Effectiveness of Schroth exercises for adolescent idiopathic scoliosis: a meta-analysis

Adolescent idiopathic scoliosis (AIS) affects 2-3% of children aged 10 to 18 and can lead to both physical and psychological challenges. This review aims to evaluate the impact of Schroth exercises on Cobb angle, angle of trunk rotation, and quality of life in patients with AIS.

A comprehensive search was conducted across Scopus, PubMed, CINAHL, Chinese National Knowledge Infrastructure, Cochrane Central, and ClinicalTrials.gov databases, identifying 11 randomized controlled trials (RCTs) with a total of 446 participants. These studies, primarily conducted in Asia and North America, compared the effects of Schroth exercises with either no treatment or alternative physical exercise interventions (standard physiotherapy regimens or non-specific exercise-based rehabilitation programs). Data were pooled using a random-effects model, and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.

Meta-analysis showed that Schroth exercises were associated with a significant reduction in Cobb angle (standardized mean difference (SMD): -0.54; 95% confidence interval (CI) [-0.81 to -0.27]; p < 0.001). However, no significant effect was observed on the angle of trunk rotation (SMD: -0.90; 95% CI [-2.45 to 0.65]; p = 0.254). A significant improvement in quality of life was also noted (SMD: 0.67; 95% CI [0.33-1.01]; p < 0.001). The quality of evidence ranged from moderate to low.

Although Schroth exercises were associated with a reduction in Cobb angle, the average change did not meet the conventional five-degree threshold considered clinically significant, and the analysis did not account for the natural progression of spinal curvature. Rather than asserting a definitive benefit, this review highlights significant methodological limitations in the current literature.PROSPERO registration number: CRD42024505289.