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Background: The purpose of this systematic review was to investigate the clinical outcome measures, either in separation or in conjunction with the Cobb angle, that were employed in randomized controlled trials to evaluate posture and spinal deformity. Methods: The PubMed, PEDro, OVID, and Scopus electronic databases were used to search for published articles from January 2004 to May 2024. All the searches included English language studies. Keywords were determined as "scoliosis, exercise, physical activity, brace, bracing, conservative treatment, rehabilitation, physiotherapy and physical therapy". Results: The most commonly used clinical evaluation parameters other than the Cobb angle in the studies were the ATR and surface topography measurements. The most commonly used assessment methods were POTSI asymmetry assessment performed with measurements made on photographs, the WRVAS, a deformity perception assessment evaluated with different photographs, and the SRS-22 scale, a disease-specific quality of life assessment. Conclusions: New developments in the treatment of scoliosis have brought about alternative measurement techniques that offer a more comprehensive view of patient outcomes. As a result of the review of the literature, it has emerged that radiation-free, valid, and reliable multidimensional evaluations should be performed in follow-up and treatment efficacy evaluations after initial diagnosis in adolescent idiopathic scoliosis. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to investigate the immediate and long-term effects of breathing exercises on simple and choice reaction time. Materials and Methods: A total of 31 participants were included in the study. The participants were randomly divided into two groups. The intervention group (IG; n:16) received 12 sessions of breathing exercises for four weeks (three days a week), while the control group (CG; n:15) received no intervention. Both groups underwent the same assessments at the same times: at baseline, after the first exercise session, and after four weeks/after 12 exercise sessions. Reaction time was assessed using three conditions: choice reaction time (CRT) of the upper limb, auditory reaction time (ART), and visual reaction time (VRT) tests. The first assessment was applied at baseline. The second assessment measured the short-term effect of the breathing exercises after the study group received their first breathing exercise session. The third assessment, to determine the long-term effect, was repeated four weeks after the baseline (A4W) assessment after completing 12 breathing exercises. Results: There was no significant difference between the groups at baseline, immediately, and A4W (p < 0.05) for the VRT, ART, and CRT results with the dominant hand (DH), whereas a group-by-time interaction was found only for the visual reaction time results with the non-dominant hand (nDH) (p > 0.05). Conclusions: The results of this study, which included the evaluation of the immediate and long-term effects of breathing exercises on reaction time, showed an improvement in visual reaction time between the groups over time. In further studies, it is recommended to evaluate the changes and responses in the central nervous system with objective methods to reveal the effect of breathing exercises on reaction time more clearly. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study focused on the impact of mental fatigue induced by motor imagery on upper limb function, an area with limited research compared to lower limb performance. It aimed to explore how diaphragmatic breathing exercises influence these effects. Materials and Methods: This study included 30 participants, and Group 1 participated in 12 sessions of diaphragmatic breathing exercises under the supervision of a physiotherapist; Group 2 did not receive any intervention. For all the participants, mental fatigue was induced with motor imagery before and after the intervention, and evaluations were performed before and after mental fatigue. Upper extremity functions were evaluated using isometric elbow flexion strength, hand grip strength, upper extremity reaction time and endurance, finger reaction time, the nine-hole peg test, shoulder position sense, light touch-pressure threshold, and two-point discrimination. Results: The study results showed that after mental fatigue, there was a decrease in isometric elbow flexion strength, nondominant hand grip strength, and nondominant upper extremity endurance, and an increase in nondominant tactile sensation (p < 0.05). No changes were found in two-point discrimination, nine-hole peg test time, and position sense on either side (p > 0.05). The effect of mental fatigue on isometric elbow flexion strength and nondominant grip strength showed significant improvement following diaphragmatic breathing exercises (p < 0.05). Conclusions: This study found that mental fatigue from motor imagery can impact elbow flexion, hand grip strength, upper extremity endurance, and tactile sensitivity. Breathing exercises may help improve strength parameters affected by mental fatigue. It is crucial to consider these effects on upper extremity functions in rehabilitation programs. [ABSTRACT FROM AUTHOR]

