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Published in: European Spine Journal 3/2012

01-03-2012 | Review Article

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

Authors: Simon C. Mordecai, Harshad V. Dabke

Published in: European Spine Journal | Issue 3/2012

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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.
Literature
1.
go back to reference Dickson RA, Lawton JO, Archer IA, Butt WP (1984) The pathogenesis of idiopathic scoliosis. Biplanar spinal asymmetry. J Bone Joint Surg Br 66(1):8–15PubMed Dickson RA, Lawton JO, Archer IA, Butt WP (1984) The pathogenesis of idiopathic scoliosis. Biplanar spinal asymmetry. J Bone Joint Surg Br 66(1):8–15PubMed
2.
go back to reference Murray DW, Bulstrode CJ (1996) The development of adolescent idiopathic scoliosis. Eur Spine J 5(4):251–257PubMedCrossRef Murray DW, Bulstrode CJ (1996) The development of adolescent idiopathic scoliosis. Eur Spine J 5(4):251–257PubMedCrossRef
3.
go back to reference Guo X, Chau WW, Chan YL, Cheng JC (2003) Relative anterior spinal overgrowth in adolescent idiopathic scoliosis. Results of disproportionate endochondral-membranous bone growth. J Bone Joint Surg Br 85(7):1026–1031PubMedCrossRef Guo X, Chau WW, Chan YL, Cheng JC (2003) Relative anterior spinal overgrowth in adolescent idiopathic scoliosis. Results of disproportionate endochondral-membranous bone growth. J Bone Joint Surg Br 85(7):1026–1031PubMedCrossRef
4.
go back to reference Dickson RA (1985) Conservative treatment for idiopathic scoliosis. J Bone Joint Surg Br 67(2):176–181PubMed Dickson RA (1985) Conservative treatment for idiopathic scoliosis. J Bone Joint Surg Br 67(2):176–181PubMed
5.
go back to reference Weiss HR, Negrini S, Hawes MC, Rigo M, Kotwicki T, Grivas TB, Maruyama T (2006) Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment—SOSORT consensus paper 2005. Scoliosis 11:1–6 Weiss HR, Negrini S, Hawes MC, Rigo M, Kotwicki T, Grivas TB, Maruyama T (2006) Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment—SOSORT consensus paper 2005. Scoliosis 11:1–6
6.
go back to reference Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME (1986) The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine 11(8):792–801PubMedCrossRef Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME (1986) The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine 11(8):792–801PubMedCrossRef
8.
go back to reference Lenssinck ML, Frijlink AC, Berger MY, Bierman-Zeinstra SM, Verkerk K, Verhagen AP (2005) Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents: a systematic review of clinical trials. Phys Ther 85(12):1329–1339PubMed Lenssinck ML, Frijlink AC, Berger MY, Bierman-Zeinstra SM, Verkerk K, Verhagen AP (2005) Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents: a systematic review of clinical trials. Phys Ther 85(12):1329–1339PubMed
9.
go back to reference Negrini S, Antonini G, Carabalona R, Minozzi S (2003) Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatr Rehabil 6(3–4):227–235PubMed Negrini S, Antonini G, Carabalona R, Minozzi S (2003) Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatr Rehabil 6(3–4):227–235PubMed
10.
go back to reference Negrini S, Fusco C, Minozzi S, Atanasio S, Zaina F, Romano M (2008) Exercises reduce the progression rate of adolescent idiopathic scoliosis: results of a comprehensive systematic review of the literature. Disabil Rehabil 30(10):772–785PubMedCrossRef Negrini S, Fusco C, Minozzi S, Atanasio S, Zaina F, Romano M (2008) Exercises reduce the progression rate of adolescent idiopathic scoliosis: results of a comprehensive systematic review of the literature. Disabil Rehabil 30(10):772–785PubMedCrossRef
11.
go back to reference Wan L, Wang G-x, Bian R (2005) Exercise therapy in treatment of essential S-shaped scoliosis: evaluation of Cobb angle in breast and lumbar segment through a follow-up of half a year. Zhongguo Linchuang Kangfu 9:82–84 Wan L, Wang G-x, Bian R (2005) Exercise therapy in treatment of essential S-shaped scoliosis: evaluation of Cobb angle in breast and lumbar segment through a follow-up of half a year. Zhongguo Linchuang Kangfu 9:82–84
12.
