Effects of Exercise on Spinal Deformities and Quality of Life in Patients with Adolescent Idiopathic Scoliosis

Abstract

Objectives. This systematic review was conducted to examine the effects of exercise on spinal deformities and quality of life in patients with adolescent idiopathic scoliosis (AIS). Data Sources. Electronic databases, including PubMed, CINAHL, Embase, Scopus, Cochrane Register of Controlled Trials, PEDro, and Web of Science, were searched for research articles published from the earliest available dates up to May 31, 2015, using the key words “exercise,” “postural correction,” “posture,” “postural curve,” “Cobb's angle,” “quality of life,” and “spinal deformities,” combined with the Medical Subject Heading “scoliosis.” Study Selection. This systematic review was restricted to randomized and nonrandomized controlled trials on AIS published in English language. The quality of selected studies was assessed by the PEDro scale, the Cochrane Collaboration's tool, and the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE). Data Extraction. Descriptive data were collected from each study. The outcome measures of interest were Cobb angle, trunk rotation, thoracic kyphosis, lumbar kyphosis, vertebral rotation, and quality of life. Data Synthesis. A total of 30 studies were assessed for eligibility. Six of the 9 selected studies reached high methodological quality on the PEDro scale. Meta-analysis revealed moderate-quality evidence that exercise interventions reduce the Cobb angle, angle of trunk rotation, thoracic kyphosis, and lumbar lordosis and low-quality evidence that exercise interventions reduce average lateral deviation. Meta-analysis revealed moderate-quality evidence that exercise interventions improve the quality of life. Conclusions. A supervised exercise program was superior to controls in reducing spinal deformities and improving the quality of life in patients with AIS.

Observational retrospective study on socio-economic and quality of life outcomes in 41 patients with adolescent idiopathic scoliosis 5 years after bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE)

“…In contrast to the compared studies [19,20,25,26], where FTRB was the only treatment, in our study population continuous PSSE, supervised at regular intervals, was standard of care, as in a short-term follow-up study [27] (satisfaction with treatment MS 3.9). In addition to the positive impact of PSSE on the effectiveness of the treatment described elsewhere [8][9][10], PSSE might also lead to higher satisfaction with the treatment [8]. On the whole, CTIS for AIS seems not to decrease quality of life, as Simony et al [26] found similar hrQoL outcomes between patients with AIS and the general population, a meta-analysis of 7 included studies even found higher hrQoL outcomes in treated vs untreated patients with AIS [28], and Schwieger et al reported that the amount of brace wear did not negatively affect QoL [29].…”

“…The effectiveness of brace treatment to prevent curve progression has been validated in several studies [4][5][6][7]; moreover, a combination of bracing with PSSE has been shown to decrease spinal deformities and improve quality of life in comparison with bracing alone [1,[7][8][9][10], but adolescents may be disinclined to comply with this enduring therapy. We aimed to examine patients' socio-economic factors and quality of life after fulfilling years of brace treatment combined with PSSE.…”

Adolescent Idiopathic Scoliosis: A Minireview

“…The forces of the brace permit to de-rotate the pelvis and the shoulders and to bring the body into normal alignment [5]. Physical therapy has not been show to improve the scoliotic curve, whereas brace has been proven to improve the curve [1]. Scoliotic curves below 20 degrees require observation, curves between 20 and 25 degrees require the use of a brace and observation, curves between 26 and 45 degree require basically the use of brace.…”

“…Curve progress in two-thirds of patients with idiopathic scoliosis before skeletal maturity. Risk factors of curve progression are female gender, time of menarche, age of 10-12 years, thoracic curves, multiple curves, skeletal immaturity and a large curve magnitude [1]. Females have a risk of progression 10 times higher than males.…”

Brace Treatment for Children and Adolescents with Scoliosis

“…It is well established in literature that pattern-based or pattern-specific exercises do have a positive impact on the course of the disease [5,6,[25][26][27]. Obviously, general exercises or sport activities also reduce the incidence of progression in small curvatures [28] or in patients with a low risk for progression [29].…”