Abstract / Summary
Abstract Background Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity associated with neuromuscular control deficits and altered sensorimotor integration. Physiotherapeutic scoliosis-specific exercises (PSSE), including the Schroth method and the Postural Restoration Institute (PRI) approach, are used clinically; however, no randomized controlled trial has directly compared their effects on spinal alignment and functional outcomes in adolescents with AIS. Methods This single-center, three-arm, parallel-group, assessor-blinded randomized controlled trial will enroll 90 adolescents aged 15–18 years with mild right thoracic AIS (Cobb angle 10–25°, Risser ≥ 3). Participants will be randomized 1:1:1, stratified by sex and baseline Cobb angle, to a Schroth exercise group, a PRI exercise group, or an active control group (usual activities). The Schroth and PRI groups will receive condition-specific supervised exercise protocols three times weekly for 12 weeks, complemented by home programs and fidelity monitoring; the active control group will continue routine physical activity without structured PSSE. Assessments will occur at baseline (T0), post-intervention (T1, 12 weeks), and follow-up (T2, 24 weeks). The primary outcome is change in photogrammetric Cobb angle from T0 to T1. Secondary outcomes include neuromuscular activation symmetry (sEMG index), angle of trunk rotation (ATR), range of motion (ROM), and Scoliosis Research Society 22r (SRS-22r) quality-of-life scores. Analyses will follow the intention-to-treat principle using linear mixed-effects models to evaluate group×time interactions, with effect sizes, minimal detectable change, and clinically meaningful differences reported. Ethics approval has been obtained from the Research Ethics Committees of University of Guilan, and informed assent/consent will be obtained from participants and guardians. Discussion This protocol will provide comparative evidence on the effects of Schroth and PRI exercise programs versus active control on photogrammetric spinal curvature and neuromuscular/functional outcomes in adolescents with mild AIS, informing clinical decision-making and supporting transparent reporting and reproducibility of the trial findings. Trial registration Iranian Registry of Clinical Trials (IRCT) IRCT20250729066684N1. Registered on 09 January 2026. URL: https://irct.behdasht.gov.ir/trial/85367.