go back to reference Negrini S, Negrini A, Romano M, Verzini N, Negrini A, Parzini S (2006) A controlled prospective study on the efficacy of SEAS.02 exercises in preparation to bracing for idiopathic scoliosis. Stud Health Technol Inform 123:519–522PubMed Negrini S, Negrini A, Romano M, Verzini N, Negrini A, Parzini S (2006) A controlled prospective study on the efficacy of SEAS.02 exercises in preparation to bracing for idiopathic scoliosis. Stud Health Technol Inform 123:519–522PubMed
13.
go back to reference Negrini S, Negrini A, Romano M, Verzini N, Negrini A, Parzini S (2006) A controlled prospective study on the efficacy of SEAS.02 exercises in preventing progression and bracing in mild idiopathic scoliosis. Stud Health Technol Inform 123:523–526PubMed Negrini S, Negrini A, Romano M, Verzini N, Negrini A, Parzini S (2006) A controlled prospective study on the efficacy of SEAS.02 exercises in preventing progression and bracing in mild idiopathic scoliosis. Stud Health Technol Inform 123:523–526PubMed
14.
go back to reference Weiss HR, Goodall D (2008) The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. Eur J Phys Rehabil Med 44(2):177–193PubMed Weiss HR, Goodall D (2008) The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. Eur J Phys Rehabil Med 44(2):177–193PubMed
15.
go back to reference Weiss HR, Hollaender M, Klein R (2006) ADL based scoliosis rehabilitation–the key to an improvement of time-efficiency? Stud Health Technol Inform 123:594–598PubMed Weiss HR, Hollaender M, Klein R (2006) ADL based scoliosis rehabilitation–the key to an improvement of time-efficiency? Stud Health Technol Inform 123:594–598PubMed
16.
go back to reference Weiss HR (1995) The Schroth scoliosis-specific back school—initial results of a prospective follow-up study. Z Orthop Ihre Grenzgeb 133(2):114–117 (discussion 118–119)PubMedCrossRef Weiss HR (1995) The Schroth scoliosis-specific back school—initial results of a prospective follow-up study. Z Orthop Ihre Grenzgeb 133(2):114–117 (discussion 118–119)PubMedCrossRef
17.
go back to reference Weiss HR, Klein R (2006) Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatr Rehabil 9(3):190–200PubMed Weiss HR, Klein R (2006) Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatr Rehabil 9(3):190–200PubMed
18.
go back to reference Weiss HR, Weiss G, Petermann F (2003) Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis in-patient rehabilitation (SIR): an age- and sex-matched controlled study. Pediatr Rehabil 6(1):23–30PubMed Weiss HR, Weiss G, Petermann F (2003) Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis in-patient rehabilitation (SIR): an age- and sex-matched controlled study. Pediatr Rehabil 6(1):23–30PubMed
20.
go back to reference Negrini S, Zaina F, Romano M, Negrini A, Parzini S (2008) Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis. J Rehabil Med 40(6):451–455PubMedCrossRef Negrini S, Zaina F, Romano M, Negrini A, Parzini S (2008) Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis. J Rehabil Med 40(6):451–455PubMedCrossRef
21.
go back to reference Shea KG, Stevens PM, Nelson M, Smith JT, Masters KS, Yandow S (1998) A comparison of manual versus computer-assisted radiographic measurement. Intraobserver measurement variability for Cobb angles. Spine 23(5):551–555 Shea KG, Stevens PM, Nelson M, Smith JT, Masters KS, Yandow S (1998) A comparison of manual versus computer-assisted radiographic measurement. Intraobserver measurement variability for Cobb angles. Spine 23(5):551–555
22.
go back to reference Adam CJ, Izatt MT, Harvey JR, Askin GN (2005) Variability in Cobb angle measurements using reformatted computerized tomography scans. Spine 30(14):1664–1669 Adam CJ, Izatt MT, Harvey JR, Askin GN (2005) Variability in Cobb angle measurements using reformatted computerized tomography scans. Spine 30(14):1664–1669
23.
go back to reference Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH (1990) Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am 72(3):320–327PubMed Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH (1990) Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am 72(3):320–327PubMed
24.
go back to reference McIntire KL, Asher MA, Burton DC, Liu W (2008) Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study. J Spinal Disord Tech 21(5):349–358PubMedCrossRef McIntire KL, Asher MA, Burton DC, Liu W (2008) Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study. J Spinal Disord Tech 21(5):349–358PubMedCrossRef
25.
go back to reference Otman S, Kose N, Yakut Y (2005) The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Saudi Med J 26(9):1429–1435PubMed Otman S, Kose N, Yakut Y (2005) The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Saudi Med J 26(9):1429–1435PubMed
