Physiotherapy Interventions for Preventing Spinal Curve Progression in Adolescent Idiopathic Scoliosis: A Systematic Review

Abstract

Adolescent idiopathic scoliosis (AIS) is an abnormal curvature of the spine that appears in late childhood or adolescence. The aim of this systematic review was to present and synthesize the most relevant therapeutic advice and evidence on the efficacy of physiotherapy exercises for preventing the growth of spinal curvature caused by adolescent idiopathic scoliosis. "Adolescent idiopathic scoliosis," "exercise," "Cobb angle," and "physiotherapy" were the sole keywords used for the published research. Using these keywords and a combination of them, electronic resources such as PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Elton B. Stephens Company (EBSCO) host, and ScienceDirect (Elsevier) were searched. The search was restricted to studies that were conducted in English between 2010 and 15 January 2022 that were controlled, randomized, and non-randomized. Studies were selected based on their titles and abstracts, with the exception of any that did not pertain to the study's goals. The Cobb angle was the important outcome measure. For each intervention, the Cobb angle's mean change score, the difference between the final and baseline scores, was determined. Nine studies were evaluated to be of outstanding quality out of a total of 20 studies that were reviewed for eligibility. With an exercise regimen of at least seven weeks, controls on lowering the Cobb angle in patients with AIS would provide encouraging outcomes. It also shows that bracing can strengthen the Cobb angle compared to exercise in the community. However, long-term orthotic activity ultimately results in trunk resistance and muscle loss in the center of the back. The combination of techniques and treatment methods seems to have better results in treating scoliosis, particularly using exercises involving the Schroth and scientific exercise approach to scoliosis (SEAS).

Prototype of Health Education to Improve the Quality of Life of Students with Scoliosis

“…Exercises for mild scoliosis are the first line of treatment that significantly impacts strength, spinal mobility, balance, and pain for people with scoliosis. 27 In this study, there are several research limitations. First, the number of samples was small.…”

Spinal Orthosis in Adolescent Idiopathic Scoliosis: An Overview of the Braces Provided by the National Health Service in Italy

“…The efficacy of bracing increases with more time spent in the brace, so compliance is the key to treatment for both patients and parents [13,80,81]. It is also suggested to combine the brace with specific physiotherapy exercises for scoliosis (PSE) according to the SOSORT guidelines [24,82,83].The articles in the available scientific literature about the number of hours/day of bracing showed that the more hours per day the brace is worn, the better the result [30,83]. For this reason, braces are usually prescribed for at least 18 h/day, and they are usually removed for showers, swimming, physical education, and sports [84].…”

Effectiveness of orthotic treatment for adolescent idiopathic scoliosis: a scoping review protocol of systematic reviews

“…25 Recent comprehensive systematic reviews also examined compliance of orthotic treatment, 26 predictive factors of orthotic treatment outcomes [27][28][29] and comparison between orthotic treatments and other treatments, including physiotherapy, exercise intervention and surgical treatment. [30][31][32][33][34][35][36] Our initial and informal review of systematic reviews of studies that have investigated orthotic treatment in AIS revealed some overlap across studies; however, the standalone studies and the systematic reviews of those studies may not yield overarching essential insights into the use, mechanisms, effectiveness and long-term outcomes of orthotic treatment in AIS. Moreover, they may not yield new and important information.…”

“…However, most of those systematic reviews focused on different orthotic designs and the effectiveness of orthotic treatment,16–24 and only one systematic review evaluated the effectiveness of different bracing concepts in AIS 25. Recent comprehensive systematic reviews also examined compliance of orthotic treatment,26 predictive factors of orthotic treatment outcomes27–29 and comparison between orthotic treatments and other treatments, including physiotherapy, exercise intervention and surgical treatment 30–36…”