Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review

Abstract

Our purpose was, through an extensive and systematic review of the literature, to verify the effectiveness of physical exercises in the treatment of adolescent idiopathic scoliosis. We performed a search of different databases (Medline, Cochrane Library, Embase, Cinhal), and a hand-search of the non-indexed pertinent literature, and found 11 papers: none of the studies was randomized, six were prospective, seven were controlled, and two compared their results to historical controls; one paper had both a prospective design and a concurrent control group. The methodological quality of the retrieved studies was reviewed and found to be very poor. With one exception, the published studies demonstrated the efficacy of physical exercises in reducing both the rate of progression or the magnitude of the Cobb angle at the end of treatment. However, being of poor quality, the literature failed to provide solid evidence for or against the efficacy of physical exercises in the treatment of adolescent idiopathic scoliosis. Nevertheless, considering that exercises could also be proposed on the basis that benefits rather than to avoid progression have been shown in the literature, and that the results contained in published studies here reviewed suggest an effect on the primary goal of preventing progression, there is a basis for discussion of this option with patients and their families, which in turn allows decisions to be made according to their preferences.

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

“…Previous literature reviews [9,10,14] have included several papers published earlier by the authors of these reviews [5,12,13,[15][16][17][18], clearly indicating the need for a more varied source of data incorporating different population groups. The current study is an un-biased review of literature on the effectiveness of exercise therapy in AIS, and has been performed by independent reviewers not affiliated in any way to rehabilitation centres or exercise therapy treatments.…”

“…A number of papers have been published by some centres that heavily endorse exercise therapy as an effective treatment option and have purpose built rehabilitation centres specifically for this use. An initial review of 11 papers published by the Italian Scientific Spine Institute, concluded that there was no solid evidence in support of or against the role of exercise therapies in reducing curve progression in AIS [9]. A subsequent up-dated review included 8 more papers and concluded that all studies excepting one, confirmed the efficacy of exercises in AIS [10].…”

Stretching Versus Mechanical Traction of the Spine in Treatment of Idiopathic Scoliosis

“…Exercise alone may be beneficial as a treatment for patients with very mild idiopathic scoliosis. Exercise used in conjunction with other methods of correction such as traction which has been shown to be beneficial 26,29) .…”

“…Strengthening of the weak convex side muscles creates a muscle balance and normal path for the body's line of gravity. The abdominal muscles, which are considered to form the anterior wall of the spine, must be strong enough to protect the spine from anterior aspect 25,26) .…”

The Effects of the Core Muscle Release Technique on Scoliosis

“…is inappropriate for the treatment of scoliosis 13) . Their conclusion was based on reports that exercises geared towards strengthening abdominal and back muscles that are out of balance with paraspinal muscle tone might create overloading on certain parts and that this could, in turn, worsen scoliosis.…”