Digitally Assisted Training System for Home-Based Scoliosis Therapy: Proof-of-Concept and Technical Verification Study

Schroth therapy is one of the conservative methods used to treat scoliosis. It includes not only therapeutic exercises in physiotherapy facilities but also concepts for independent training at home. Consistent and correct performance of this training has a major impact on the success of the therapy. However, without guidance and supervision by a therapist, patient motivation may decline. In addition, incorrect training techniques may be used, which can have a negative impact on the success of the therapy.

This study aimed to develop a digitally assisted training system for home-based scoliosis therapy and to verify it technically on a laboratory scale.

On the basis of training devices used in Schroth therapy, such as mirrors, balance boards, wall bars, and exercise sticks, we developed a concept for a modular, digitally assisted scoliosis training system (iScoolio). The development process included a requirements specification, iterative design drafts, and the transfer of the concepts into a functional demonstrator. Finally, a theoretical evaluation of the use cases and a technical verification of the measurement functions were carried out using specifically developed test scenarios.

A demonstrator with tracking, training, and modification functions was developed, consisting of 4 modules. Technical verification of the integrated measurement functions showed that the angle measurement in motion tracking (n=50) had a mean deviation of 2.29° (SD 1.66°) compared to the ARAMIS 3D optical reference system. Respiration tracking enabled the detection of all simulated respiratory cycles (n=40) and the significant distinction between shallow and deep breathing (t₃₉=-27.4; P<.001). The investigation of the 2 force sensor concepts in the handles (χ²₂=80.0; P<.001) and supporting feet (χ²₂=50.0; P<.001) showed a significant differentiation between 3 force levels, but approximately linear drift behavior in each case. When tracking the stance width (n=50), the mean value was 15.4 (SD 0.54) cm. Verification of the center of pressure measurement function (n=50) showed that 48% of the measurements had a deviation of ≤10 mm, and 82% of the measurements had a deviation of ≤20 mm.

In this paper, we have presented the iScoolio concept, which has the potential to support home-based scoliosis therapy through adaptable devices and tracking elements. Integrated sensors enable monitoring of movements, breathing, forces, and pressure distribution during training. An associated web application visualizes the recorded data and serves as a guide for performing the exercises. Technical verification indicates that the integrated tracking methods are functional; however, there is still room for optimization in terms of hardware and software. Further validation is required before conducting clinical trials under real-world conditions.