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Comparative Study
. 2024 Dec 26;25(1):1070.
doi: 10.1186/s12891-024-08223-1.

Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis

Zhenghui Wang  1 , Wenpan Zhu  2 , Guang Li  1 , Xuejun Guo  1
Affiliations
Comparative Study

Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis

Zhenghui Wang et al. BMC Musculoskelet Disord. .

Abstract

Background: Adolescent idiopathic scoliosis (AIS) stands as the predominant spinal deformity in adolescents, manifesting symptoms including back pain, functional limitations, cosmetic worries, and respiratory dysfunction. At present, six approaches of scoliosis-specific exercises are globally practiced, encompassing Schroth exercise, the Scientific Exercise Approach to Scoliosis (SEAS), the Dobomed, the side shift exercise, active self-correction, and the Functional Individual Therapy of Scoliosis (FITS). However, there is no systematic review and meta-analysis comparing the efficacy of these six types of scoliosis-specific exercises on adolescent idiopathic scoliosis.

Objective: To evaluate and compare the efficacy of six types of scoliosis-specific exercises on spinal deformity and quality of life in AIS.

Materials and methods: A systematic search was performed on PubMed, EMBASE, and the Cochrane Library from their inception to September 2023. Two independent auditors screened all studies according to predefined inclusion and exclusion criteria. Clinical trials were compiled to investigate the effects of six exercise interventions on spinal deformity and quality of life in AIS.

Results: Twenty-four studies were included, with a sample size of 1069 subjects. After meta-analysis, it was shown that SEAS ranked first in reducing Cobb angles (SUCRA: 84.8%); active self-correction and Schroth significantly improved the angles of trunk rotation in AIS (SUCRA: 86.6% and SUCRA: 79.1%, respectively); active self-correction and Schroth showed significant improvements in quality of life (SUCRA: 76.6% and SUCRA: 76.0%, respectively).

Conclusion: According to the current findings, active self-correction demonstrated superior short-term benefits compared to other exercise interventions in ameliorating spinal deformity and improving quality of life for adolescents with idiopathic scoliosis. Meanwhile, Schroth exhibited long-term effects in improving both spinal deformity and quality of life.

Registration information: This review was registered on PROSPERO on June 20, 2023 (ID: CRD42023433152).

Keywords: Exercise; Meta-analysis; Scoliosis; Systematic review.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This is a systematic review. The First Affiliated Hospital of Xinxiang Medical University Research Ethics Committee has confirmed that no ethical approval is required. Informed consent was obtained from all individual participants included in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of literature selection. The flow of the search and selection process in this systematic review and meta-analysis of scoliosis-specific exercises
Fig. 2
Fig. 2
(A) Network meta-analysis map of intervention comparison for Cobb angle. Circle sizes represent the number of studies. Line widths indicate the number of direct comparisons. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis, FITS: Functional Individual Therapy of Scoliosis, PNF: Proprioceptive Neuromuscular Facilitation. (B) Surface under the cumulative ranking curve plot for Cobb angle. The larger the surface, the larger the SUCRA, the better the efficacy of the intervention. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis, FITS: Functional Individual Therapy of Scoliosis, PNF: Proprioceptive Neuromuscular Facilitation
Fig. 3
Fig. 3
(A) Network meta-analysis map of intervention comparison for angle of trunk rotation. Circle sizes represent the number of studies. Line widths indicate the number of direct comparisons. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis, PNF: Proprioceptive Neuromuscular Facilitation. (B) Surface under the cumulative ranking curve plot for angle of trunk rotation. The larger the surface, the larger the SUCRA, the better the efficacy of the intervention. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis, PNF: Proprioceptive Neuromuscular Facilitation
Fig. 4
Fig. 4
(A) Network meta-analysis map of intervention comparison for quality of life score. Circle sizes represent the number of studies. Line widths indicate the number of direct comparisons. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis. (B) Surface under the cumulative ranking curve plot for quality of life score. The larger the surface, the larger the SUCRA, the better the efficacy of the intervention. CON: control group with routine care (no exercise), SEAS: the Scientific Exercise Approach to Scoliosis
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