Efficacy of exercise therapy in adolescent idiopathic scoliosis: A meta-analysis

BackgroundAdolescent idiopathic scoliosis represents a complex three-dimensional spinal deformity of unknown etiology. It frequently results in visible deformities, decreased daily functional capacity, impaired pulmonary function, and psychological distress. Personalized treatment options for adolescent idiopathic scoliosis include exercise therapy, brace use, and surgical intervention, tailored to individual patient needs. Exercise therapy is often employed for patients with mild-to-moderate adolescent idiopathic scoliosis, those undergoing postoperative rehabilitation, or those ineligible for surgery because of its noninvasive nature, low cost, ease of application, and avoidance of prolonged brace use. However, a unified standard or guideline for the use of exercise therapy in managing adolescent idiopathic scoliosis is lacking. This study aimed to investigate the clinical efficacy of exercise therapy for adolescent idiopathic scoliosis and evaluate its therapeutic significance.MethodsWe conducted a systematic review by searching several databases, including China National Knowledge Infrastructure, Wanfang, PubMed, Web of Science, Excerpta Medica Database, MEDLINE, Ovid, and Cochrane Library, with no language restriction, to retrieve randomized controlled trials on exercise therapy for scoliosis. Meta-analysis was performed using RevMan 5.4. The protocol was registered with PROSPERO (registry number: CRD420251106878).ResultsA total of 9 studies involving 571 patients with adolescent idiopathic scoliosis were included. The pooled results revealed that the mean difference for the impact on Cobb angle was 3.31 (95% confidence interval: 2.56-4.05; P < 0.00001), indicating a statistically significant difference (P < 0.05). Regarding angulation of trunk rotation, the mean difference was 2.80 (95% confidence interval: 1.90-3.70; P < 0.00001), indicating a statistically significant difference (P < 0.05). For the Scoliosis Research Society-22 scores, the mean differences were as follows: pain, mean difference = 0.64 (95% confidence interval: 0.10-1.19; P = 0.02); function/activity, mean difference = 0.83 (95% confidence interval: 0.20-1.45; P = 0.009); self-image, mean difference = 0.51 (95% confidence interval: 0.10-0.91; P = 0.01); mental health, mean difference = 0.18 (95% confidence interval: 0.13-0.48; P = 0.25); and satisfaction with treatment, mean difference = 1.36 (95% confidence interval: 0.41-2.32; P = 0.005). Statistically significant differences were observed in all scores except for mental health (P < 0.05).ConclusionSpecific spinal exercise therapy has demonstrated effectiveness in improving Cobb angle, correcting angulation of trunk rotation measurements, and positively impacting pain, functional activity, and self-image compared with other non-exercise conservative treatments, resulting in higher patient satisfaction with treatment outcomes.