The effect of physiotherapeutic scoliosis specific exercises on adolescent idiopathic scoliosis: a meta analysis

English Keywords:Adolescent idiopathic scoliosis  Physical therapy  Exercise intervention  Schroth method  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To evaluate with meta-analysis the clinical effects of physiotherapeutic scoliosis specific exercises(PSSE) comparing with other conservative treatments in treating adolescent idiopathic scoliosis(AIS). Methods: PubMed, Web of Science, The Cochrane Library, WanFang Data and China National Knowledge Infrastructure(CNKI) were searched by computer from their establishments to July 2023. The randomized controlled trials(RCTs) of PSSE therapy(PSSE therapy group) and other conservative treatments(control group) in treating AIS were collected. Two researchers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta analysis was performed using RevMan 5.4 software on the Cobb angle, angle of trunk rotation(ATR), and quality of life score of Scoliosis Research Society-22(SRS-22) scale reported in the included literature, and subgroup analysis was carried on according to Cobb angle and treatment duration. Results: A total of 14 studies were included, consisting of 16 RCTs(2 studies included 2 RCTs each), involving 944 AIS patients. The quality of the literature was of medium and high. Meta analysis results showed that, comparing with the control group, the PSSE therapy group was superior in reducing Cobb angle of AIS patients(MD=1.64; 95%CI: 2.78, 0.50; P<0.05) and ATR(MD=1.45; 95%CI: -2.58, -0.32; P<0.05), and improving the SRS-22 quality of life score(MD=0.25; 95%CI: 0.17, 0.33; P<0.05). The results of subgroup analysis showed that for the AIS patients with duration of treatment≤6 months(MD=-2.88; 95%CI: -3.85, -1.91; P<0.05) and a Cobb angle< 25° at enrollment(MD=-2.41; 95%CI: -3.51, -1.30; P<0.05), the PSSE therapy group had a better effect with a smaller Cobb angle(P<0.05) than the control group. In terms of ATR improvement, for the patients with treatment duration≤6 months(MD=2.63; 95%CI: 3.30, 1.96; P<0.05), the PSSE therapy group had a lower ATR degree comparing with the control group(P<0.05). Conclusions: Comparing with other conservative treatments, PSSE therapy has advantages in improving the Cobb angle, reducing ATR and improving the quality of life in AIS patients, especially for mild scoliosis patients with Cobb angle< 25°. PSSE therapy has a better therapeutic effect on reducing the Cobb angle and ATR more obviously in AIS patients with duration of treatment≤6 months.