The effects of physiotherapeutic scoliosis-specific exercise on idiopathic scoliosis in children and adolescents: a systematic review and meta-analysis

Background Physiotherapeutic scoliosis-specific exercise (PSSE) is recommended by SOSORT as the first step in the treatment of adolescent idiopathic scoliosis (AIS). However, a thorough summary and meta-analysis of the evidence for the effectiveness of PSSE is lacking.Objective To summarise the up-to-date evidence on the efficacy of PSSE in AIS compared with the other non-surgical therapies.Data sources The PubMed, Web of Science, Cochrane, Scopus, Embase and CNKI databases were systematically searched from 1 January 2012 to 1 November 2022. Study selection Controlled trials comparing the effects of PSSE and other non-surgical therapies on improving Cobb angle and quality of life in young people aged 6-18 years were included.Data synthesis Three researchers independently extracted data and evaluated methodological quality. Meta-analysis was performed where possible; otherwise, descriptive syntheses were reported.Results Seventeen studies with a total of 930 participants (76% female) were included. Among them, ten studies were RCTs. Six studies were of excellent quality. Thirteen studies were included in the meta-analysis. PSSE corrected the Cobb angle in patients better than other non-surgical therapies (I2 = 82%, MD = -2.82, 95%CI = -4.17 to -1.48, P < 0.01). PSSE was more effective than brace in improving patients' pain, self-image and mental health. Patients with a Risser grade of 0-3 or who had never received brace therapy had better outcomes.Conclusion Evidence from higher quality studies suggests that PSSE was superior to general exercise and conventional therapy for correcting the Cobb angle in AIS.