Behavior Change Strategies in Digital Exercise Interventions for Adolescent Idiopathic Scoliosis: Scoping Review

Area of Science:

• Digital Health
• Rehabilitation Medicine
• Behavioral Science

Background:

• Adolescent idiopathic scoliosis (AIS) is a common spinal deformity managed with exercise therapy.
• Digital interventions are increasingly used, but effective integration of behavior change techniques (BCTs) and theories is lacking.

Purpose of the Study:

• To identify digital characteristics and BCTs in AIS interventions.
• To analyze theoretical mechanisms using the Theoretical Domains Framework and the capability, opportunity, motivation, and behavior (COM-B) model.

Main Methods:

• A scoping review followed PRISMA-ScR guidelines, screening 5 databases up to April 4, 2024.
• Included studies of any design involving AIS patients using digital exercise rehabilitation interventions.
• Data extraction and descriptive analysis were performed, with quality assessed by the Mixed Methods Appraisal Tool.

Main Results:

• 21 studies were included from 3267 identified papers.
• Videoconferencing and instructional videos were common technologies.
• Key BCT clusters included 'Shaping Knowledge,' 'Social Support,' and 'Antecedents,' primarily targeting 'Capability' and 'Opportunity' but neglecting 'Automatic Motivation.'

Conclusions:

• Common digital technologies and BCTs in AIS interventions were identified.
• Recommendations for technology use were provided.
• Future research should enhance patient motivation and user experience for digital interventions.