Effectiveness of Spinal Stabilization Exercises for Low Back Pain in Adolescents with Idiopathic Scoliosis
Zapata, Karina Amani
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Background: The purpose of this study was to investigate the effectiveness of spinal stabilization exercises in reducing pain intensity and disability and improving disability, quality-of-life (QOL), back muscle endurance, and perceived changes in participants with low back pain (LBP) and adolescent idiopathic scoliosis (AIS). Methods: Participants were randomized into either a supervised PT group or unsupervised home exercise program (HEP) group. Thirty participants (15 in each group) completed the study. The supervised group received weekly supervised PT for 8 weeks. The unsupervised group received a one-time treatment and an 8-week HEP on DVD. Both groups received the same standardized spinal stabilization exercise program. Exercise progression was determined by the treating PTs for the supervised group and by the participants/caregivers for the unsupervised group. The following outcome measures were collected before and after 8 weeks: the Numeric Pain Rating Scale (NPRS) for pain intensity, the Revised Oswestry Back Pain Disability Questionnaire (OSW) for disability, the Scoliosis Research Society-22 Health-Related Quality-of-Life Questionnaire (SRS-22) for QOL, the prone-double-leg-raise (PDLR) test for back muscle endurance, and the Global Rating of Change (GROC) for participants' perceived changes. Four 2X2 ANOVAs with repeated measures were used to analyze the NPRS, OSW, SRS-22, and PDLR data. A Mann-Whitney U test was used to analyze the GROC scores. Results: The ANOVA results revealed a significant interaction for the NPRS (p = .01), but not for the PDLS, OSW, and SRS-22 scores. Further, post-hoc analysis revealed significant between-group and within-group differences in the NPRS (p < .01), showing that the supervised group had significantly greater reductions in pain intensity than the unsupervised group. The ANOVA results also showed that all participants, regardless of group, improved in all outcome measures after 8 weeks (p < .001). Both groups had improved GROC scores after 8 weeks of intervention, but no significant difference was found between groups. Conclusions: This study indicates that supervised PT is superior to an unsupervised HEP in reducing pain intensity in AIS and LBP. Spinal stabilization exercises may provide clinicians with an evidence-based treatment option for adolescents with idiopathic scoliosis with LBP.