Efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Wei ^1,2 ,  BO Shumin ¹ , WANG Tao ^1,3 , WANG Pukui ¹

1. Capital University of Physical Education and Sports, Beijing 100191, P. R. China;
2. College of Basic Medicine, Jining Medical University, Jining 272067, P. R. China;
3. School of Physical Education, Liaocheng University, Liaocheng 252059, P. R. China;

Corresponding?author：

BO Shumin, Email: boshumin@163.com

Keywords：

Exercise intervention; Adolescent; Idiopathic scoliosis; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202202039

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Objective To systematically review the efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis (AIS). Methods PubMed, Web of Science, The Cochrane Library, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise intervention in adolescents with mild to moderate AIS from inception to November 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 11 RCTs involving 638 patients were included. The results of meta-analysis showed that exercise intervention significantly improved the Cobb angle of the spine in patients with AIS (MD=?1.65, 95%CI ?2.63 to ?0.68, P<0.01), reduced the angle of trunk rotation (ATR) (MD=?0.68, 95%CI ?0.96 to ?0.40, P<0.01), and increased their forced vital capacity (FVC) (MD=0.63, 95%CI 0.10 to 1.15, P=0.02). However, there was no statistically significant improvement in the forced expiratory volume in the first second (FEV₁) or the ratio of FEV₁/FVC between the two groups. Conclusion Current evidence shows that the exercise intervention could improve the Cobb angle of the spine, reduce ATR and enhance FVC. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： ZHANG Wei, BO Shumin, WANG Tao, WANG Pukui. Efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(8): 896-900. doi: 10.7507/1672-2531.202202039 Copy

