Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Scoliosis and Spinal Disorders
Published in: Scoliosis and Spinal Disorders 1/2015

Open Access 01-12-2015 | Review

Research quality in scoliosis conservative treatment: state of the art

Authors: Fabio Zaina, Michele Romano, Patrick Knott, Jean Claude de Mauroy, Theodoros B. Grivas, Tomasz Kotwicki, Toru Maruyama, Joseph O’Brien, Manuel Rigo, Stefano Negrini

Published in: Scoliosis and Spinal Disorders | Issue 1/2015

Login to get access

Abstract

The publication of research in the field of conservative treatment of scoliosis is increasing after a long period of progressive decline. In 2014, three high quality and scientifically sound papers gave new strength to the conservative scoliosis approach. The efficacy of treatment over observation was demonstrated by two RCTs for bracing, and one for scoliosis-specific exercises provided by a physical therapist. It is difficult to design strong studies in this field due to the long time needed for follow up and the challenge of recruiting patients and families willing to be involved in the decision process. Nevertheless, the main methodological errors are not related to the study design but rather on the way it is performed, which very frequently affects the reliability of results. The most common errors are: selection bias, with many studies including functional rather than a true structural scoliosis; inappropriate outcome measures, utilizing parameters not related to scoliosis progression or quality of life; inappropriate follow up, reporting only immediate results and not addressing end of growth results; an incorrect interpretation of findings, with an overestimation of results; and missing the evaluation of skeletal maturity, without which results cannot be considered stable. Being aware of these errors is extremely important both for authors and for readers in order to avoid questionable practices based on inconclusive studies that could harm patients.
Literature
1.
Negrini S, De Mauroy JC, Grivas TB, Knott P, Kotwicki T, Maruyama T, et al. Actual evidence in the medical approach to adolescents with idiopathic scoliosis. Eur J Phys Rehabil Med. 2014;50(1):87–92.PubMed
2.
Negrini S. Approach to scoliosis changed due to causes other than evidence: patients call for conservative (rehabilitation) experts to join in team orthopedic surgeons. Disabil Rehabil. 2008;30(10):731–41.CrossRefPubMed
3.
4.
5.
Bunge EM, Habbema JDF, de Koning HJ. A randomised controlled trial on the effectiveness of bracing patients with idiopathic scoliosis: failure to include patients and lessons to be learnt. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2010;19(5):747–53.CrossRef
6.
7.
Negrini S, Zaina F. Physical and rehabilitation medicine specialists in the medical approach to idiopathic scoliosis. Eur J Phys Rehabil Med. 2014;50(1):83–6.PubMed
8.
Nachemson AL, Peterson LE. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. J Bone Joint Surg Am. 1995;77(6):815–22.PubMed
9.
Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas TB, et al. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev. 2010;1, CD006850.PubMed
10.
Coillard C, Circo AB, Rivard CH. A Prospective Randomized Controlled Trial of the Natural History of Idiopathic Scoliosis versus treatment with the Spinecor brace. Sosort Award 2011 Winner. Eur J Phys Rehabil Med. 2014;50(5):479–87.PubMed
11.
Lusini M, Donzelli S, Minnella S, Zaina F, Negrini S. Brace treatment is effective in idiopathic scoliosis over 45°: an observational prospective cohort controlled study. Spine J. 2014 Sep 1;14(9):1951–6.
12.
Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342(25):1887–92.CrossRefPubMedPubMedCentral
13.
Fusco C, Zaina F, Atanasio S, Romano M, Negrini A, Negrini S. Physical exercises in the treatment of adolescent idiopathic scoliosis: An updated systematic review. Physiother Theory Pract. 2011;27(1):80–114.CrossRefPubMed
14.
Mordecai SC, Dabke HV. Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2012;21(3):382–9.CrossRef
15.
Romano M, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Kotwicki T, et al. Exercises for adolescent idiopathic scoliosis. Cochrane Database Syst Rev. 2012;8, CD007837.PubMed
16.
Negrini S, Fusco C, Minozzi S, Atanasio S, Zaina F, Romano M. Exercises reduce the progression rate of adolescent idiopathic scoliosis: results of a comprehensive systematic review of the literature. Disabil Rehabil. 2008;30(10):772–85.CrossRefPubMed
17.
Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S. Active self-correction and taskoriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2014;23(6):1204–14.CrossRef
18.
