Adolescent Idiopathic Scoliosis (AIS)NCT07319702
Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training for Adolescent Spinal Curvature Abnormalities
A study testing Proprioceptive Neuromuscular Facilitation (PNF) Therapy, Spiral Muscle Chain (SPS) Training and Combined Exercise Therapy in people with Adolescent Idiopathic Scoliosis (AIS) and Spinal Curvature Abnormalities, run by Nie danning at 1 site in China.
Trial summary
The goal of this clinical trial is to evaluate the clinical effectiveness of proprioceptive neuromuscular facilitation (PNF) combined with spiral muscle chain training in improving spinal function and posture in adolescents aged 13 to 18 years with spinal curvature abnormalities. Read more about this study
- Who is it for?
- Ages 13 to 18 years
- Conditions the study is for
- Adolescent Idiopathic Scoliosis (AIS), Spinal Curvature Abnormalities, Kyphosis
- What is being tested?
- Proprioceptive Neuromuscular Facilitation (PNF) Therapy, Spiral Muscle Chain (SPS) Training and Combined Exercise Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 189 participants
- Where
- 1 siteChina
- Study dates
- 5 Mar 2024to 30 Dec 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Aged 13 to 18 years
- Newly diagnosed with no prior treatment and meeting the diagnostic criteria for spinal curvature abnormalities
- Scoliosis or coronal spinal curvature abnormality determined by poor posture and angle of trunk inclination or angle of trunk rotation of 5° or greater
- Anterior-posterior spinal curvature abnormality determined by poor posture or abnormal spinal side-view assessment, including kyphotic angle less than 20° or greater than 40°
- No prior brace treatment
- No history of spinal surgery
- Able to complete proprioceptive neuromuscular facilitation therapy, spiral muscle chain training, or combined exercise training as required
- Written informed consent obtained from participants and their parents or legal guardians
Who cannot join
- Menstruating females at the time of assessment
- Metal implants
- History of brace use or prior treatment for spinal curvature abnormalities
- Severe scoliosis, defined as angle of trunk inclination or angle of trunk rotation greater than 13°
- Congenital spinal curvature abnormality
- Neuromuscular disorders
Show all 10Show fewer
- Respiratory dysfunction
- Any contraindication to exercise
- Any trauma within the previous 6 months
- Any accompanying neurological, rheumatological, or mental health problems
Trial locations and contacts
1 site in 1 country.
China1 site
The Affiliated High School of Nanjing Normal University
Nanjing, Jiangsu, 210023
About this study
Official title: Clinical Effects of Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training in Adolescents With Spinal Curvature Abnormalities: A Randomized Controlled Trial
The goal of this clinical trial is to evaluate the clinical effectiveness of proprioceptive neuromuscular facilitation (PNF) combined with spiral muscle chain training in improving spinal function and posture in adolescents aged 13 to 18 years with spinal curvature abnormalities.
The main questions it aims to answer are:
Read more
Does exercise-based intervention improve trunk inclination angle, kyphotic angle, and body balance parameters in adolescents with spinal curvature abnormalities?
Researchers will compare a PNF therapy group, a spiral muscle chain training group, and a combined PNF plus spiral muscle chain training group to assess differences in trunk inclination angle, kyphotic angle, and spinal mobility outcomes. Body mass index, fat-to-muscle ratio, and other body-composition-related indicators will be analyzed as exploratory post hoc outcomes.
Participants will:
Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training.
Participate in supervised exercise training sessions three times per week for 12 weeks.
Undergo pre- and post-intervention assessments, including body composition testing, and electronic spinal measurements.
Participants will:
Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training.
Participate in supervised exercise training sessions three times per week for 12 weeks.
Undergo pre- and post-intervention assessments, including body composition testing, and electronic spinal measurements.
- Conditions
- Adolescent Idiopathic Scoliosis (AIS), Spinal Curvature Abnormalities, Kyphosis, Flat Back
- Being tested
- Proprioceptive Neuromuscular Facilitation (PNF) Therapy, Spiral Muscle Chain (SPS) Training, Combined Exercise Therapy
- Keywords
- Adolescent Idiopathic Scoliosis, Proprioceptive Neuromuscular Facilitation, Spiral Muscle Chain Training, Exercise Therapy, Rehabilitation, Spinal Curvature Abnormalities
- Medical subject headings
- Kyphosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Proprioceptive Neuromuscular Facilitation (PNF) TherapyBehavioural
Also called Proprioceptive Neuromuscular Facilitation
Proprioceptive neuromuscular facilitation (PNF) therapy is used as an exercise-based intervention to address abnormal spinal curvature in children with adolescent idiopathic scoliosis.
