R.W.L. Lau1,2, K.Y. Cheuk3, E.M.S. Tam3, S.S.C. Hui4, J.C.Y. Cheng1, T.P. Lam1
1The Chinese University of Hong Kong, SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong, Hong Kong, 2Tung Wah College, School of Medical and Health Sciences, Hong Kong, Hong Kong, 3The Chinese University of Hong Kong, Department of Orthopaedics and Traumatology, Hong Kong, Hong Kong, 4The Chinese University of Hong Kong, Department of Sports Science and Physical Education, Hong Kong, Hong Kong
Background: Adolescent idiopathic scoliosis (AIS) patients have lower physical activity level when compared with healthy controls, and are associated with lower bone mineral density (BMD), lower skeletal muscle mass, decreased in muscle strength and poorer quality of life (QoL). Cultivating exercise habits during early diagnosis of scoliosis may bring physical and psychological benefits to AIS patients and has potential to reduce physical and psychological sequalae such as curve progression leading to functional disabilities and morbidities in later life.
Purpose: We aimed to assess a 6-month home-based electronic exercise intervention named E-Fit on bone mineral density (BMD), muscle functions and quality of life (QoL) in AIS girls.
Methods: Forty AIS girls (11-14 years old) were randomly assigned in 1:1 ratio to E-Fit or control group. E-Fit group received a 7-minute of home exercises, 5 times per week for 6 months, with demonstration videos administered using an online platform. This short duration exercise intervention was designed for small home environment and comprised of a broad range of moderate-to-high impact weight-bearing exercises in order to load a variety of muscle groups and skeletal regions in upper and lower body. At baseline, 6-months and 12-months follow-up, BMD using Dual-energy X-ray Absorptiometry (DXA), muscle strength and endurance tests, physical activity level using Modified Baecke Questionnaire (MBQ), QoL using SRS-22r were investigated.
Results: A total of 30 subjects (14 in E-Fit and 16 in control group) completed the study. Both groups had similar maturity and baseline characteristics. At 6-months, E-Fit group showed better improvement and significant interaction effect as compared to control group in left femoral neck bone mineral content (BMC) (p=0.021) and isometric curl up test (p=0.04). Left arm lean muscle mass showed better improvement between 6-months and 12-months follow-up (p=0.046) and the whole-body areal BMD had marginally significant interaction effect at 12-months follow-up (p=0.077). Continuous improvement on participation of work and sport activities as measured by MBQ were noted in E-Fit group from baseline to 12-months follow-up. E-Fit group also showed marginally significant interaction effect in self-image domain (p=0.666) and total score (p=0.086) of SRS-22r between 6-monts and 12-months follow-up. On contrary, control group showed a decline in physical activity level and QoL measures across time.
Conclusion(s): Results showed benefits of E-Fit on improving some bone and muscle parameters including whole body areal BMD, left femoral neck bone BMC, left arm lean muscle mass and trunk muscle strength for AIS girls. E-Fit also seemed to improve self-image and encourage habitual physical activity among AIS girls. E-Fit was well received by AIS girls and appeared to be safe and feasible to perform at small homes. Further large-scale randomised controlled trial aiming to evaluate the therapeutic effects and optimal dosage of E-Fit is warranted.
Implications: The physical and psychological benefits brought by E-Fit indicated the potentials for using this intervention at early stage of scoliosis to promote regular exercise habits among relatively inactive AIS girls which in turn can improve musculoskeletal health, generate self-image, relieve stress and promote healthy lifestyle.
Funding, acknowledgements: This project was supported by Health and Medical Research Fund of Hong Kong SAR, China. (HMRF-funding no.: 14152371)
Keywords: adolescent idiopathic scoliosis, home-based exercise intervention, physical activity
Topic: Paediatrics
Did this work require ethics approval? Yes
Institution: The Joint Chinese University of Hong Kong New Territories East Cluster
Committee: Clinical Research Ethics Committee
Ethics number: 2016341
All authors, affiliations and abstracts have been published as submitted.