26.
go back to reference Mooney V, Brigham A (2003) The role of measured resistance exercises in adolescent scoliosis. Orthopedics 26(2):167–171PubMed Mooney V, Brigham A (2003) The role of measured resistance exercises in adolescent scoliosis. Orthopedics 26(2):167–171PubMed
27.
go back to reference Weiss HR, Weiss G (2002) Curvature progression in patients treated with scoliosis in-patient rehabilitation–a sex and age matched controlled study. Stud Health Technol Inform 91:352–356PubMed Weiss HR, Weiss G (2002) Curvature progression in patients treated with scoliosis in-patient rehabilitation–a sex and age matched controlled study. Stud Health Technol Inform 91:352–356PubMed
28.
go back to reference Wong HK, Tan KJ (2010) The natural history of adolescent idiopathic scoliosis. Indian J Orthop 44(1):9–13PubMedCrossRef Wong HK, Tan KJ (2010) The natural history of adolescent idiopathic scoliosis. Indian J Orthop 44(1):9–13PubMedCrossRef
29.
go back to reference Weiss HR, Lohschmidt K, el-Obeidi N, Verres C (1997) Preliminary results and worst-case analysis of in patient scoliosis rehabilitation. Pediatr Rehabil 1(1):35–40PubMed Weiss HR, Lohschmidt K, el-Obeidi N, Verres C (1997) Preliminary results and worst-case analysis of in patient scoliosis rehabilitation. Pediatr Rehabil 1(1):35–40PubMed
30.
go back to reference El-Sayyad M, Conine TA (1994) Effect of exercise, bracing and electrical surface stimulation on idiopathic scoliosis: a preliminary study. Int J Rehabil Res 17(1):70–74PubMedCrossRef El-Sayyad M, Conine TA (1994) Effect of exercise, bracing and electrical surface stimulation on idiopathic scoliosis: a preliminary study. Int J Rehabil Res 17(1):70–74PubMedCrossRef
31.
go back to reference Tanure MC, Pinheiro AP, Oliveira AS (2010) Reliability assessment of Cobb angle measurements using manual and digital methods. Spine J 10(9):769–774PubMedCrossRef Tanure MC, Pinheiro AP, Oliveira AS (2010) Reliability assessment of Cobb angle measurements using manual and digital methods. Spine J 10(9):769–774PubMedCrossRef
32.
go back to reference Daruwalla JS, Balasubramaniam P (1985) Moiré topography in scoliosis. Its accuracy in detecting the site and size of the curve. J Bone Joint Surg Br 67(2):211–213PubMed Daruwalla JS, Balasubramaniam P (1985) Moiré topography in scoliosis. Its accuracy in detecting the site and size of the curve. J Bone Joint Surg Br 67(2):211–213PubMed
33.
go back to reference Weiss HR (1992) Influence of an in-patient exercise program on scoliotic curve. Ital J Orthop Traumatol 18(3):395–406PubMed Weiss HR (1992) Influence of an in-patient exercise program on scoliotic curve. Ital J Orthop Traumatol 18(3):395–406PubMed
34.
go back to reference Mamyama T, Kitagawal T, Takeshita K, Nakainura K (2002) Side shift exercise for idiopathic scoliosis after skeletal maturity. Stud Health Technol Inform 91:361–364PubMed Mamyama T, Kitagawal T, Takeshita K, Nakainura K (2002) Side shift exercise for idiopathic scoliosis after skeletal maturity. Stud Health Technol Inform 91:361–364PubMed
35.
go back to reference Dobosiewicz K, Durmala J, Czernicki K, Jendrzejek H (2002) Pathomechanic basics of conservative treatment of progressive idiopathic scoliosis according to Dobosiewicz method based upon radiologic evaluation. Stud Health Technol Inform 91:336–341PubMed Dobosiewicz K, Durmala J, Czernicki K, Jendrzejek H (2002) Pathomechanic basics of conservative treatment of progressive idiopathic scoliosis according to Dobosiewicz method based upon radiologic evaluation. Stud Health Technol Inform 91:336–341PubMed
36.
go back to reference Chromy CA, Carey MT, Balgaard KG, Iaizzo PA (2006) The potential use of axial spinal unloading in the treatment of adolescent idiopathic scoliosis: a case series. Arch Phys Med Rehabil 87(11):1447–1453PubMedCrossRef Chromy CA, Carey MT, Balgaard KG, Iaizzo PA (2006) The potential use of axial spinal unloading in the treatment of adolescent idiopathic scoliosis: a case series. Arch Phys Med Rehabil 87(11):1447–1453PubMedCrossRef
Metadata
Title
Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature
Authors
Simon C. Mordecai
Harshad V. Dabke
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 3/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-2063-4

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