Diaphragm Mobilization in Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that can affect posture, trunk movement, and respiratory function. Changes in the shape of the rib cage may influence diaphragm function and breathing mechanics in individuals with scoliosis. The Schroth Best Practice (SBP) exercise program is commonly used in the conservative treatment of scoliosis and focuses on posture correction and scoliosis-specific exercises. However, the additional benefits of manual diaphragm mobilization combined with this exercise program are not well known. The aim of this randomized controlled trial is to investigate the effect of diaphragm mobilization added to the Schroth Best Practice program in adolescents with idiopathic scoliosis. Participants will be randomly assigned to two groups: one group will perform the SBP exercise program alone, and the other group will receive SBP exercises combined with diaphragm mobilization. The intervention will be performed three times per week for six weeks. Assessments will be conducted at baseline, at the end of the 6-week intervention, and at a 12-week follow-up. Outcomes will include respiratory function measured by spirometry, trunk rotation, thoracic mobility, trunk flexibility, quality of life, and body image. The results of this study may help determine whether adding diaphragm mobilization to scoliosis-specific exercise programs improves clinical outcomes in adolescents with idiopathic scoliosis.

Inclusion Criteria: * Adolescents aged between 10 and 18 years * Diagnosis of adolescent idiopathic scoliosis * Cobb angle ≥ 10° * Ability to participate in exercise sessions * Written informed consent from the participant and their parent or legal guardian Exclusion Criteria: * Non-idiopathic scoliosis (e.g., neuromuscular, congenital, or syndromic scoliosis) * Presence of congenital anomalies affecting the musculoskeletal system * Previous scoliosis treatment within the last 6 months * Participation in another physiotherapy or rehabilitation program during the study period * Current use of a scoliosis brace * History of spinal surgery * Presence of neurological, rheumatological, or cardiopulmonary diseases that may affect participation in the intervention * Cognitive impairment, communication disorders, or any condition that may limit the ability to follow instructions or complete assessments