Impact of scoliosis-specific exercises on adolescents with idiopathic scoliosis.

BACKGROUND: This meta-analysis aimed to assess the therapeutic efficacy and impact on health-related quality of life (QoL) of physiotherapeutic scoliosis-specific exercises (PSSE) in adolescent idiopathic scoliosis (AIS) patients based on randomized controlled trials (RCTs) and controlled clinical trials (CCTs). METHODS: Conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD42023423158), this analysis focused on outcomes including changes in Cobb angle, thoracic kyphosis Cobb angle, angle of trunk rotation (ATR), and health-related QoL. RESULTS: Sixteen studies were included, comprising 12 RCTs and 4 CCTs. PSSE significantly improved the thoracic kyphosis Cobb angle (WMD = -4.97º) and health-related QoL (WMD = 0.14). With significant heterogeneity, PSSE intervention showed improvement in the Cobb angle (mean difference = -4.50º) and ATR (mean difference = -2.27º) in AIS patients. The subgroup analysis results indicated that the combination of Schroth exercise and bracing significantly improved the Cobb angle in patients with moderate AIS (WMD = -2.79; 95% CI [-4.81, -0.76], p = 0.007, I² = 0.0%). Additionally, PSSE improved the thoracic kyphosis Cobb angle in patients with severe AIS (WMD = -4.97; 95% CI [-6.96, -2.98], p < 0.001, I² = 0.0%). Patients with mild symptoms experienced greater improvements in the ATR and QoL compared to those with moderate or severe symptoms. CONCLUSIONS: PSSE may provide modest improvements in the thoracic scoliosis Cobb angle and QoL in patients with AIS, particularly in those with mild symptoms or who receive Schroth exercises in combination with brace treatment. However, the mean improvement in Cobb angle was less than 5 degrees, suggesting that the clinical significance of these changes may be limited. Further high-quality studies are needed to confirm the optimal intervention protocols and to clarify their impact on long-term clinical outcomes.