The PNF program includes resisted scapular-pelvic patterns, cervical flexion and extension, trunk diagonal patterns (chopping and lifting), bilateral upper-limb diagonal patterns, and bridge exercises.
Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.
Spiral Muscle Chain (SPS) TrainingBehavioural
Also called Spiral Stabilization Training
Spiral muscle chain (SPS) training is applied as an exercise-based intervention aimed at improving spinal alignment, postural control, and neuromuscular coordination in children with adolescent idiopathic scoliosis.
The SPS program consists of spiral stabilization exercises performed with elastic resistance, body positioning control, and stretching components according to a standardized training protocol.
Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.
Combined Exercise TherapyBehavioural
The combined intervention integrates proprioceptive neuromuscular facilitation (PNF) therapy and spiral muscle chain (SPS) training as a comprehensive exercise program for children with adolescent idiopathic scoliosis.
Participants perform both PNF and SPS exercise components within each training cycle to target spinal alignment, muscle endurance, and neuromuscular activation.
Training sessions are supervised and conducted three times per week (every other day) for 12 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Proprioceptive Neuromuscular Facilitation (PNF) Therapy | Experimental | Participants receive proprioceptive neuromuscular facilitation (PNF) therapy as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The PNF protocol includes resisted scapular-pelvic patterns, cervical flexion/extension, trunk chopping/lifting patterns, bilateral upper-limb patterns, and bridge exercises (per PNF schedule). Receives: Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) Therapy |
| Spiral Muscle Chain (SPS) Training | Experimental | Participants receive spiral stabilizing muscle chain (SPS) training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The SPS program follows the SPS training schedule (Training 1A-6A, 7C-10C, and stretching component), with planned repetitions/sets and practice time as listed in the protocol schedule. Receives: Behavioral: Spiral Muscle Chain (SPS) Training |
| Combined Exercise Therapy | Experimental | Participants receive a combined program consisting of PNF therapy plus SPS spiral muscle chain training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. Receives: Behavioral: Combined Exercise Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Trunk Tilt Angle (ATI)
Trunk tilt angle (Angle of Trunk Rotation, ATI) measured using an electronic spine assessment device to evaluate changes in spinal asymmetry and trunk alignment.
Measured: Baseline and after 12 weeks of intervention
Change in Kyphotic Angle (KA)
Kyphotic angle will be measured using an electronic spinal assessment device to evaluate changes in sagittal spinal curvature.
Measured: Baseline and after 12 weeks of intervention
Change in Body Balance Parameters
Body balance parameters assessed by electronic spine measurement, including head lateral deviation, shoulder asymmetry, and pelvic tilt.
Measured: Baseline and after 12 weeks of intervention
Secondary outcomes (3)
Change in Body Mass Index (BMI)
Body mass index will be calculated from measured height and weight to evaluate changes in body composition and growth-related physical characteristics after the 12-week exercise intervention.
Measured: Baseline and after 12 weeks of intervention
Change in Fat-to-Muscle Ratio (FMR)
Fat-to-muscle ratio will be derived from body composition testing to evaluate changes in the relative distribution of fat mass and muscle mass after the 12-week exercise intervention.
Measured: Baseline and after 12 weeks of intervention
Change in Spinal Mobility
Spinal mobility assessed by electronic spine measurement, including lateral flexion, flexion-extension, and rotational range of motion.
Measured: Baseline and after 12 weeks of intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jan 2026
- Study start5 Mar 2024
- Primary completion30 Dec 2024
- Study completion30 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Adolescent Idiopathic Scoliosis (AIS)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 189 participants (actual)
Sponsor and investigators
- Lead sponsor
- Nie danning
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Nie danning, Nanjing Normal University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07319702
- Sponsor's protocol ID
- NNU202410016
- Status last verified
- May 2026
- First submitted
- 20 Dec 2025
- Last updated
- 19 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will not be shared because the study involves minors, and the data include sensitive health information related to spinal posture and neuromuscular function. According to the approved ethics protocol, strict measures are required to protect participants' privacy and confidentiality. Although all data are de-identified, sharing IPD may still pose a potential risk of re-identification. Therefore, IPD will not be made publicly available in order to ensure compliance with ethical requirements and data protection regulations.
Publications
Xu Y, Feng M, Wu R, Wang Y, Yang Z, Wang Z, Kang Z, Xie L, Liu H. Effect of adding proprioceptive neuromuscular facilitation to conventional physiotherapy on scapular balance and shoulder proprioception in adolescents with idiopathic scoliosis: a randomised controlled trial protocol. BMJ Open. 2025 Nov 19;15(11):e106848. doi: 10.1136/bmjopen-2025-106848.
