European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
Comprehensive scoliosis conservative rehabilitation for adolescent idiopathic scoliosis: effects on spinal deformity, physical function, and quality of life, with a parallel mediation analysis of core muscle endurance and pulmonary function.
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Li Xin, Zhou Xuan, Liang Juping, Yu Hong, Fan Qimeng, Chen Peijie, Du Qing
Аннотация
PURPOSE: This prospective cohort study aimed to evaluate the effects of a comprehensive scoliosis conservative rehabilitation (CSCR) program on spinal deformity, physical function, and quality of life in patients with adolescent idiopathic scoliosis (AIS), to identify relevant influencing factors, and to examine the mediating mechanisms through which CSCR improves spinal deformity.
METHODS: Patients with AIS were followed from November 2018 to April 2025. According to the preferences of patients and their guardians, those who accepted CSCR were allocated to the intervention group, whereas those who declined structured training and chose routine observation/follow-up were allocated to the control group. Participants in both groups additionally received bracing if the Cobb angle was ≥ 25°. The primary outcome was the 6-month change in the major-curve Cobb angle. Secondary outcomes included core muscle endurance, pulmonary function, and angle of trunk rotation (ATR), among other measures.
RESULTS: A total of 351 patients were enrolled, including 233 in the CSCR group and 118 in the control group. After 6 months, the CSCR group showed a significant reduction in Cobb angle, whereas the control group showed a slight increase; the therapeutic response rate was also significantly higher in the CSCR group (26.6% vs. 5.9%, P < 0.001). Significant improvements were also observed in ATR, core muscle endurance, pulmonary function parameters (FVC and FEV1), skeletal muscle mass, and SRS-22 scores in the CSCR group. Parallel mediation analysis identified core muscle endurance (plank time) and pulmonary function (FVC and FEV1) as key mediators of the effect of CSCR on spinal deformity.
CONCLUSION: CSCR effectively reduces the major-curve Cobb angle and improves therapeutic response, physical function, and quality of life in patients with mild AIS. Core muscle endurance and pulmonary function appear to be key mediating pathways through which CSCR improves spinal deformity.
TRIAL REGISTRATION: www.chictr.org.cn, ChiCTR1800017943. Registered on August 24, 2018..
METHODS: Patients with AIS were followed from November 2018 to April 2025. According to the preferences of patients and their guardians, those who accepted CSCR were allocated to the intervention group, whereas those who declined structured training and chose routine observation/follow-up were allocated to the control group. Participants in both groups additionally received bracing if the Cobb angle was ≥ 25°. The primary outcome was the 6-month change in the major-curve Cobb angle. Secondary outcomes included core muscle endurance, pulmonary function, and angle of trunk rotation (ATR), among other measures.
RESULTS: A total of 351 patients were enrolled, including 233 in the CSCR group and 118 in the control group. After 6 months, the CSCR group showed a significant reduction in Cobb angle, whereas the control group showed a slight increase; the therapeutic response rate was also significantly higher in the CSCR group (26.6% vs. 5.9%, P < 0.001). Significant improvements were also observed in ATR, core muscle endurance, pulmonary function parameters (FVC and FEV1), skeletal muscle mass, and SRS-22 scores in the CSCR group. Parallel mediation analysis identified core muscle endurance (plank time) and pulmonary function (FVC and FEV1) as key mediators of the effect of CSCR on spinal deformity.
CONCLUSION: CSCR effectively reduces the major-curve Cobb angle and improves therapeutic response, physical function, and quality of life in patients with mild AIS. Core muscle endurance and pulmonary function appear to be key mediating pathways through which CSCR improves spinal deformity.
TRIAL REGISTRATION: www.chictr.org.cn, ChiCTR1800017943. Registered on August 24, 2018..