Implementation of Specific Tailored Exercises Program Versus Exergaming Exercises on Cobb Angle in the Treatment of Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis is a structural spinal disorder that occurs during puberty and lacks a definitive etiology. The spinal deviation of the thoracic region occurs more frequently in adolescent and typical manifestations may include noticeable spinal deformities, impair posture and restrict body movement . Existing studies on scoliosis-specific exercises like Schroth, lyon and side shifts approaches have shown positive outcomes in reducing curvature progression and enhancing postural stability. Also, the exergaming exercises enhance postural deformity by providing real-time body movement of postural correction exercises through games.However, research on the tailored program for AIS is limited, leading to uncertainties about it's their clearance effect. Recent literature underscores the need for standardized protocols.The current study aims to assess the evidence of the specific tailored program based on differential approaches of the scoliosis specific exercises as (schroth, lyon and side shifts) methods. Also, asses the evidence of the specific customized tailored exergaming exercises, to identifying their impact on cobb's angle, angle of trunk rotation, pulmonary function and quality of life.

• Specific Tailored Exercises Program (Other): the patients will receive a specific tailored exercise program in the form of corrective exercises, positioning, mirror therapy, ADL adaptation, and instructions in addition to traditional physical therapy treatment.
• Exergaming Exercises (Other): Every participant in group B will be received an exergaming exercises in form of a series of Kinect training game, sports island freedom game . dance evolution game and Kinect sports games designed for Xbox 360 Kinect console. The games will be projected onto a 24-Inch screen monitor. Each session consisted of playing 1-2 trials in a row of each game for 45-60 minutes in addition to traditional physical therapy
• traditional physical therapy (Other): the patients will receive traditional treatment only of the intervention in the form of stretching, strengthening, core stabilization and breathing exercises

Primary outcomes

• Cobb's angle [up to three months]: cobbs angle will be measured by x-ray. This method quantifies the lateral spinal curvature measured on a radiograph in the coronal plane, using anterior-posterior (AP) or posterior-anterior (PA) radiographs.A Cobb angle in the range of 10 to 20 degrees is considered as mild scoliosis. Scoliosis severity is moderate when the Cobb angle ranges from 20 to 40 degrees.
• the angle of trunk rotation [up to three months]: Scoliometer mobile applications is a valid and reliable method used to assess the angle of trunk rotation. It is a portable, accessible and easy tracking and follow up. Visual interface and digital readout. Save and track angle trunk rotation values over time
• flow rate of inhalation [up to three months]: The flow rate of inhalation in respiratory physiology refers to the rate at which air moves into the lungs during inspiration, i.e., The volume of air that enters the lungs per unit of time during inspiration. (e.g., mL/sec ). In a flow-based incentive spirometer, this flow rate is indicated by rising elements (e.g., balls) in the device that reflect how quickly air is drawn in during inspiration. For proper medication delivery from a Dry Powder Inhaler (DPI), a flow rate of inhalation of greater than 60 L/min is generally considered optimal.

Secondary outcomes

• life disability [up to three months]: It will be measured by the Arabic version of the Scoliosis Research Society -22 Questionnaire (SRS-22). The scale consists of 22 questions and 5 subdimensions, namely, pain, self-image, spinal functions, mental health, and treatment satisfaction. All of these sections are evaluated separately or by summing all questions under a total result score. Scores were calculated by assigning a value between 1 and 5 for each question. Accordingly, the lowest total score of the survey was 1, and the highest total score was 5, with higher scores indicating better QoL.

Sex: All, ages: 10 Years to 18 Years

Inclusion Criteria:

* Thoracic spine region with C-shaped scoliosis
* Individuals aged 10-18 years
* Cobb's angle from 10 to 25 degrees
* Both genders (male and female)
* Adolescent idiopathic scoliosis

Exclusion Criteria:

* Mental health disorders
* Neuromuscular or rheumatic diseases
* A history of spinal surgery
* Patients been prescribed brace treatment
* Leg length discrepancy