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Background: Adolescent idiopathic scoliosis (AIS) patients have been found to exhibit cortical asymmetry. Although asymmetries in cortical structures have been found in patients with AIS, there has been no research on how conservative treatments affect cerebellar functional organization. Aims: This study aimed to examine the impact of conservative treatments on perceptual and cognitive asymmetry in the auditory system assessed by dichotic listening in AIS patients with thoracic major curves. Method: This study involved 30 AIS patients and 21 healthy subjects. The intervention group used a Cheneau brace and performed 18 Schroth Best Practice (SBP) exercise sessions. Auditory lateralization was assessed using the Dichotic Listening Paradigm (DLP) in both groups before and after the intervention. Results: The 6-week intervention resulted in a significant increase in left ear responses in the force-left condition in the AIS (p < 0.05). Left ear responses were lower in AIS at baseline (p < 0.05). The results at week 6 were similar in all conditions (p > 0.05). Conclusion: The results of this study demonstrated that SBP exercises and Cheneau brace treatment can improve perceptual and cognitive asymmetry in the auditory system in AIS patients with thoracic major curve. Scoliosis-associated changes in the spine and postural control may affect auditory perception by causing adaptations in sensory and motor networks. Future studies are needed to examine the connectivity in brain regions related to motor control and auditory processing after conservative treatment. Trial registration: Clinical trials number: NCT06141759. [ABSTRACT FROM AUTHOR]

Background: Bracing is an essential part of scoliosis treatment. The standard of brace treatment for patients with scoliosis today is still very variable in terms of brace quality and outcome. The Gensingen brace is a further developed Chêneau brace derivative with individual design, which can be adapted through computer-aided design. Objective: This study aims to generate a template to obtain a database for prospective multicenter studies study to analyze the results of high-corrective asymmetric Gensingen brace treatment for patients with adolescent idiopathic scoliosis (AIS). Methods: A template for the database was created, which contains the patients' basic data (age, menarcheal status, Risser Sign, curve pattern, and daily brace wearing time), the Cobb angles of curvature, and the cosmetically relevant angles of trunk rotation (ATR). A retrospective review of medical records of patients with AIS, who met the Scoliosis Research Society's inclusion criteria for brace studies, was performed to test the feasibility of the template. Template items were filled in by the researchers. Results: Out of 115 patients between 2014 and 2018, the complete data of 33 patients followed up at least 3 months after complete Gensingen brace weaning could be analyzed. The mean age was 12 years, the mean Cobb angle was 33.6°, and the mean Risser value was 0.7 at the beginning of the treatment. The mean improvement in the Cobb angle on in-brace x-ray imaging was –26.1० (80% of in-brace correction). The Cobb angle of the major curvature changed as follows: curve stabilization was achieved in 7 (21.2%) cases, and curve improvement was achieved in 26 (78.8%) cases. None of the patients showed a curve progression. The Cobb angle was significantly reduced in the brace at the end of treatment and at follow-up evaluation (P <.001). ATR improved significantly for thoracic (P <.001) and lumbar curves (P <.001). Conclusions: The database proved to be informative in the assessment of radiological and clinical outcome parameters. The example data set we have generated can be a helpful tool for professionals who work in clinics but do not store regular patient data. Especially with regard to different patient collectives worldwide, different results may be achieved with the same standards of care. In addition, the results of this study suggest that above-average correction effects with a full-time brace application lead to significant improvements in the Cobb angle after brace treatment has been completed. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the immediate effect of relaxed and corrected posture applied while sitting and standing on the angle of trunk rotation (ATR) in adolescent idiopathic scoliosis (AIS) patients. Materials and Methods: The study included 38 patients with AIS. Corrected sitting and standing postures were taught according to the Schroth Best Practice® method, and patients were asked to sit/stand for 5 min. ATR was measured using a scoliometer before and after four postural positions: relaxed sitting and standingand corrected sitting and standing. Results: The mean age of the participants was 14 years, the Cobb angle was 28.63°, and the ATR was 8.14°. Baseline ATR values increased after relaxed sitting and standing postures and decreased after corrected sitting and standing (p<0.001). Improvements in corrected sitting were superior to corrected standing (p<0.001). ATR values increased more in relaxed sitting than in relaxed standing (p=0.008). Conclusion: The results showed that corrected posture might have a corrective effect on scoliosis curvature during activities of daily living (ADL). Integrating ADL adaptations into a rehabilitation program may help decrease asymmetric loading on the spine in growing adolescents with AIS. [ABSTRACT FROM AUTHOR]

