Effect of Scapular Stabilization Exercises in Individuals With Adolescent Idiopathic Scoliosis

Individuals' trunk rotation angles will be measured with the Adam's Forward Bend Test, which is considered the most practical scoliosis evaluation method in the clinic.

Radiography measurements will be taken in the anterio-posterior direction by the same technician. Scapular position will be measured by drawing a vertical axis line connecting two points on the centerline of the sternal body. The vertical distance to the vertical axis line will be calculated separately at the superior border, at the midpoint of the vertebral border, and at the inferior border of the scapula.

It is a quantitative method developed by Kibler and used to define scapular symmetry by measuring the distance between the distal end of the scapula and the spinous process of the aligned vertebra in three different arm positions. Patients will be asked to stand steadily on a hard, flat surface. Measurements; It will be performed in 3 different positions: arms next to the body, hands on the waist, arms raised to the sides at shoulder level, and the thumb pointing to the ground. A difference of more than 1.5 cm between two edges will be considered asymmetric.

It is obtained by measuring the distance from the sternal notch (SN) to the coracoid process (CP) and the horizontal distance from the posterolateral angle (PLA) of the acromion to the corresponding thoracic spine (TS) with a tape measure. As the final score; The formula [(distance between SN-CP / distance between PLA-TS) X 100] is used. A lower scapular index score indicates an increase in scapula internal rotation.

Isometric strength testing of the upper trapezius, middle trapezius, lower trapezius and serratus anterior muscles will be performed using a hand dynamometer as described by Kendall.

For radiographic evaluation of shoulder imbalance; coracoid height difference, clavicular angle, clavicle-rib intersection difference, radiographic shoulder height, T1 tilt, first rib angle and neck tilt measurements will be used.

For clinical evaluation of shoulder imbalance; shoulder level angle, anterior/posterior axillary angle, scapular angle, shoulder height difference, trapezial and clavicular angle and trapezial area measurements will be used.

It will be evaluated using the Japanese Scoliosis Questionnaire-27, which was developed by Doi et al. and its validity and reliability in Turkish was made by Bazancir et al. Ratings are on a 5-point Likert-type scale from 0 = "not at all" to 4 = "quite a bit", and the total score ranges from 0 to 108 points. A lower score indicates a better quality of life

The Walter Reed Visual Assessment Scale (WRVAS) is a scale consisting entirely of visual figures developed to help individuals with idiopathic scoliosis describe how they perceive their deformity. The WRVAS scale consists of 7 items that evaluate spinal deformity, costal protrusion, lumbar protrusion, thoracic deformity, trunk imbalance, shoulder asymmetry and scapular asymmetry, and include 5 different figures representing severity, showing different aspects of spinal deformity. The figures in each item are scored between 1 and 5 points according to the severity of deformity (1: no deformity, 5: severe deformity). The person marks the figure that suits his/her body in each item of the scale. The scale allows scoring of curve severity by focusing on the person's perception of posture.

Individuals' satisfaction levels with scapula and spine position and shoulder symmetry will be evaluated with a survey created by the researchers in the light of current literature.