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. 2025 May 16:17:137661.
doi: 10.52965/001c.137661. eCollection 2025.

The effects of exercise on patients with moderate adolescent idiopathic scoliosis : a systematic review and meta-analysis

Peng Zhao  1 , Meng Li  2 , Yuwei He  2 , Jialin Wang  2 , Ruirui Wang  2
Affiliations

The effects of exercise on patients with moderate adolescent idiopathic scoliosis : a systematic review and meta-analysis

Peng Zhao et al. Orthop Rev (Pavia). .

Abstract

Purpose: The effectiveness of exercise therapy for moderate adolescent idiopathic scoliosis and its potential benefits when combined with other treatments require further investigation. This systematic review and meta-analysis evaluated the efficacy of exercise therapy as a conservative management strategy for AIS.

Methods: Following PRISMA guidelines, we searched PubMed, Cochrane Library, Embase, and Web of Science up to June 4, 2024, for RCTs. Eligible studies included AIS patients (10-18 years, Cobb angle 20°-45°) undergoing various exercise therapies, such as scoliosis-specific exercises and core stabilization training. Primary outcomes included Cobb angle, ATR, trunk appearance, QoL, and respiratory function. Data extraction and risk-of-bias assessment followed Cochrane guidelines, and study quality was evaluated using the 11-item PEDro scale. Meta-analyses were conducted based on standardized mean differences.

Results: Eight RCTs with nine intervention groups were analyzed. At six months, exercise alone showed no significant advantage over bracing in improving Cobb angle, ATR, QoL, or trunk appearance (p < 0.05). However, exercise combined with other therapies significantly improved Cobb angle (MD = -6.11, 95% CI: -9.21 to -3.02), QoL (SMD = 0.89, 95% CI: 0.27 to 1.51), and lung function (SMD = 0.46, 95% CI: 0.13 to 0.80) at three months. These effects persisted for Cobb angle at six months (MD = -4.87, 95% CI: -8.77 to -0.98).

Conclusions: Low to moderate evidence suggests exercise alone is comparable to bracing for AIS, while exercise combined with other therapies offers short-term benefits for Cobb angle, QoL, and lung function.

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

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Conflict of interest statement

The authors of this article have no financial affiliations (including research funding) or involvement with any commercial organization to disclose.

Figures

Figure 1.
Figure 1.. PRISMA flow diagram of article inclusion.
244 studies were extracted by searching the database; citations tracked 15 studies. Finally, 8 articles were included in the study. The flow chart shows the number of studies excluded and the reasons for exclusion.
Figure 2.
Figure 2.. The Cochrane risk-of-bias tool results.
The overall risk assessment of bias showed a high risk of bias in all included studies because each study with at least one item was at high risk of bias.
Figure 3.
Figure 3.. Exercise: Brace (6 months).
Forest plot of Cobb angle; b) forest plot of ATR; c) forest plot of QoL; d) forest plot of trunk appearance
Figure 4.
Figure 4.. Exercise+Others：Others (1-3months).

  1. forest plot of Cobb angle; b) forest plot of QoL; c) forest plot of lung function.; d) forest plot of Trunk Rotation Angle; e) forest plot of trunk appearance.

Figure 5.
Figure 5.. Exercise + Others: Others (6 months).

  1. forest plot of Cobb angle; b) forest plot of lung function.

See this image and copyright information in PMC

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