Physiotherapeutic Scoliosis-Specific Exercise for the Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review and Network Meta-analysis.

This systematic review and network meta-analysis asked which physiotherapy scoliosis-specific exercise (PSSE) approach works best for adolescent idiopathic scoliosis, a spinal curvature that develops during growth. Researchers pooled 17 randomized controlled trials involving 857 patients, comparing methods like the Schroth method, alone or combined with a scientific exercise approach to scoliosis (SEAS), against conventional rehabilitation. Overall, PSSE improved Cobb's angle (a measure of spinal curve severity), angle of trunk rotation, and quality of life compared with conventional therapy. Network comparisons suggested Schroth combined with SEAS was most effective for Cobb angle and trunk rotation, while Schroth alone appeared best for quality of life.

The abstract does not report risk of bias assessment or heterogeneity details, so the certainty of these comparative rankings between specific PSSE techniques remains unclear.

This review looked at exercise-based physiotherapy programs for teenagers with idiopathic scoliosis, a sideways curve of the spine that appears during growth spurts. Researchers combined results from 17 studies with 857 participants total, comparing different scoliosis-specific exercise programs, including the Schroth method and a combined Schroth plus SEAS approach, against standard rehabilitation. The combined results showed that scoliosis-specific exercises were associated with improvements in spinal curve angle, trunk rotation (a marker of the rib hump or asymmetry often seen in scoliosis), and quality of life compared with usual rehabilitation.

When comparing specific programs to each other, combining Schroth with SEAS appeared best for straightening the curve and reducing trunk rotation, while Schroth alone appeared best for quality of life. The abstract does not describe how reliable or consistent the included studies were, so while these results are promising, we cannot say how strong or certain this evidence is regarding which specific program works best.

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

This network meta-analysis pooled 17 RCTs (n=857) comparing physiotherapy scoliosis-specific exercise (PSSE) approaches, including Schroth, SEAS, and combined Schroth+SEAS, against conventional rehabilitation for adolescent idiopathic scoliosis. Standard meta-analysis found statistically significant improvements favoring PSSE over conventional therapy for Cobb angle (SMD -0.7), angle of trunk rotation (SMD -1.05), and quality of life (SMD 0.61). Network meta-analysis ranking suggested Schroth+SEAS was most effective for Cobb angle and trunk rotation, while Schroth alone ranked highest for quality of life.

This indicates outcome-specific differences between PSSE approaches rather than one technique being universally superior. The abstract does not report risk of bias assessment, heterogeneity statistics, or GRADE certainty ratings for the network comparisons, which limits confidence in the relative rankings between specific techniques. The pooled results establish that PSSE generally outperforms conventional rehabilitation, but the comparative superiority of one PSSE method over another rests on indirect network comparisons whose underlying study quality is not detailed here.