The aim of this systematic review was to evaluate the effectiveness of scoliosis-specific exercises compared with other non-surgical interventions for adolescent with idiopathic scoliosis. Studies were eligible if they were randomised controlled trials evaluating scoliosis-specific exercises in participants with idiopathic scoliosis (defined as a primary Cobb angle of at least 10 degrees) and aged between 10 years and skeletal maturity. Scoliosis-specific exercises were defined ‘specific movements performed with a therapeutic aim of reducing the deformity.’ Comparators were non-surgical interventions, including bracing, electrical stimulation, manual therapy, generalised exercise, sports, active recreational activities, advice or waiting list. Primary outcomes were Cobb angle (in degrees) and angle of trunk rotation.
The review identified 9 studies (480 participants) that were conducted in Egypt, Brazil, Italy, Turkey, Korea, China, and Canada. There was variability in terms of the exercise parameters prescribed across studies. Treatment duration ranged from 3 weeks to 42 months.
Compared to general exercise or standard care, there was very low quality evidence that scoliosis-specific exercises reduced the thoracic Cobb angle (3 studies, 125 participants, mean difference -7 degrees,95% confidence interval (CI) -9 to -5), lumbar Cobb angle (2 studies, 105 participants, mean difference -7 degrees, 95% CI -10 to -4), and main curve location (3 studies, 172 participants, mean difference -5 degrees, 95% CI -9 to -1). Compared to general exercises or standard care, there was very low quality evidence that scoliosis-specific exercises did not reduce the angle of trunk rotation (1 study, 25 participants, mean difference -1 degrees,95% CI -3 to 5).
Very low quality evidence supports the use of scoliosis-specific exercise rather than standard care or other types of exercise for patients with adolescent idiopathic scoliosis to reduce spinal curvature. Large-scale and rigorous randomised controlled trials are required to evaluate the effectiveness and cost-effectiveness of scoliosis-specific exercise.
Thompson JY, et al. Effectiveness of scoliosis-specific exercises for adolescent idiopathic scoliosis compared with other non-surgical interventions: a systematic review and meta-analysis. Physiotherapy;105(2):214-34