Functional Outcomes of Schroth-Based Interventions in Adolescent Idiopathic Scoliosis: A Systematic Review of Randomized Controlled Trials.

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Physiotherapeutic scoliosis specific exercises (PSSE). Particularly, the Schroth method are widely used in the conservative management. However, evidence regarding their effects on functional outcomes remain unclear.

OBJECTIVE

To evaluate the effects of Schroth-based interventions on patient-reported and performance based functional outcomes in adolescents with AIS and to assess the methodological quality and certainty of evidence.

METHODS

This systematic review followed PRISMA guidelines. A comprehensive search was conducted in PubMed, MEDLINE, PEDro, Scopus and Google Scholar. Randomized controlled trials including adolescents with AIS and reporting at least one functional outcome were included. Functional outcomes were predefined and categorized as patient reported (e.g., quality of life) or performances-based outcomes (e.g., functional capacity, mobility and muscle endurance). Methodological quality was assessed using the PEDro scale and certainty of evidence using the GRADE framework. Due to heterogeneity across studies a narrative synthesis was performed.

RESULTS

Nine randomized controlled trials, including more than 400 adolescents with AIS were included. PEDro scores ranged from 5-8/10 indicating moderate to high methodological quality. The certainty of evidence ranged from low to moderate with lower confidence observed in patient-reported outcomes.

CONCLUSIONS

Schroth based interventions appear to improve selected functional outcomes in adolescents with AIS particularly performance-based measures. However, the overall certainty of evidence remains limited.