Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 10;9(2):120-129.
doi: 10.22603/ssrr.2024-0191. eCollection 2025 Mar 27.

Effects of Physiotherapeutic Scoliosis-Specific Exercise for Adolescent Idiopathic Scoliosis Cobb Angle: A Systematic Review

Hiroki Oba  1   2 , Kei Watanabe  1   3 , Tomoyuki Asada  1   4 , Akira Matsumura  1   5 , Ryo Sugawara  1   6 , Shinji Takahashi  1   7 , Haruki Ueda  1   8 , Satoshi Suzuki  1   9 , Toru Doi  1   10 , Takumi Takeuchi  1   11 , Hideyuki Arima  1   12 , Yu Yamato  1   12 , Satoru Demura  1   13 , Naobumi Hosogane  1   11
Affiliations
Review

Effects of Physiotherapeutic Scoliosis-Specific Exercise for Adolescent Idiopathic Scoliosis Cobb Angle: A Systematic Review

Hiroki Oba et al. Spine Surg Relat Res. .

Abstract

Background: The study of physiotherapeutic scoliosis-specific exercise (PSSE) for adolescent idiopathic scoliosis (AIS) is rapidly progressing. However, there are limited reports on the medium- to long-term effects of PSSE on scoliosis.

Methods: A systematic review and meta-analysis feasibility study were conducted according to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In our exhaustive search, we employed nine search formulas and four search databases according to a preregistered protocol. Identification, screening, eligibility, inclusion, and meta-analysis were performed through repeated meetings involving all coauthors. Each process was conducted by three or more authors.

Results: A total of 1,518 studies were identified in the initial search. After manually reviewing abstracts and full texts, 11 studies were chosen for evaluation and reporting. The overall risk-of-bias was high in approximately half of the studies and moderate in the other half, with none found to have a low risk-of-bias. Only two randomized controlled trials (RCTs) specifically evaluated the therapeutic effect of PSSE on over a 1-year clinical course and the preventive ability of PSSE on surgery. One RCT reported that Cobb angle was substantially smaller in the PSSE group than in the control group at the final follow up, whereas the other found no significant difference between the groups. The methods of exercise intervention, control group selection, and timing of outcome assessments were not standardized in the selected studies. Thus, conducting a meta-analysis of the literature was deemed unfeasible at this time.

Conclusions: The certainty of the evidence that PSSE reduces the progression of Cobb angle in patients with AIS in the short and long term was extremely low. Accordingly, healthcare providers should carefully examine the current evidence when explaining and applying PSSE in such patients. High-quality studies addressing the long-term changes in Cobb angle and Cobb angle at bone maturity as primary outcomes are warranted.

Level of evidence: Level 1.

Keywords: Cobb angle; Schroth; Scientific exercises approach to scoliosis; adolescent idiopathic scoliosis; angle of trunk rotation; physiotherapeutic scoliosis-specific exercise; quality of life.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The corresponding author belongs to an endowed chair (Surgical Spine Co., Ltd. NuVasive Japan Co., Ltd).

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of the review process. Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PSSE, physiotherapeutic scoliosis-specific exercise; RCT, randomized control trial
Figure 2.
Figure 2.
Summary of the risk-of-bias and time period for each study in terms of Cobb angle. Abbreviations: W, week; Y, year
Figure 3.
Figure 3.
Summary of the risk-of-bias and time period for each study in terms of ATR. Abbreviations: ATR, angle of trunk rotation; W, week; Y, year
Figure 4.
Figure 4.
Summary of the risk-of-bias and time period for each study in terms of SRS-22r score. Abbreviations: SRS, Scoliosis Research Society; W, week; Y, year
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Menger RP, Sin AH. Adolescent Idiopathic Scoliosis [Internet]. Treasure Island (FL): StatPearls; 2024 Jan - [cited 2023 Apr 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499908/
    1. Fruergaard S, Ohrt-Nissen S, Dahl B, et al. Neural axis abnormalities in patients with adolescent idiopathic scoliosis: is routine magnetic resonance imaging indicated irrespective of curve severity? Neurospine. 2019;16(2):339-46. - PMC - PubMed
    1. Choudhry MN, Ahmad Z, Verma R. Adolescent idiopathic scoliosis. Open Orthop J. 2016;10:143-54. - PMC - PubMed
    1. Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet. 2008;371(9623):1527-37. - PubMed
    1. Peng Y, Wang SR, Qiu GX, et al. Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis. Chin Med J. 2020;133(4):483-93. - PMC - PubMed

LinkOut - more resources