The efficacy of combined physiotherapeutic scoliosis-specific exercises and manual therapy in adolescent idiopathic scoliosis

Abstract

Background: Adolescent idiopathic scoliosis (AIS) is a pathological condition characterized by vertebral curvature and associated trunk deformities in adolescents. The clinical efficacy of conservative treatment in alleviating spinal curvature of AIS remains a topic of ongoing debate. The objective of this study was to investigate the impact of combined physiotherapeutic scoliosis-specific exercises (PSSE) and manual therapy (MT) on trunk deformity, spinal function, mobility, and mental health in patients with AIS.

Methods: Thirty-one participants who were diagnosed with AIS whose Cobb angle was between 10-45°were enrolled in the study. Participants in the intervention group received 50 min of PSSE combined with 10 min of MT, while the control group performed 50 min of PSSE as their home exercise program. Both treatments were implemented three times a week for four weeks. Cobb angle, spinal mobility, trunk morphology (vertebral rotation angle, apical deviation, pelvic obliquity distance and angle), movement capability, and quality of life (QOL) were assessed at baseline and post intervention. The treatment effects between the intervention and control groups were analyzed using a two-way repeated measures ANOVA.

Results: Following a 4-week treatment period, Cobb angle was significantly reduced from 21.58° to 18.58° in intervention group and increased from 18.00° at baseline and 19.14° post intervention in the control group. Significant improvements were also observed in spinal mobility, movement capability, quality of life, and some of the trunk morphology indices in the intervention group compared to baseline (p < 0.05). Improvements were significantly higher in the intervention group than the control group.

Conclusion: Combining PSSE and MT shows potential benefits in alleviating AIS symptoms and improving QOL. Further studies to substantiate these findings are warranted.

Trial registration: The trial was retrospectively registered in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn ) with the registration number: ChiCTR2300071357, (Date: 12/05/2023).

Keywords: Exercise therapy; Manual therapy; Scoliosis; Surface topography.

Fig. 1

a-f Illustrations of the positions for muscle strengthening exercises that primarily target core stabilization. g, h Standing with both shoulders abducted and externally rotated. i, j Intensive corrective exercises by curve stretching action movements; (k) breathing training (including lying and sitting)