Physiotherapeutic Scoliosis-Specific Exercise for the treatment of adolescent idiopathic scoliosis: A systematic review and network meta-analysis

Huanrun Dong; Mengjia You; Yaning Li; Bingjie Wang; Hailiang Huang

doi:10.1097/PHM.0000000000002524

Physiotherapeutic Scoliosis-Specific Exercise for the treatment of adolescent idiopathic scoliosis: A systematic review and network meta-analysis

Am J Phys Med Rehabil. 2024 May 10. doi: 10.1097/PHM.0000000000002524. Online ahead of print.

Authors

Huanrun Dong¹, Mengjia You², Yaning Li¹, Bingjie Wang¹, Hailiang Huang¹

Affiliations

¹ College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China.
² School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China.

PMID: 38726971
DOI: 10.1097/PHM.0000000000002524

Abstract

Objective: To compare the rehabilitative efficacy of different physiotherapy scoliosis-specific exercises (PSSE) for adolescent idiopathic scoliosis (AIS) using a network meta-analysis.

Design: PubMed, Cochrane Library, Web of Science, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan Fang Data were searched until October 2023. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and R4.3.1. This study follows the PRISMA statement and was registered on the PROSPERO platform (No. CRD42022379206).

Results: Seventeen RCTs involving 857 patients were included. The meta-analysis showed that PSSE therapy improved Cobb's angle than conventional rehabilitation therapy (standardized mean difference [SMD] = -0.7; 95% confidence interval [CI] = -0.95, -0.44; p = 0.001), angle of trunk rotation (ATR; SMD = -1.05; 95% CI = -1.52, -0.58; p < 0.001), and quality of life (QoL; SMD = 0.61; 95% CI = 0.16, 1.07; p < 0.001). Network meta-analysis showed that Schroth + Scientific Exercise Approach to Scoliosis (SEAS) was the most effective in improving Cobb angle and ATR, while Schroth alone was most effective in improving the QoL.

Conclusion: The combination of Schroth and SEAS improved the body posture and trunk deformity in patients with AIS, while Schroth alone improved the QoL. The effectiveness of combining different PSSE techniques supports future evidence-based research on AIS treatment.