1.	Normand E, Franco A, Marcil V. Nutrition and physical activity level of adolescents with idiopathic scoliosis: a narrative review. Spine J, 2020, 20(5): 785-799.
2.	Negrini S, Minozzi S, Bettany-Saltikov J, et al. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev, 2015, (6): CD006850.
3.	Théroux J, Stomski N, Hodgetts CJ, et al. Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropr Man Therap, 2017, 25: 10.
4.	Ceballos LL, Tejedor CC, Mingo GT, et al. Effects of corrective, therapeutic exercise techniques on adolescent idiopathic scoliosis: a systematic review. Arch Argent Pediatr, 2018, 116(4): e582-e589.
5.	Bettany-Saltikov J, Weiss HR, Chockalingam N, et al. Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Database Syst Rev, 2015, (4): CD010663.
6.	Weinstein SL. The natural history of adolescent idiopathic scoliosis. J Pediatr Orthop, 2019, 39(Suppl 1): S44-S46.
7.	Plaszewski M, Kotwicki T, Chwala W, et al. Study protocol and overview of the literature on long-term health and quality of life outcomes in patients treated in adolescence for scoliosis with therapeutic exercises. J Back Musculoskelet Rehabil, 2015, 28(3): 453-462.
8.	楊紅杰, 喬文菲, 董勝利. 功能性康復訓練結合矯形器對青少年特發性脊柱側彎患者Cobb角, 腰部活動范圍的影響. 內蒙古醫學雜志, 2021, 53(10): 1163-1166.
9.	劉瀟. 觀察分析牽引下運動療法對青少年脊柱側彎Cobb角恢復價值. 中國傷殘醫學, 2020, 28(1): 50-51.
10.	陳俊澤, 廖八根, 韓曉峰, 等. 青少年特發性脊柱側彎應用特定運動療法的臨床效果分析. 華夏醫學, 2020, 33(5): 105-108.
11.	蘇錫文. 體操鍛煉配合俯臥位下肢懸吊牽引治療青少年特發性脊柱側凸的臨床療效觀察. 福州: 福建中醫藥大學, 2020.
12.	張澤, 王春南. 支具矯正聯合姿態訓練治療青少年特發性脊柱側彎的效果. 中國民康醫學, 2021, 33(12): 59-61.
13.	馮國棟. 支具聯合BSPTS療法對中度青少年特發性脊柱側凸的影響. 天津: 天津體育學院, 2021.
14.	葉勇智. 輕度特發性脊柱側凸患者應用脊柱側凸特定運動療法的可行性. 中外醫學研究, 2018, 16(28): 19-21.
15.	Schreiber S, Parent EC, Khodayari ME, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better cobb angle outcomes in adolescents with idiopathic scoliosis - an assessor and statistician blinded randomized controlled trial. PLoS One, 2016, 11(12): e0168746.
16.	Kumar A, Kumar S, Sharma V, et al. Efficacy of task oriented exercise program based on ergonomics on Cobb's angle and pulmonary function improvement in adolescent idiopathic scoliosis- a randomized control trial. J Clin Diagn Res, 2017, 11(8): YC01-YC04.
17.	Kuru T, Yeldan ?, Dereli EE, et al. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil, 2016, 30(2): 181-190.
18.	Gao C, Zheng Y, Fan C, et al. Could the clinical effectiveness be improved under the integration of orthotic intervention and scoliosis-specific exercise in managing adolescent idiopathic scoliosis. A randomized controlled trial study. Am J Phys Med Rehabil, 2019, 98(8): 642-648.
19.	Yen TC, Weinstein SL. Evaluation of predictors and outcomes of bracing with emphasis on the immediate effects of in-brace correction in adolescent idiopathic scoliosis. Iowa Orthop J, 2019, 39(2): 62-65.
20.	Bettany-Saltikov J, Parent E, Romano M, et al. Physiotherapeutic scoliosis-specific exercises for adolescents with idiopathic scoliosis. Eur J Phys Rehabil Med, 2014, 50(1): 111-121.
21.	Karol LA, Virostek D, Felton K, et al. Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am, 2016, 98(1): 9-14.
22.	Cheung PWH, Wong CKH, Lau ST, et al. Responsiveness of the EuroQoL 5-dimension (EQ-5D) in adolescent idiopathic scoliosis. Eur Spine J, 2018, 27(2): 278-285.
23.	Wong CKH, Cheung PWH, Samartzis D, et al. Mapping the SRS-22r questionnaire onto the EQ-5D-5L utility score in patients with adolescent idiopathic scoliosis. PLoS One, 2017, 12(4): e0175847.
24.	Cheung JPY, Chong CHW, Cheung PWH. Underarm bracing for adolescent idiopathic scoliosis leads to flatback deformity: the role of sagittal spinopelvic parameters. Bone Joint J, 2019, 101-B(11): 1370-1378.
25.	Park JH, Jeon HS, Park HW. Effects of the Schroth exercise on idiopathic scoliosis: a meta-analysis. Eur J Phys Rehabil Med, 2018, 54(3): 440-449.
26.	Zheng Y, Dang Y, Yang Y, et al. Whether orthotic management and exercise are equally effective to the patients with adolescent idiopathic scoliosis in mainland china. A randomized controlled trial study. Spine, 2018, 43(9): E494-E503.
27.	Li K, Miao J, Zhang J. Network meta-analysis of short-term effects of different strategies in the conservative treatment of AIS. Eur J Med Res, 2021, 26(1): 54.
28.	倪國新, 鄧曉琴, 徐玥, 等. 體醫融合的歷史推進與發展路徑研究. 北京體育大學學報, 2020, 43(12): 22-34.
29.	Tolo VT, Herring JA. Scoliosis-specific exercises: a state of the art review. Spine Deform, 2020, 8(2): 149-155.

