A Non-surgical Multimodal Approach to Adolescent Idiopathic Scoliosis (Lenke 5C) Using an Intensive Two-Week CLEAR Institute Protocol: A Report of Two Cases

Adolescent idiopathic scoliosis (AIS) is a progressive three-dimensional spinal deformity often managed with physiotherapeutic scoliosis-specific exercises (PSSE), bracing, or spinal fusion. Emerging evidence suggests that multimodal, high-frequency non-surgical rehabilitation may produce measurable improvements in spinal alignment through combined biomechanical loading and neuromuscular re-education. This case series evaluates radiographic and functional outcomes in two AIS subjects (Lenke 5C) undergoing a two-week intensive CLEAR protocol followed by ScoliBrace® implementation. Two female adolescents, with a mean age of 12 years, presented with rapid curve progression and no prior exposure to bracing or scoliosis-specific therapy. Both completed a two-week, 20-session intensive CLEAR program incorporating mechanical traction, Mirror Image® positioning, proprioceptive neuromuscular training, whole-body vibration, and corrective exercise. ScoliBrace® fitting occurred during week two. Radiographs were obtained at baseline, immediately post-intensive care, and at 6- and 12-month follow-up. Functional outcomes included the Functional Rating Index (FRI), height, chest expansion, angle of trunk rotation, Stork balance testing, and Modified Cox measurements. Case 1 demonstrated a lumbar Cobb angle reduction from 35.7° pre-intensive to 21.7° post-intensive and 10.4° at 12 months (71% total reduction). Case 2 demonstrated a reduction from 38.9° to 24.7° post-intensive and 15.7° at 12 months (60% total reduction). Both exhibited corresponding improvements in functional metrics. A short-duration, high-frequency multimodal rehabilitation program combined with custom bracing may produce rapid and sustained radiographic improvements in AIS. These outcomes warrant further investigation through larger prospective studies.