Therapeutic exercises for idiopathic scoliosis in adolescents.

A large systematic review by Romano and colleagues examined whether therapeutic exercises can slow or stop the curve progression that happens in adolescent idiopathic scoliosis, the most common type of spinal curvature in teenagers. The researchers looked at 13 randomised controlled trials involving 583 young people and compared different types of exercises, bracing, and no treatment at all. What they found is that the evidence remains uncertain and quite mixed.

Exercises designed specifically for scoliosis (called PSSE) showed only very small reductions in spinal curve when compared to doing nothing, and most of the improvements in quality of life or appearance were also small. When exercises were added to bracing, there was a slightly larger curve reduction than bracing alone, but again the gains were modest. The overall picture is that while some benefit may exist, the current research is too sparse and inconsistent to draw strong conclusions about whether exercises are truly effective at preventing progression in the long term.

If you or your teenager has been told they have a scoliosis curve, you may have heard about exercises that might help slow it down. This study looked at what science currently knows about whether those exercises actually work.

The researchers found that when young people do scoliosis-specific exercises, the curve may get slightly worse or stay about the same compared to doing nothing, and improvements in how the back looks or how people feel about their appearance tend to be very small. When exercises are combined with a brace, the curve appears to worsen a little less than with a brace alone, but again the difference is not large.

The honest answer right now is that doctors and physiotherapists do not yet have strong proof that exercises can reliably stop curve progression in the way bracing can. More research following young people over many years is needed before we can be sure either way.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This Cochrane review synthesises a relatively small evidence base across heterogeneous interventions, making it difficult to draw firm conclusions about exercise efficacy in AIS. The most substantial finding was that PSSE probably reduces angle of trunk rotation compared to generic therapeutic exercise, an outcome the authors judged clinically meaningful.

However, when examining Cobb angle progression against no treatment, the certainty was very low and the effect size modest. The combination of PSSE plus bracing showed a small additional reduction in Cobb angle over bracing alone, though this was rated low-certainty evidence.

A critical limitation is that only one trial followed participants to skeletal maturity, and most studies had short follow-up periods, small sample sizes, and variable physiotherapist training. The authors explicitly note that subjective outcomes were at high risk of bias because blinding was impossible.

Current evidence does not support claiming that exercise alone is effective at halting progression in the way bracing demonstrates, though whether exercises play a meaningful role in multimodal management remains incompletely answered.