Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature

Abstract

Purpose Current evidence regarding the use of exercise therapy in the treatment of adolescent idiopathic scoliosis (AIS) was assessed with a review of published literature. Methods An extensive literature search was carried out with commonly used medical databases. A total of 155 papers were identified out of which only 12 papers were deemed to be relevant. Results There were nine prospective cohort studies, two retrospective studies and one case series. All studies endorsed the role of exercise therapy in AIS but several shortcomings were identified-lack of clarity of patient recruitment and in the method of assessment of curve magnitude, poor record of compliance, and lack of outcome scores. Many studies reported ''significant'' changes in the Cobb angle after treatment, which were actually of small magnitude and did not take into account the reported inter or intra-observer error rate. All studies had poor statistical analysis and did not report whether the small improvements noted were maintained in the long term. Conclusions This unbiased literature review has revealed poor quality evidence supporting the use of exercise therapy in the treatment of AIS. Well-designed randomised controlled studies are required to assess the role of exercise therapy in AIS.

Consenso de escoliosis idiopática del adolescente

“…32,33 No existe evidencia científica para pensar que actividades deportivas de ningún tipo aumenten el riesgo de progresión de la escoliosis, por lo tanto, es un error desaconsejar la práctica deportiva.…”

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review

“…The review by Mordecai et al [35] dealing with the efficacy of exercise therapy for the treatment of idiopathic scoliosis identifies a common problem with literature reviews, a paucity of acceptable studies. In their review out of 155 papers dealing with the subject, only 12 were deemed to be relevant.…”

“…Every European country is represented. Although China (35), USA (27) and Japan (34) dominate the non-European contributions, the remaining 51 papers are from 16 other non-European countries. EuroSpine-the Spine Society of Europe is very committed to education with the hope in time that a spinal speciality will be recognized as an independent specialty in Europe, and the Society will create a Diploma, which aspiring spinal surgeons will aim to acquire.…”

Disuse induced by the spine rectification vest: experimental study

“…And because it presents this great functional structured composition, it is subjected to several forms of compromise, which can lead to permanent or temporary 1 functional restriction. Out of the most common conditions that lead to functional spinal restriction, there are: vertebral, rib, scapular and pelvic waste fractures, degenerative diseases, scoliosis, besides other forms of compromise that range in causal mechanisms and complexity and corroborate the restriction and consequent disuse or hypoactivity [2][3][4] . Concerning static and dynamic spinal stability, this system is inherently stable, which requires an active muscle support for postural maintenance and changes 3,5 .…”

“…Out of the most common conditions that lead to functional spinal restriction, there are: vertebral, rib, scapular and pelvic waste fractures, degenerative diseases, scoliosis, besides other forms of compromise that range in causal mechanisms and complexity and corroborate the restriction and consequent disuse or hypoactivity [2][3][4] . Concerning static and dynamic spinal stability, this system is inherently stable, which requires an active muscle support for postural maintenance and changes 3,5 . Considering there is spinal static stability is ensured by different ligaments, besides intervertebral disks, the dynamic stability calls the attention, since it is ensured by intrinsic and extrinsic spinal muscles.…”