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NCT Number: NCT07319702

Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training for Adolescent Spinal Curvature Abnormalities

The goal of this clinical trial is to evaluate the clinical effectiveness of proprioceptive neuromuscular facilitation (PNF) combined with spiral muscle chain training in improving spinal function and posture in adolescents aged 13 to 18 years with spinal curvature abnormalities.

The main questions it aims to answer are:

Does exercise-based intervention improve trunk inclination angle, kyphotic angle, and body balance parameters in adolescents with spinal curvature abnormalities?

Does the combined intervention improve spinal mobility and paraspinal muscle endurance compared with single-intervention approaches?

Does the combined intervention lead to favorable changes in surface electromyography (sEMG) indicators of the paraspinal muscles?

Researchers will compare a PNF therapy group, a spiral muscle chain training group, and a combined PNF plus spiral muscle chain training group to assess differences in trunk inclination angle, kyphotic angle, spinal mobility, paraspinal muscle endurance, and neuromuscular activation outcomes. Body mass index, fat-to-muscle ratio, and other body-composition-related indicators will be analyzed as exploratory post hoc outcomes.

Participants will:

Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training.

Participate in supervised exercise training sessions three times per week for 12 weeks.

Undergo pre- and post-intervention assessments, including body composition testing, electronic spinal measurements, and surface electromyography testing.

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Key information

Conditions

Adolescent Idiopathic Scoliosis (AIS) Bone Diseases Flat Back Kyphosis Musculoskeletal Diseases Spinal Curvature Abnormalities Spinal Curvatures Spinal Diseases

Age range

13 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The Affiliated High School of Nanjing Normal University

Nanjing, Jiangsu, 210023, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Aged 13 to 18 years
  • Newly diagnosed with no prior treatment and meeting the diagnostic criteria for spinal curvature abnormalities
  • Scoliosis or coronal spinal curvature abnormality determined by poor posture and angle of trunk inclination or angle of trunk rotation of 5° or greater
  • Anterior-posterior spinal curvature abnormality determined by poor posture or abnormal spinal side-view assessment, including kyphotic angle less than 20° or greater than 40°
  • No prior brace treatment
  • No history of spinal surgery
  • Able to complete proprioceptive neuromuscular facilitation therapy, spiral muscle chain training, or combined exercise training as required
  • Written informed consent obtained from participants and their parents or legal guardians

Exclusion criteria

  • Menstruating females at the time of assessment
  • Metal implants
  • History of brace use or prior treatment for spinal curvature abnormalities
  • Severe scoliosis, defined as angle of trunk inclination or angle of trunk rotation greater than 13°
  • Congenital spinal curvature abnormality
  • Neuromuscular disorders
  • Respiratory dysfunction
  • Any contraindication to exercise
  • Any trauma within the previous 6 months
  • Any accompanying neurological, rheumatological, or mental health problems

Treatment and study plan

Proprioceptive Neuromuscular Facilitation (PNF) Therapy

Behavioral

Proprioceptive neuromuscular facilitation (PNF) therapy is used as an exercise-based intervention to address abnormal spinal curvature in children with adolescent idiopathic scoliosis.

The PNF program includes resisted scapular-pelvic patterns, cervical flexion and extension, trunk diagonal patterns (chopping and lifting), bilateral upper-limb diagonal patterns, and bridge exercises.

Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Other names: Proprioceptive Neuromuscular Facilitation

Spiral Muscle Chain (SPS) Training

Behavioral

Spiral muscle chain (SPS) training is applied as an exercise-based intervention aimed at improving spinal alignment, postural control, and neuromuscular coordination in children with adolescent idiopathic scoliosis.

The SPS program consists of spiral stabilization exercises performed with elastic resistance, body positioning control, and stretching components according to a standardized training protocol.

Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Other names: Spiral Stabilization Training

Combined Exercise Therapy

Behavioral

The combined intervention integrates proprioceptive neuromuscular facilitation (PNF) therapy and spiral muscle chain (SPS) training as a comprehensive exercise program for children with adolescent idiopathic scoliosis.

Participants perform both PNF and SPS exercise components within each training cycle to target spinal alignment, muscle endurance, and neuromuscular activation.

Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.

Primary outcomes

  1. Change in Trunk Tilt Angle (ATI)

    Time frame: Baseline and after 12 weeks of intervention

    Trunk tilt angle (Angle of Trunk Rotation, ATI) measured using an electronic spine assessment device to evaluate changes in spinal asymmetry and trunk alignment.

  2. Change in Kyphotic Angle (KA)

    Time frame: Baseline and after 12 weeks of intervention

    Kyphotic angle will be measured using an electronic spinal assessment device to evaluate changes in sagittal spinal curvature.

  3. Change in Body Balance Parameters

    Time frame: Baseline and after 12 weeks of intervention

    Body balance parameters assessed by electronic spine measurement, including head lateral deviation, shoulder asymmetry, and pelvic tilt.

Secondary outcomes

  1. Change in Body Mass Index (BMI)

    Time frame: Baseline and after 12 weeks of intervention

    Body mass index will be calculated from measured height and weight to evaluate changes in body composition and growth-related physical characteristics after the 12-week exercise intervention.

  2. Change in Fat-to-Muscle Ratio (FMR)

    Time frame: Baseline and after 12 weeks of intervention

    Fat-to-muscle ratio will be derived from body composition testing to evaluate changes in the relative distribution of fat mass and muscle mass after the 12-week exercise intervention.

  3. Change in Spinal Mobility

    Time frame: Baseline and after 12 weeks of intervention

    Spinal mobility assessed by electronic spine measurement, including lateral flexion, flexion-extension, and rotational range of motion.

  4. Change in Surface Electromyography Parameters

    Time frame: Baseline and after 12 weeks of intervention

    Surface electromyography parameters of the trunk and paraspinal muscles will be assessed, including amplitude-domain and frequency-domain indicators such as integrated electromyography, mean power frequency, and median frequency.

  5. Change in Trunk Muscle Activation Patterns

    Time frame: Baseline and after 12 weeks of intervention

    Trunk muscle activation patterns will be assessed during standardized functional tasks using surface electromyography to evaluate neuromuscular coordination and activation symmetry of trunk and paraspinal muscles.

  6. Change in Paraspinal Muscle Endurance

    Time frame: Baseline and after 12 weeks of intervention

    Paraspinal muscle endurance will be assessed using standardized endurance testing, such as the Biering-Sorensen test, to evaluate the sustained contraction capacity of the trunk extensor muscles.

Sponsors and collaborators

Lead sponsor

Nie danning

Other

Registry information

Official study title

Clinical Effects of Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training in Adolescents With Spinal Curvature Abnormalities: A Randomized Controlled Trial

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Jan 6, 2026
Registry last updated
May 14, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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