PubMed 41263915Nechvatal P, Hitrik T, Kendrova LD, Macej M. Comparison of the effect of the McKenzie method and spiral stabilization in patients with low back pain: A prospective, randomized clinical trial. J Back Musculoskelet Rehabil. 2022;35(3):641-647. doi: 10.3233/BMR-210055.
PubMed 34657873Maruyama T, Kitagawa T, Takeshita K, Mochizuki K, Nakamura K. Conservative treatment for adolescent idiopathic scoliosis: can it reduce the incidence of surgical treatment? Pediatr Rehabil. 2003 Jul-Dec;6(3-4):215-9. doi: 10.1080/13638490310001642748.
PubMed 14713588
Study at a glance
From the registry record, last updated by the sponsor on 19 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Effects of Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training in Adolescents With Spinal Curvature Abnormalities: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07319702
- Acronym / sponsor ID
- NNU202410016
- Conditions
- Adolescent Idiopathic Scoliosis (AIS), Spinal Curvature Abnormalities, Kyphosis, Flat Back
- Keywords
- Adolescent Idiopathic Scoliosis, Proprioceptive Neuromuscular Facilitation, Spiral Muscle Chain Training, Exercise Therapy, Rehabilitation, Spinal Curvature Abnormalities
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 189 participants (actual)
- Lead sponsor
- Nie danningUniversity, hospital or other
- Study start
- 5 Mar 2024 (actual)
- Primary completion
- 30 Dec 2024 (actual)
- Study completion
- 30 Dec 2024 (actual)
- First posted
- 6 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to evaluate the clinical effectiveness of proprioceptive neuromuscular facilitation (PNF) combined with spiral muscle chain training in improving spinal function and posture in adolescents aged 13 to 18 years with spinal curvature abnormalities.
The main questions it aims to answer are:
Does exercise-based intervention improve trunk inclination angle, kyphotic angle, and body balance parameters in adolescents with spinal curvature abnormalities?
Researchers will compare a PNF therapy group, a spiral muscle chain training group, and a combined PNF plus spiral muscle chain training group to assess differences in trunk inclination angle, kyphotic angle, and spinal mobility outcomes. Body mass index, fat-to-muscle ratio, and other body-composition-related indicators will be analyzed as exploratory post hoc outcomes.
Participants will:
Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training.
Participate in supervised exercise training sessions three times per week for 12 weeks.
Undergo pre- and post-intervention assessments, including body composition testing, and electronic spinal measurements.
Participants will:
Be assigned to one of three intervention groups: PNF therapy alone, spiral muscle chain training alone, or combined PNF plus spiral muscle chain training.
Participate in supervised exercise training sessions three times per week for 12 weeks.
Undergo pre- and post-intervention assessments, including body composition testing, and electronic spinal measurements.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Proprioceptive Neuromuscular Facilitation (PNF) Therapy | Experimental | Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) TherapyParticipants receive proprioceptive neuromuscular facilitation (PNF) therapy as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The PNF protocol includes resisted scapular-pelvic patterns, cervical flexion/extension, trunk chopping/lifting patterns, bilateral upper-limb patterns, and bridge exercises (per PNF schedule). |
| Spiral Muscle Chain (SPS) Training | Experimental | Behavioral: Spiral Muscle Chain (SPS) TrainingParticipants receive spiral stabilizing muscle chain (SPS) training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. The SPS program follows the SPS training schedule (Training 1A-6A, 7C-10C, and stretching component), with planned repetitions/sets and practice time as listed in the protocol schedule. |
| Combined Exercise Therapy | Experimental | Behavioral: Combined Exercise TherapyParticipants receive a combined program consisting of PNF therapy plus SPS spiral muscle chain training as an exercise intervention for abnormal spinal curvature. Training is conducted 3 times per week (every other day) for 12 weeks. |
Who may qualify
- Ages
- 13 to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (8 listed)
- Aged 13 to 18 years
- Newly diagnosed with no prior treatment and meeting the diagnostic criteria for spinal curvature abnormalities
- Scoliosis or coronal spinal curvature abnormality determined by poor posture and angle of trunk inclination or angle of trunk rotation of 5° or greater
- Anterior-posterior spinal curvature abnormality determined by poor posture or abnormal spinal side-view assessment, including kyphotic angle less than 20° or greater than 40°
- No prior brace treatment
Key exclusion criteria (10 listed)
- Menstruating females at the time of assessment
- Metal implants
- History of brace use or prior treatment for spinal curvature abnormalities
