Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment

Abstract

Background: There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis. Objectives: Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis. Methods: Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°–45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life. Results: Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only. Conclusion: Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis. Clinical relevance This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

Effectiveness of Scoliosis-Specific Exercise for Alleviating Adolescent Idiopathic Scoliosis: A Systematic Review

“…The PEDro scale was ranked from 5 to 9, with an average score of 6.9/10 for overall articles (Table 1). Speci cally, the average scores of Schroth studies (35)(36)(37)(38)45), scienti c exercise approach to scoliosis (SEAS) studies (41,47,48), and alternative SSE(40, 46) studies were 6.4 (n=5, score: 5-8), 8 (n=3, score: 8-9), and 6.5 (n=2, score: 6-7), respectively. Criteria 4 (blinding subjects) and 5 (blinding therapists) were not met for 80% (n=8) of studies (35)(36)(37)(38)(45)(46)(47)(48).…”

“…Two studies found no signi cant differences of QoL between the groups in either adding SSE to bracing treatment or comparing supervised SSE with home exercises (37,46). Another study found improved pain domain outcomes in the core exercise group only (47).…”

“…Two studies showed better improvement of ATR in the study group (37,41). For QoL (Table 3), ve studies adopted the SRS-22 questionnaire (38,41,(46)(47)(48), and one study adopted the SRS-23 questionnaire (37). However, a high initial score (mean score: 3.8-4.2) was noted in all studies (Table 3), with three studies reporting better QoL outcomes in terms of function and mental domain, favoring the SSE group (41,46,48).…”

“…One study demonstrated that only body awareness therapy could signi cantly improve thoracic curvatures, and yet, no difference was detected in comparison with the traditional exercise group (46). Another study revealed that both thoracic and lumbar Cobb angles decreased in all participants wearing braces regardless of the exercise strategy (SEAS vs Core muscle training) (47).…”

“…No study investigated the correlation of exercise compliance with intervention effects. Five studies reported exercise compliance in the percentage value of the prescribed dosage (Table 3: 58 ± 0.27% to 88%) (38,(45)(46)(47)(48), of which three trials reported signi cant intergroup differences in Cobb angles that were beyond measurement error (38,46,48): one study showed greater Cobb angle reduction in patients undergoing brace with exercise (38); another study showed that bracing was superior to exercise alone for moderate scoliosis(48); and the third study suggested body awareness exercise with bracing could effectively improve scoliosis (46).…”