Objective: The cervical and lumbar spines are the more mobile parts of the spinal column than the thoracic spine. Reference range of motion (ROM) measurements is one of the important clinical outcome measures used in patient assessment and follow-up of treatment efficacy. The aim of this study was to obtain normative values of cervical and lumbar ROM in young adults. Materials and Methods: The sample comprised 300 healthy volunteers (198 female, 102 male, mean age: 21.4±1.9 years, range, 18-29 years). Cervical (C) and lumbar (L) ROM values were measured in three planes with a two-arm digital goniometer according to the American Academy of Orthopaedic Surgeons (AAOS) criteria. The mean ROM measurements were analyzed according to gender using the Mann-Whitney U test. Results: Cervical ROM values were determined to be: cervical flexion 57.7±8.2º, extension 59.1±10.2º, right-left lateral flexion 42.1±7.9º-41.4±7.7º, and right-left rotation 71.1±10.5º-70.2±9.7º. There was no statistically significant difference between the genders with respect to the cervical ROM (p>0.05). The lumbar ROM values were determined to be lumbar flexion 69.9±14.5º, extension 40±10.2º, right-left lateral flexion 36.3±6.4º-36.2±6.6º, and right-left rotation 38.4±8.7º-38.6±9.4º. The lumbar flexion ROM values were statistically significantly higher in females than in males (p=0.043). Conclusion: The flexion and extension angles of the lumbar spine in the sagittal plane were higher in females than in males, and there was no difference between the genders regarding all the other cervical and lumbar joint ROM values. These goniometrically measured cervical and lumbar ROM values were found to be generally similar to the widely used reference values of AAOS and Kendall McCreary. Further research is needed on the effects of individual differences such as physical activity or inactivity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the information needs of individuals with adolescent idiopathic scoliosis (AIS) and their families when the disease was first diagnosed. Materials and Methods: A total of 117 patients with AIS and their parents volunteered to participate in this study. A survey developed specifically to assess the information needs of AIS patients and their families was sent by e-mail. Of the AIS patients, 59.8% were aged >16 years and completed the survey alone, and 40.2% were aged <16 years and they completed the survey together with their parents. Results: The results of this study demonstrated that in the initial diagnosis, scoliosis could be observed even if the angle was <20°. Generally, scoliosis was first noticed by the child's mother. As expected, at the time of the initial diagnosis, the children diagnosed as having scoliosis were upset and confused and their parents also felt upset and worried. The information most needed was reported to be answers to the questions of "Will it get better, what are the causes of scoliosis?", "What is scoliosis and what are the possible treatment options?", and the least frequently asked question was "Will surgery be needed?" Conclusion: Clear, accurate, complete, and personalized information is required by patients and their families. This information is essential in enabling patients to make major decisions and to take ownership and responsibility for the decision. Involvement in decision-making helps to improve compliance with treatment and finally also improves satisfaction with the agreed treatment method used. [ABSTRACT FROM AUTHOR]

Background/Objectives: The effectiveness of night braces alone or in combination with other treatments for adolescent idiopathic scoliosis remains unclear. This systematic review study aimed to review and analyze the available literature to determine whether night braces are an effective treatment for idiopathic scoliosis. Methods: A total of 162 databases, including Cochrane Library (reviews, protocols, trials), Web of Science, PubMed, Medline, Scopus, PEDro, CINAHL (EBSCO), Ovid and Google Scholar, were searched for published articles from inception to February 2024. The available literature was screened by the following terms: "scoliosis and night-time brace", "scoliosis and night brace", "scoliosis and part-time bracing", "scoliosis and Providence" and "scoliosis and Charleston". Results: Twenty studies were included; only one study was a randomized controlled trial, and most of the studies were retrospectively designed. Providence, Charleston and Boston braces were used as night braces. The Cobb angle was evaluated in all studies, and Cobb angle change after treatment and surgical treatment rates were the parameters that were evaluated the most. In one study, the angle of trunk rotation, quality of life, perception of spinal appearance, and physical activity level were measured. In one study, sagittal plane assessments were performed in addition to the Cobb angle. Conclusions: The results of this review suggest that there is no evidence to support the use of night braces in the treatment of adolescent idiopathic scoliosis. Randomized controlled trials with a well-designed methodology are needed to determine the efficacy of night braces.