Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis

This study investigates mild AIS to assess this ultrasound-assisted scoliosis-specific exercise clinical effects. Currently ultrasound and AI-assisted diagnose and treatment are used to advance mild AIS research. To begin, gather the ultrasound device, the coupling gel, the disposable mat, and the disposable gloves.

Inform the patient and their parents about the examination and training procedure. Explain that the treatment area will be exposed and that coupling gel will be applied between the ribs. Instruct the patient to observe the realtime ultrasound imaging on the screen.

Position the patient in a seated posture or in lateral decubitus with the concave side facing up. If in lateral decubitus, place a five to 10-centimeter pillow under the ribs at the level of the apical vertebra. Ensure both feet are flat or stacked.

Maintain spinal neutrality and expose the target intercostal area. Put on disposable gloves. Apply a small amount of ultrasound coupling gel evenly over the target intercostal space.

Press the power button and wait about 30 seconds for the self-check to finish and the main interface to appear. Enter the patient's name, sex, age, ID, and examination date into the system. For intercostal imaging, select MSK Superficial with the linear probe L10-5.

And for diaphragm imaging, select abdomen general with the convex probe C5-2. Using palpation and anatomical landmarks, identify the concave intercostal space corresponding to the apical vertebra along the mid-axillary line. Place the ultrasound probe over this area with the ultrasound plane perpendicular to the rib's long axis and visualize the intercostal muscles and rib dynamics.

Adjust the depth knob to two to four centimeters. Set the 2D gain knob to clearly visualize the rib interface and fascial line, and set the focus position to the intercostal muscle layer. At end expiration, press freeze, then measure and choose distance to measure the intercostal space width and muscle thickness in millimeters.

At end inspiration, repeat the measurement. Save two static images and label them expiration end and inspiration end. Now instruct the patient to perform slow, deep breaths while observing the expansion of the concave intercostal space on the ultrasound screen.

Ask the patient to actively control breathing by lifting the ribs to the maximal position, hold for five seconds, then exhale slowly through the mouth. Ensure that both treatment and control groups complete the same functional training procedures. For radiographic identification and Cobb angle measurement, instruct the patient to stand upright on an x-ray platform.

Acquire a standing Posterior-Anterior radiograph of the entire spine. Import the radiographic image into the PACS software for further analysis. Seat the subject upright on a stable examination chair or treatment bed with feet flat on the floor and arms relaxed at the sides.

Instruct the subject to maintain a natural, neutral posture without leaning forward or backward. Apply sufficient ultrasound coupling gel to the target intercostal space for optimal acoustic contact. Use a linear ultrasound probe with frequency set between 7 and 12 megahertz in musculoskeletal or high resolution mode, and place it longitudinally along the concave intercostal space at the mid-axillary line.

Adjust the probe angle until the adjacent ribs and intercostal muscle layer are clearly visualized. Instruct the subject to perform quiet breathing for orientation and capture images at end expiration and end inspiration. Use the caliper tool to measure the intercostal space width by measuring the distance between the inner margins of two adjacent ribs.

Record the measurements at end inspiration and end expiration to capture dynamic changes. Identify the intercostal muscle layer between the ribs. Place the calipers perpendicular to the muscle belly and measure the vertical distance between the inner and outer fascial layers.

Record the values at both end inspiration and end expiration. Calculate and record the average value. After the session, wipe off the gel with a disposable tissue and help the patient adjust their clothing.

Both the experimental and control groups were comparable in all parameters. After treatment, the Cobb angle of the major curve was significantly lower in the treatment group than in the control group. Tidal volume, inspiratory capacity, vital capacity, and maximal voluntary ventilation were significantly higher in the treatment group than in the control group.

Patient one showed little change in Cobb angle and intercostal space after treatment, whereas patient two showed marked improvement in both parameters. Our main experimental challenges involve achieving standardized data collection, maintaining consistent innovation delivery, and ensuring strong adolescent adherence. Our most significant finding is that ultrasound-assisted scoliosis exercise reduce mild curve progression and improve intercostal structure and diaphragmatic mobility.

Our results raise new questions about the long-term effects of ultrasound-assisted scoliosis exercise, and how to individualize training parameters.