Physiotherapeutic Scoliosis-Specific Exercise for the Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review and Network Meta-analysis.

Objective: The aim of the study is to compare the rehabilitative efficacy of different physiotherapy scoliosis-specific exercises for adolescent idiopathic scoliosis using a network meta-analysis.

Design: PubMed, Cochrane Library, Web of Science, Embase, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan Fang Data were searched until October 2023. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and R4.3.1. This study follows the Preferred Reporting Items for Systematic Evaluation and Network Meta-analysis statement and was registered on the PROSPERO platform (no. CRD42022379206).

Results: Seventeen randomized controlled trials (RCTs) involving 857 patients were included. The meta-analysis showed that physiotherapy scoliosis-specific exercise therapy improved Cobb's angle than conventional rehabilitation therapy (standardized mean difference = -0.7; 95% confidence interval = -0.95, -0.44; P = 0.001), angle of trunk rotation (standardized mean difference = -1.05; 95% confidence interval = -1.52, -0.58; P < 0.001), and quality of life (standardized mean difference = 0.61; 95% confidence interval = 0.16, 1.07; P < 0.001). Network meta-analysis showed that Schroth + scientific exercise approach to scoliosis was the most effective in improving Cobb angle and angle of trunk rotation, while Schroth alone was most effective in improving the quality of life.

Conclusions: The combination of Schroth and Schroth + scientific exercise approach to scoliosis improved the body posture and trunk deformity in patients with adolescent idiopathic scoliosis, while Schroth alone improved the quality of life. The effectiveness of combining different physiotherapy scoliosis-specific exercise techniques supports future evidence-based research on adolescent idiopathic scoliosis treatment.