Myofascial and Articular Treatment of Adolescent Idiopathic Scoliosis
NCT ID: NCT05423509
Last Updated: 2024-06-11
Study Results
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View full resultsBasic Information
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COMPLETED
NA
21 participants
INTERVENTIONAL
2020-12-01
2022-06-10
Brief Summary
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Detailed Description
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This study will test whether DMAMR produces clinically relevant changes in progression of scoliosis curvatures and rib humps, and whether this treatment protocol improves pain scores and quality of life.
Current research has demonstrated unilateral muscle shortening in AIS. Of most importance for this research proposal, research has also identified a set of muscles, portions of which are at an angle to the spine, that are shorter on the concave side of the curvature: the quadratus lumborum, psoas major and minor, and the abdominal obliques. The researchers have suggested this is a compensatory effect of the spinal deformities seen1. The investigators agree that unilateral muscle shortening is present in AIS but the investigators suggest that this asymmetry represents differences between muscle tension on either side of the spine and results in a tethering effect on the spine itself. Supporting a finding of the importance of these muscle imbalances, research using individualized physical therapeutic exercise programs to balance these types of muscle imbalances has demonstrated effectiveness in AIS treatment.
The investigators hypothesize this asymmetrical muscle imbalance, and its resultant tethering effect on the spine, represent myofascial dysfunction. The investigators believe the forces generated by this dysfunction are sufficient to induce worsening of the AIS curvature. The myofascial factors involved in the tethering of the spine in AIS include asymmetrical muscle imbalances involving muscles at an angle to the spine, primarily iliopsoas, quadratus lumborum, abdominal obliques, latissimus dorsi, and anterior serratus muscles.
Fascia overlies and interpenetrates these muscles. At a critical point, these myofascial imbalances generate sufficient stress on the overlying fascia to create a further contractile force within the fascia itself. The investigators ask whether this contractile force is mediated not only by anatomic shortening of individual muscle groups but also by intrinsic changes in fibroblast gene expression within the fascia itself.
The investigators further hypothesize that the asymmetrical muscle imbalances observed in AIS may be part of a larger contracted fascial spiral force influencing the development and progression of deformity. Therefore, treatment of the muscles, fascia, and related articular dysfunction may contribute to the control or reduction of AIS-associated deformities including scoliotic curvatures and accompanying rib humps. Effective treatment of these imbalances and deformities may reduce or eliminate AIS-associated spinal area pain, which the investigators hypothesize is largely myofascial in nature.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Standard treatment for AIS
These are the participants with AIS that recieved the standard treatment with observation or bracing depending on the size of their curve.
Standard AIS treatment with observation or bracing
Observation with radiographs and bracing of curves greater than 20 degrees
Treatment with Dynamic Myofascial Manipulation
These are the participants that still received the standard treatment with observation or bracing depending on the size of their curve, but also had weekly treatment with a chiropractor for 6 months for dynamic myofascial manipulation
Dynamic myofascial manipulation
Dynamic myofascial manipulation of the muscles in the back to improve the scoliosis appearance/flexibility/rotation
Standard AIS treatment with observation or bracing
Observation with radiographs and bracing of curves greater than 20 degrees
Interventions
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Dynamic myofascial manipulation
Dynamic myofascial manipulation of the muscles in the back to improve the scoliosis appearance/flexibility/rotation
Standard AIS treatment with observation or bracing
Observation with radiographs and bracing of curves greater than 20 degrees
Eligibility Criteria
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Inclusion Criteria
* Scoliosis curve of 15-30 degrees on cobb angle
* Risser stage of 0-2
Exclusion Criteria
10 Years
15 Years
ALL
Yes
Sponsors
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National Institutes of Health (NIH)
NIH
University of New Mexico
OTHER
Responsible Party
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Selina Silva
Associate Professor, Orthopaedic Surgerey
Locations
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UNM Carrie Tingley Hospital
Albuquerque, New Mexico, United States
Countries
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Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Document Type: Informed Consent Form
Other Identifiers
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Study 20-228
Identifier Type: -
Identifier Source: org_study_id
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