| Author: | Zou, Yiying |
| Title: | Clinical outcome comparison of the group and individual exercises of the patients with moderate adolescent idiopathic scoliosis under orthotic treatment |
| Advisors: | Wong, Man Sang (BME) |
| Degree: | Ph.D. |
| Year: | 2025 |
| Department: | Department of Biomedical Engineering |
| Pages: | xvi, 147 pages : color illustrations |
| Language: | English |
| Abstract: | Adolescent idiopathic scoliosis (AIS), characterised by a lateral curvature with a Cobb angle ≥10° and often accompanied by vertebral rotation, is the most common spinal deformity. Orthosis has been shown to effectively prevent scoliosis progression in moderate AIS, thereby reducing the need for spinal surgery. While orthosis provides passive correction to maintain spinal alignment, exercise offers active correction and maintains spinal flexibility and muscle strength. Previous studies have shown that group exercise (GE) can provide mutual support, which improves compliance, enhances quality of life (QoL), and benefits treatment outcomes in adults with various conditions. However, no study has directly investigated the effects of GE in patients with AIS undergoing orthotic treatment. This thesis applied a comprehensive AIS management programme that combines ultrasound assessment of scoliosis progression, sensor-based monitoring of orthosis-wear compliance, and a mobile application for structuring and documenting home exercises. The primary goal is to explore whether GE improves compliance and clinical outcomes compared to individual exercise (IE). To minimise risks in measurement and design choices, three sub-studies were conducted. Study 1 (n = 165) evaluated the impact of body mass index (BMI) on the reliability and validity of ultrasound assessment in AIS. Results showed the highest reliability and validity in normal-weight adolescents, leading to their inclusion in the main study, which utilised ultrasound to assess treatment progress. Study 2 (n = 12) applied force-temperature sensors during orthotic treatment, identifying a 4.5 hours/day discrepancy between self-reported and sensor-recorded wear time, highlighting the need for objective monitoring in the main study. Study 3 (n = 45) examined trunk appearance perception and QoL during orthotic treatment without regular supervised exercise, finding no significant sex differences. This supported the decision to include both sexes in the main study and established predefined psychological baselines. The main study (n = 40) compared compliance and treatment outcomes between GE (involving 3-4 patients per session) and IE (with one patient per session) in patients with AIS undergoing orthotic treatment. The study included a 1-month adaptation period, a 6-month supervised exercise session, and a 6-month follow-up. Participants attended one supervised exercise session per month over the 6-month supervision, supported by a mobile app to facilitate and monitor home-based exercises. Results showed that GE significantly improved compliance with exercise and orthotic wear, reduced scoliosis progression, and enhanced QoL, especially in self-esteem and emotional well-being, compared to IE. However, these benefits diminished following the end of supervised sessions. In summary, this thesis advocates for a comprehensive approach to managing AIS via integrating non-ionising ultrasound evaluation, objective digital monitoring of compliance, and group exercise programmes that provide psychosocial support. Future research should focus on creating long-term preservation strategies to sustain the treatment outcomes after the supervised intervention period. |
| Rights: | All rights reserved |
| Access: | open access |
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