Manual therapy for idiopathic scoliosis A protocol for systematic review and meta-analysis

Introduction: More patients with idiopathic scoliosis (IS) preferred to choose manual therapy as a complementary conservative treatment, but the effects of manual therapy for IS remains controversial. The previous reviews could not draw reliable conclusion due to few eligible studies to perform a meta-analysis. In the last decade, however, several new studies were published that assessed the effects of manual therapy in the management of IS, especially in China. Therefore, the present systematic review and meta-analysis will be performed to examine whether manual therapy is effective for IS primarily in improving patient-centerd symptoms and secondarily in radiographic outcomes. Methods and analysis: A computerized literature search will be performed in the following electronic databases from their inceptions to June 2020 to identify randomized controlled trials of manual therapy in the management of IS: PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Clinical Trials, China Knowledge Resource Integrated Database, Wanfang Data Information, and Weipu Database for Chinese Technical Periodicals. The quality of included studies will be assessed independently by 2 reviewers using the Physiotherapy Evidence Database scale. The meta-analysis will be performed with the Review Manager Version 5.3 software to assess the effects on patient-centred outcomes and radiographic outcomes of manual therapy for IS. The heterogeneity will be assessed usingI(2)statistic and CochranQstatistic. The subgroup analysis will be conducted based on different control interventions and subpopulations. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation. Ethics and dissemination: No ethical statement will be required for the performance of this review and meta-analysis. The results of this review will be published in an international peer-reviewed journal. INPLASY registration number: INPLASY202070058