The effects of physiotherapeutic scoliosis-specific exercise on idiopathic scoliosis in children and adolescents: a systematic review and meta-analysis.

Adolescent idiopathic scoliosis is often managed with bracing, general exercise, or observation, and physiotherapy organisations have promoted a specific style of physiotherapy exercise, called physiotherapeutic scoliosis-specific exercise, as a first-line non-surgical option. This review pooled results from seventeen controlled studies comparing this scoliosis-specific exercise approach against other non-surgical treatments in children and adolescents, looking mainly at the Cobb angle, which is the standard x-ray measurement of spinal curve severity, along with quality of life measures. Overall, the scoliosis-specific exercise approach was associated with a small but statistically significant improvement in Cobb angle compared with other non-surgical therapies, and it also showed advantages over bracing for pain, self-image and mental health.

Younger patients with less skeletal maturity, or those who had not yet used a brace, seemed to respond better. The main caveat is substantial inconsistency between the pooled studies, meaning the true size of benefit remains uncertain even though the overall direction favoured this exercise approach.

If your child has been diagnosed with idiopathic scoliosis, a curve in the spine with no clear cause, you may have heard about a specific type of physiotherapy exercise designed just for scoliosis, sometimes called scoliosis-specific exercise. This review looked at seventeen studies, involving about 930 young people aged six to eighteen, comparing this exercise approach to other non-surgical treatments like bracing or general exercise programmes. The combined results suggest that this scoliosis-specific exercise was linked to a small improvement in the spinal curve measurement compared with other non-surgical approaches, and it also seemed to help more than bracing with pain, body image and mental wellbeing.

Children who were less physically mature or who had not previously worn a brace tended to do better. It is important to know that the studies varied quite a bit in their results, so while the overall pattern favoured this exercise approach, the exact size of benefit is not certain. This was a summary of existing research rather than a single large trial, so the findings give a general picture rather than a precise answer for any individual child.

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

This systematic review and meta-analysis pooled seventeen controlled trials, including ten randomised controlled trials, totalling 930 participants, of whom thirteen studies contributed to the pooled Cobb angle analysis. Only six studies were rated as excellent quality, meaning the overall body of evidence is a mix of stronger and weaker designs.

The pooled result showed a mean difference in Cobb angle of -2.82 degrees favouring physiotherapeutic scoliosis-specific exercise over other non-surgical therapies (95% CI -4.17 to -1.48, P<0.01), but heterogeneity was high (I2=82%), which limits confidence in the precise magnitude of effect despite the statistically significant direction. Secondary findings, drawn from a smaller subset of studies, indicated that this exercise approach outperformed bracing on pain, self-image and mental health outcomes, and that patients with lower Risser grade or no prior brace exposure had better responses; these should be regarded as exploratory subgroup observations rather than confirmed effects. The authors note that higher-quality studies specifically supported superiority over general exercise and conventional therapy for Cobb angle correction, but the overall heterogeneity across the full pooled dataset means clinicians should weigh the modest average effect size against considerable between-study variability when interpreting these findings.