Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis.

Adolescent idiopathic scoliosis is usually managed with bracing or surgery in more severe cases, but exercise-based programmes are widely used too, and several different scoliosis-specific exercise systems exist worldwide. This review asked how six of these approaches, including Schroth, SEAS, Dobomed, side shift, active self-correction, and FITS, compare against each other for reducing spinal curvature and improving quality of life in adolescents. Pooling 24 studies covering just over a thousand participants, the analysis found that SEAS ranked highest for reducing the Cobb angle, while active self-correction and Schroth ranked highest for improving trunk rotation and quality of life, with active self-correction showing the strongest short-term results and Schroth showing benefits that persisted longer. Because this is a network meta-analysis combining indirect comparisons across different trial designs, the rankings reflect probability estimates rather than head-to-head proof, and the relatively small, varied set of studies behind each comparison limits how confident we can be in any single ranking.

If you or your teenager has been diagnosed with idiopathic scoliosis, a spinal curve that develops during growth, you may have come across different named exercise programmes, such as Schroth or SEAS, each claiming certain benefits. This review pooled data from 24 studies with just over a thousand young people to see which of six exercise approaches worked best for reducing the curve and improving quality of life.

The analysis suggested that one approach, SEAS, ranked best for reducing the degree of spinal curvature, while active self-correction and Schroth ranked best for improving trunk rotation and quality of life, with active self-correction showing the strongest short-term results and Schroth showing effects that lasted longer. These rankings come from indirect statistical comparisons across a number of smaller studies rather than large head-to-head trials, so they give a sense of which approaches have shown promise rather than firm proof that one is definitively better than another.

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

This network meta-analysis speaks to a question many physiotherapists managing adolescent idiopathic scoliosis face, which scoliosis-specific exercise approach to favour when several systems (Schroth, SEAS, Dobomed, side shift, active self-correction, FITS) are all in clinical use with limited direct comparative data. Pooling 24 clinical trials and 1069 participants, the analysis ranked SEAS first for reducing Cobb angle (surface-under-cumulative-ranking 84.8%), and active self-correction and Schroth highest for trunk rotation angle (86.6% and 79.1%) and quality of life (76.6% and 76.0%), with active self-correction showing superior short-term benefits and Schroth showing effects sustained longer term. These findings inform relative confidence in different exercise systems for specific outcomes, but the rankings derive from a network meta-analysis combining indirect comparisons across heterogeneous trials rather than large, direct head-to-head studies, so the hierarchy should be treated as probabilistic rather than conclusive.

The abstract does not report individual trial designs, risk-of-bias assessment, heterogeneity statistics, or adverse event monitoring, so the certainty underlying each ranking and the safety profile of these interventions cannot be judged from this summary alone. The review does not establish that any one approach is clinically superior in a direct comparative trial, and subgroup rankings for each outcome rest on different, generally small sets of studies, which should temper how firmly any single exercise system is favoured in practice.