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CompletedNCT07319702Updated Aug 19, 2026

Proprioceptive Neuromuscular Facilitation Combined With Spiral Muscle Chain Training for Adolescent Spinal Curvature Abnormalities

An interventional study of Proprioceptive Neuromuscular Facilitation (PNF) Therapy and Spiral Muscle Chain (SPS) Training in Adolescent Idiopathic Scoliosis (AIS), Spinal Curvature Abnormalities and Kyphosis, sponsored by Nie danning. Completed at 1 site in China. Open to participants aged 13 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Nie danning · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
189
Allocation
Randomized
Ages
13 Years to 18 Years
Sex
All
01

Study 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.

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.

02

Conditions studied

  • Adolescent Idiopathic Scoliosis (AIS)
  • Spinal Curvature Abnormalities
  • Kyphosis
  • Flat Back

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Keywords

  • Adolescent Idiopathic Scoliosis
  • Proprioceptive Neuromuscular Facilitation
  • Spiral Muscle Chain Training
  • Exercise Therapy
  • Rehabilitation
  • Spinal Curvature Abnormalities
03

Who can participate

Ages eligible
13 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 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

Exclusion criteria

Exclusion Criteria:

  • 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
  • Respiratory dysfunction
  • Any contraindication to exercise
  • Any trauma within the previous 6 months
  • Any accompanying neurological, rheumatological, or mental health problems
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
189 participants (actual)

Study arms

  • Experimental
    Proprioceptive Neuromuscular Facilitation (PNF) Therapy

    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).

    Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) Therapy

  • Experimental
    Spiral Muscle Chain (SPS) Training

    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.

    Behavioral: Spiral Muscle Chain (SPS) Training

  • Experimental
    Combined Exercise Therapy

    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.

    Behavioral: Combined Exercise Therapy

Interventions

  • BehavioralProprioceptive Neuromuscular Facilitation (PNF) Therapy

    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.

    Also known as: Proprioceptive Neuromuscular Facilitation

  • BehavioralSpiral Muscle Chain (SPS) 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.

    Also known as: Spiral Stabilization Training

  • BehavioralCombined Exercise Therapy

    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.

05

What researchers measure

Primary outcomes

  1. 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.

    Time frame: Baseline and after 12 weeks of intervention

  2. Change in Kyphotic Angle (KA)

    Kyphotic angle will be measured using an electronic spinal assessment device to evaluate changes in sagittal spinal curvature.

    Time frame: Baseline and after 12 weeks of intervention

  3. Change in Body Balance Parameters

    Body balance parameters assessed by electronic spine measurement, including head lateral deviation, shoulder asymmetry, and pelvic tilt.

    Time frame: Baseline and after 12 weeks of intervention

Secondary outcomes

  1. 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.

    Time frame: Baseline and after 12 weeks of intervention

  2. 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.

    Time frame: Baseline and after 12 weeks of intervention

  3. Change in Spinal Mobility

    Spinal mobility assessed by electronic spine measurement, including lateral flexion, flexion-extension, and rotational range of motion.

    Time frame: Baseline and after 12 weeks of intervention

06

Study locations

1 site
  • The Affiliated High School of Nanjing Normal University
    Nanjing, Jiangsu 210023, China
07

References and documents

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 41263915 ↗
  • Nechvatal 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 34657873 ↗
  • Maruyama 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 documents

  • Study protocol · Mar 1, 2024
  • Informed consent form · Mar 1, 2024

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: 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.

08

Registry details

Key details

Study ID
NCT07319702
Lead sponsor
Nie danning
Responsible party
Nie danning (PhD Candidate, Nanjing Normal University) — Sponsor-investigator
First posted
Jan 6, 2026
Start date
Mar 5, 2024
Primary completion
Dec 30, 2024
Completion
Dec 30, 2024
Last update
Aug 19, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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