Negrini S, Bettany-Saltikov J, De Mauroy JC, Durmala J, Grivas TB, Knott P, et al. Letter to the Editor concerning: “Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial” by Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S (2014). Eur Spine J; DOI:10.1007/s00586-014-3241-y. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2014 Aug 23;
19.
Monticone M. Answer to the Letter to the Editor of S. Negrini et al. concerning “Active selfcorrection and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial” by Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S (2014) Eur Spine J; DOI 10.1007/s00586-014-3241-y. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2014;23(10):2221–2.CrossRef
20.
Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, et al. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 2012;7(1):3.CrossRefPubMedPubMedCentral
21.
Weiss H-R, Negrini S, Hawes MC, Rigo M, Kotwicki T, Grivas TB, et al. Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment -- SOSORT consensus paper 2005. Scoliosis. 2006;1:6.CrossRefPubMedPubMedCentral
22.
Bettany-Saltikov J, Parent E, Romano M, Villagrasa M, Negrini S. Physiotherapeutic scoliosis-specific exercises for adolescents with idiopathic scoliosis. Eur J Phys Rehabil Med. 2014;50(1):111–21.PubMed
23.
Hresko MT. Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med. 2013;368(9):834–41.CrossRefPubMed
24.
Alves de Araújo ME, Bezerra da Silva E, Bragade Mello D, Cader SA, Shiguemi Inoue Salgado A, Dantas EHM. The effectiveness of the Pilates method: reducing the degree of non-structural scoliosis, and improving flexibility and pain in female college students. J Bodyw Mov Ther. 2012;16(2):191–8.CrossRefPubMed
25.
26.
Toledo PCV, de Mello DB, Araújo ME, Daoud R, Dantas EHM. Global Posture Reeducation effects in students with scoliosis. Fisioter E Pesqui. 2011;18(4):329–34.
27.
28.
Minnella S, Zaina F, Romano M, Negrini A, Negrini S. Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis. Glob Adv Health Med. 2015;4(1):79–80.CrossRef
29.
Polak J. Adolescent Idiopathic Scoliosis: A 71 Cases Study Ascertaining that Straightening Is Possible, and a New Etiological Hypothesis. Asian Spine J. 2013;7(4):282–8.CrossRefPubMedPubMedCentral
30.
Negrini S, Grivas TB, Kotwicki T, Maruyama T, Rigo M, Weiss HR, et al. Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper. Scoliosis. 2006;1:4.CrossRefPubMedPubMedCentral
31.
Choi J, Kim HS, Kim GS, Lee H, Jeon H-S, Chung K-M. Posture management program based on theory of planned behavior for adolescents with mild idiopathic scoliosis. Asian Nurs Res. 2013;7(3):120–7.CrossRef
32.
Zaina F. Letter to the Editor concerning the article “Adolescent Idiopathic Scoliosis: A 71 Cases Study Ascertaining That Straightening Is Possible, and a New Etiological Hypothesis.”. Asian Spine J. 2015;9(2):1–2.CrossRef
33.
Richards BS, Bernstein RM, D’Amato CR, Thompson GH. Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine. 2005;30(18):2068–75. discussion 2076–7.CrossRefPubMed
34.
Negrini S, Hresko TM, O’Brien JP, Price N, SRS Non-Operative Committee. Non-Operative Committee. Recommendations for research studies on treatment of idiopathic scoliosis: Consensus 2014 between SOSORT and SRS non-operative management committee. Scoliosis. 2015;10:8.CrossRefPubMedPubMedCentral
35.
Wan L, Wang GX, Bian R. 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. Chin J Clin Rehabil. 2005;9(34):82–4.
36.
Negrini S. Research and scientists, the media and the disabled, politicians and judges, actual real treatments and possible false hopes: a PRM perspective on the Italian Stamina Foundation case. Eur J Phys Rehabil Med. 2013;49(6):761–3.PubMed
Metadata
Title
Research quality in scoliosis conservative treatment: state of the art
Authors
Fabio Zaina
Michele Romano
Patrick Knott
Jean Claude de Mauroy
Theodoros B. Grivas
Tomasz Kotwicki
Toru Maruyama
Joseph O’Brien
Manuel Rigo
Stefano Negrini
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Scoliosis and Spinal Disorders / Issue 1/2015
Electronic ISSN: 2397-1789
DOI
https://doi.org/10.1186/s13013-015-0046-7

Other articles of this Issue 1/2015

Scoliosis and Spinal Disorders 1/2015 Go to the issue

Research

The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis—an assessor and statistician blinded randomized controlled trial: “SOSORT 2015 Award Winner”

Reviewer acknowledgement

Reviewer acknowledgement 2014

Research

Early weaning in idiopathic scoliosis

Review

Complications associated with surgical repair of syndromic scoliosis

Research

Patient-reported side effects immediately after chiropractic scoliosis treatment: a cross-sectional survey utilizing a practice-based research network

Research

Does bracing affect bone health in women with adolescent idiopathic scoliosis?