):1310-4. doi: 10.1093/gerona/60.10.1310.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Emine Kübra AY principal investigator
Ankara Yildirim Beyazıt University
Bahar ANAFOROĞLU study chair
Ankara Yildirim Beyazıt University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Schroth Group and Schroth and Pilates Group in people with Adolescent Idiopathic Scoliosis (AIS), run by Ankara Yildirim Beyazıt University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 14 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Emine Kübra AY (+90 312 906 10 00, ekay@aybu.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Assessment of Lung Capacity (time frame: Baseline and 2 months). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07702812, which also lists 20 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jul 2026; AzTrials last refreshed its copy on 8 Nov 2026.