Project 442959

At adolescence, 2-3% of adolescents are at risk of developing an idiopathic scoliosis, which is a 3D spinal deformity affecting mostly girls with unknown cause. Scoliosis causes body deformities which affects appearance and activities of daily living and increases the occurrence of back pain (50-78%). The current treatment in Canada is observation or bracing when scoliosis is at risk of progression or surgery if curve becomes too severe. Bracing and surgery impact quality of life, reduces respiratory function, mobility and activity performance without being necessarily effective on back pain. Early physiotherapy specific to scoliosis showed good results to prevent scoliosis progression and reduces brace prescription and number of surgeries. The aim of this project is to verify, in girls and boys, the effect of the global postural re-education (GPR) intervention used in physiotherapy on scoliosis progression (scoliosis angle), back pain, quality of life, respiratory function, trunk posture and trunk muscle functioning and walking endurance. To do so, we will recruit 156 participants at three scoliosis specialized Centers. Participants will be randomly allocated to the standard of care (SC) group (observation or brace plus home video of exercises for 12 months) or to the GPR group (SC plus individual sessions once a week for 6 months and individual sessions alternating with telerehabilitation sessions once per two weeks between 6 and 12 months). At initial, 6, 12- and 24-months evaluation, participants will have x-ray, complete self-report questionnaires to document back pain and quality of life. Thereafter, measurement of trunk posture, electromyography activity of the back muscles, excursion of the diaphragm muscle using echography and respiratory function as well as walking endurance using the 6-minute walk test will be done. We believe that GPR intervention may prevent scoliosis progression and improve physical health and quality of life in adolescence.