- Severe scoliosis, defined as angle of trunk inclination or angle of trunk rotation greater than 13°
- Congenital spinal curvature abnormality
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Proprioceptive Neuromuscular Facilitation (PNF) TherapyAlso: Proprioceptive Neuromuscular FacilitationProprioceptive neuromuscular facilitation (PNF) therapy is used as an exercise-based intervention to address abnormal spinal curvature in children with adolescent idiopathic scoliosis. The PNF program includes resisted scapular-pelvic patterns, cervical flexion and extension, trunk diagonal patterns (chopping and lifting), bilateral upper-limb diagonal patterns, and bridge exercises. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks. | Behavioural | Proprioceptive Neuromuscular Facilitation (PNF) Therapy |
| Spiral Muscle Chain (SPS) TrainingAlso: Spiral Stabilization TrainingSpiral muscle chain (SPS) training is applied as an exercise-based intervention aimed at improving spinal alignment, postural control, and neuromuscular coordination in children with adolescent idiopathic scoliosis. The SPS program consists of spiral stabilization exercises performed with elastic resistance, body positioning control, and stretching components according to a standardized training protocol. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks. | Behavioural | Spiral Muscle Chain (SPS) Training |
| Combined Exercise TherapyThe combined intervention integrates proprioceptive neuromuscular facilitation (PNF) therapy and spiral muscle chain (SPS) training as a comprehensive exercise program for children with adolescent idiopathic scoliosis. Participants perform both PNF and SPS exercise components within each training cycle to target spinal alignment, muscle endurance, and neuromuscular activation. Training sessions are supervised and conducted three times per week (every other day) for 12 weeks. | Behavioural | Combined Exercise Therapy |
Primary outcome
Change in Trunk Tilt Angle (ATI)
Time frame: Baseline and after 12 weeks of intervention
Trunk tilt angle (Angle of Trunk Rotation, ATI) measured using an electronic spine assessment device to evaluate changes in spinal asymmetry and trunk alignment.
Change in Kyphotic Angle (KA)
Time frame: Baseline and after 12 weeks of intervention
Kyphotic angle will be measured using an electronic spinal assessment device to evaluate changes in sagittal spinal curvature.
Change in Body Balance Parameters
Time frame: Baseline and after 12 weeks of intervention
Body balance parameters assessed by electronic spine measurement, including head lateral deviation, shoulder asymmetry, and pelvic tilt.
3 secondary outcomes
Change in Body Mass Index (BMI)
Time frame: Baseline and after 12 weeks of intervention
Change in Fat-to-Muscle Ratio (FMR)
Time frame: Baseline and after 12 weeks of intervention
Change in Spinal Mobility
Time frame: Baseline and after 12 weeks of intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Aug 2026.
- Results publication: PubMed 41263915Xu Y, Feng M, Wu R, Wang Y, Yang Z, Wang Z, Kang Z, Xie L, Liu H. Effect of adding proprioceptive neuromuscular facilitation to conventional physiotherapy on scapular balance and shoulder proprioception in adolescents with idiopathic scoliosis: a randomised controlled trial protocol. BMJ Open. 2025 Nov 19;15(11):e106848. doi: 10.1136/bmjopen-2025-106848.
- Results publication: PubMed 34657873Nechvatal P, Hitrik T, Kendrova LD, Macej M. Comparison of the effect of the McKenzie method and spiral stabilization in patients with low back pain: A prospective, randomized clinical trial. J Back Musculoskelet Rehabil. 2022;35(3):641-647. doi: 10.3233/BMR-210055.
- Results publication: PubMed 14713588Maruyama T, Kitagawa T, Takeshita K, Mochizuki K, Nakamura K. Conservative treatment for adolescent idiopathic scoliosis: can it reduce the incidence of surgical treatment? Pediatr Rehabil. 2003 Jul-Dec;6(3-4):215-9. doi: 10.1080/13638490310001642748.
- Individual participant dataSharing planned: No. Individual participant data (IPD) will not be shared because the study involves minors, and the data include sensitive health information related to spinal posture and neuromuscular function. According to the approved ethics protocol, strict measures are required to protect participants' privacy and confidentiality. Although all data are de-identified, sharing IPD may still pose a potential risk of re-identification. Therefore, IPD will not be made publicly available in order to ensure compliance with ethical requirements and data protection regulations.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Proprioceptive Neuromuscular Facilitation (PNF) Therapy, Spiral Muscle Chain (SPS) Training and Combined Exercise Therapy in people with Adolescent Idiopathic Scoliosis (AIS) and Spinal Curvature Abnormalities, run by Nie danning at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Trunk Tilt Angle (ATI) (time frame: Baseline and after 12 weeks of intervention). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07319702, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Aug 2026.