Short-term effects of exercise therapy on pulmonary function and exercise tolerance in patients with mild to moderate adolescent idiopathic scoliosis: a meta-analysis of randomized controlled trial.

OBJECTIVE

This meta-analysis aimed to evaluate the effects of exercise therapy on pulmonary function and exercise tolerance in patients with mild to moderate adolescent idiopathic scoliosis (AIS).

METHODS

We systematically searched PubMed, Embase, Medline, Web of Science, and Cochrane Library from inception to April 1st, 2025. We included randomized controlled trials (RCTs) enrolling participants with mild to moderate AIS (Cobb angle 10-40°). Data were extracted for the following outcomes: forced expired volume in 1 s (FEV1), forced vital capacity (FVC), FEV₁/FVC ratio, peak expiratory flow (PEF), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and the six-minute walking test (6MWT). The Cochrane systematic review tool was used to assess the methodological quality of the RCTs, and the GRADE approach was applied to evaluate the quality of evidence.

RESULTS

Of 912 screened records, six RCTs involving 224 patients were included. All studies were judged to have a low risk of bias. Compared with control, exercise therapy improved FEV1 (MD = 0.41 L, 95% CI: 0.22 to 0.59, P < 0.001), FVC (SMD = 0.40 L, 95% CI: 0.02 to 0.78, P < 0.01), FEV1/FVC ratio compared to the control interventions (SMD = 0.46, 95% CI: 0.05 to 0.86, I2: 48%, P < 0.05), MEP (MD = 10.70 cmH₂O, 95% CI: 3.27 to 18.13, P < 0.01), and MIP (MD = 16.44 cmH₂O, 95% CI: 6.87 to 26.01, P < 0.001). Although the subgroup sample size is limited and needs to be interpreted with caution, preliminary results show that long-term (more than 8 weeks) interventions have significant improvement effects on both FEV1 and FVC, while a single long-term (more than 60 min) intervention only shows significant benefits on FEV1.

CONCLUSIONS

Exercise therapy can effectively improve lung volumes and enhance respiratory muscle strength in patients with AIS in short term. Therefore, further high-quality RCTs are warranted to confirm these findings.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251034100.