1. Normand E, Franco A, Marcil V. Nutrition and physical activity level of adolescents with idiopathic scoliosis: a narrative review. Spine J, 2020, 20(5): 785-799.
2. Negrini S, Minozzi S, Bettany-Saltikov J, et al. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev, 2015, (6): CD006850.
3. Théroux J, Stomski N, Hodgetts CJ, et al. Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropr Man Therap, 2017, 25: 10.
4. Ceballos LL, Tejedor CC, Mingo GT, et al. Effects of corrective, therapeutic exercise techniques on adolescent idiopathic scoliosis: a systematic review. Arch Argent Pediatr, 2018, 116(4): e582-e589.
5. Bettany-Saltikov J, Weiss HR, Chockalingam N, et al. Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Database Syst Rev, 2015, (4): CD010663.
6. Weinstein SL. The natural history of adolescent idiopathic scoliosis. J Pediatr Orthop, 2019, 39(Suppl 1): S44-S46.
7. Plaszewski M, Kotwicki T, Chwala W, et al. Study protocol and overview of the literature on long-term health and quality of life outcomes in patients treated in adolescence for scoliosis with therapeutic exercises. J Back Musculoskelet Rehabil, 2015, 28(3): 453-462.
8. 楊紅杰, 喬文菲, 董勝利. 功能性康復訓練結合矯形器對青少年特發性脊柱側彎患者Cobb角, 腰部活動范圍的影響. 內蒙古醫學雜志, 2021, 53(10): 1163-1166.
9. 劉瀟. 觀察分析牽引下運動療法對青少年脊柱側彎Cobb角恢復價值. 中國傷殘醫學, 2020, 28(1): 50-51.
10. 陳俊澤, 廖八根, 韓曉峰, 等. 青少年特發性脊柱側彎應用特定運動療法的臨床效果分析. 華夏醫學, 2020, 33(5): 105-108.
11. 蘇錫文. 體操鍛煉配合俯臥位下肢懸吊牽引治療青少年特發性脊柱側凸的臨床療效觀察. 福州: 福建中醫藥大學, 2020.
12. 張澤, 王春南. 支具矯正聯合姿態訓練治療青少年特發性脊柱側彎的效果. 中國民康醫學, 2021, 33(12): 59-61.
13. 馮國棟. 支具聯合BSPTS療法對中度青少年特發性脊柱側凸的影響. 天津: 天津體育學院, 2021.
14. 葉勇智. 輕度特發性脊柱側凸患者應用脊柱側凸特定運動療法的可行性. 中外醫學研究, 2018, 16(28): 19-21.
15. Schreiber S, Parent EC, Khodayari ME, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better cobb angle outcomes in adolescents with idiopathic scoliosis - an assessor and statistician blinded randomized controlled trial. PLoS One, 2016, 11(12): e0168746.
16. Kumar A, Kumar S, Sharma V, et al. Efficacy of task oriented exercise program based on ergonomics on Cobb's angle and pulmonary function improvement in adolescent idiopathic scoliosis- a randomized control trial. J Clin Diagn Res, 2017, 11(8): YC01-YC04.
17. Kuru T, Yeldan ?, Dereli EE, et al. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil, 2016, 30(2): 181-190.
18. Gao C, Zheng Y, Fan C, et al. Could the clinical effectiveness be improved under the integration of orthotic intervention and scoliosis-specific exercise in managing adolescent idiopathic scoliosis. A randomized controlled trial study. Am J Phys Med Rehabil, 2019, 98(8): 642-648.
19. Yen TC, Weinstein SL. Evaluation of predictors and outcomes of bracing with emphasis on the immediate effects of in-brace correction in adolescent idiopathic scoliosis. Iowa Orthop J, 2019, 39(2): 62-65.
20. Bettany-Saltikov J, Parent E, Romano M, et al. Physiotherapeutic scoliosis-specific exercises for adolescents with idiopathic scoliosis. Eur J Phys Rehabil Med, 2014, 50(1): 111-121.
21. Karol LA, Virostek D, Felton K, et al. Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Joint Surg Am, 2016, 98(1): 9-14.
22. Cheung PWH, Wong CKH, Lau ST, et al. Responsiveness of the EuroQoL 5-dimension (EQ-5D) in adolescent idiopathic scoliosis. Eur Spine J, 2018, 27(2): 278-285.
23. Wong CKH, Cheung PWH, Samartzis D, et al. Mapping the SRS-22r questionnaire onto the EQ-5D-5L utility score in patients with adolescent idiopathic scoliosis. PLoS One, 2017, 12(4): e0175847.
24. Cheung JPY, Chong CHW, Cheung PWH. Underarm bracing for adolescent idiopathic scoliosis leads to flatback deformity: the role of sagittal spinopelvic parameters. Bone Joint J, 2019, 101-B(11): 1370-1378.
25. Park JH, Jeon HS, Park HW. Effects of the Schroth exercise on idiopathic scoliosis: a meta-analysis. Eur J Phys Rehabil Med, 2018, 54(3): 440-449.
26. Zheng Y, Dang Y, Yang Y, et al. Whether orthotic management and exercise are equally effective to the patients with adolescent idiopathic scoliosis in mainland china. A randomized controlled trial study. Spine, 2018, 43(9): E494-E503.
27. Li K, Miao J, Zhang J. Network meta-analysis of short-term effects of different strategies in the conservative treatment of AIS. Eur J Med Res, 2021, 26(1): 54.
28. 倪國新, 鄧曉琴, 徐玥, 等. 體醫融合的歷史推進與發展路徑研究. 北京體育大學學報, 2020, 43(12): 22-34.
29. Tolo VT, Herring JA. Scoliosis-specific exercises: a state of the art review. Spine Deform, 2020, 8(2): 149-155.

Chinese Journal of Evidence-Based Medicine

Efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis: a meta-analysis

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