Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis

Abstract Background Adolescent idiopathic scoliosis (AIS) refers to a spinal curvature of an unknown origin diagnosed in otherwise healthy children. A conservative treatment approach includes physiotherapy scoliosis-specific exercises (PSSE) with or without corrective bracing in preventing further s...

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Main Authors: Joseph M. Day, Jeremy Fletcher, Mackenzie Coghlan, Terrence Ravine
Format: Article
Language:English
Published: AboutScience Srl 2019-08-01
Series:Archives of Physiotherapy
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40945-019-0060-9
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author Joseph M. Day
Jeremy Fletcher
Mackenzie Coghlan
Terrence Ravine
author_facet Joseph M. Day
Jeremy Fletcher
Mackenzie Coghlan
Terrence Ravine
author_sort Joseph M. Day
collection DOAJ
description Abstract Background Adolescent idiopathic scoliosis (AIS) refers to a spinal curvature of an unknown origin diagnosed in otherwise healthy children. A conservative treatment approach includes physiotherapy scoliosis-specific exercises (PSSE) with or without corrective bracing in preventing further spinal column deviation. However, several PSSE types have been developed to facilitate a positive patient outcome and/or preclude surgical remediation. Based on other reviews, there has been insufficient evidence published on the efficacy of PSSEs. In addition, the superiority of PSSE over no intervention or compared to other exercise modes has yet to be determined. Methods A comprehensive search of AIS literature, inception through February 2018, was conducted to reveal relevant PSSE articles. Only studies using commonly reported PSSEs were included. Examined databases included PubMed, Scopus, CINAHL Complete, and Physiotherapy Evidence Database (PEDro). Google Scholar search engine was also examined. Article types included randomized or clinical control trials. All articles were published in English or were of English translation. Search parameters were collectively defined by the reviewers and subsequently used to determine included studies. Individual PSSE study methodology quality was determined by the PEDro scale. Effect sizes (Hedge’s g) and their 95% confidence intervals were calculated for Cobb angle between group changes. Results Of the initial 24 articles recovered only eight (33%) met the established search criteria. Patient ages from these sources ranged from 11.4–16.2 including both males and females. Examined papers included two Schroth method and six specifying the Scientific Exercise Approach to Scoliosis (SEAS) method. All articles demonstrated positive between group effect sizes for PSSEs. There were no studies that compared one PSSE to another. Determined PEDro scores indicated an overall moderate quality of these studies. Conclusions There is insufficient evidence to suggest that both Schroth and SEAS methods can effectively improve Cobb angles in patients with AIS compared to no intervention. There is limited evidence that the SEAS method is more effective at reducing Cobb angles compared to traditional exercises in treating AIS. Overall, this review revealed a noticeable lack of contemporary studies that could be used in answering our questions. Evidence-based medicine (EBM) supplies clinicians with verifiable results from well-designed and managed research studies. Consequently, more and varied studies of higher quality are needed before any definitive determination can be made as to the effectiveness of any PSSE let alone the one offering better patient outcomes.
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spelling doaj.art-fe0b2098c5a348a1898cdc459e121a232024-03-02T12:45:12ZengAboutScience SrlArchives of Physiotherapy2057-00822019-08-019111110.1186/s40945-019-0060-9Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosisJoseph M. Day0Jeremy Fletcher1Mackenzie Coghlan2Terrence Ravine3Department of Physical Therapy, School of Education and Health Sciences, University of DaytonDepartment of Physical Therapy, University of South AlabamaUniversity of South AlabamaDepartment of Biomedical Sciences, University of South AlabamaAbstract Background Adolescent idiopathic scoliosis (AIS) refers to a spinal curvature of an unknown origin diagnosed in otherwise healthy children. A conservative treatment approach includes physiotherapy scoliosis-specific exercises (PSSE) with or without corrective bracing in preventing further spinal column deviation. However, several PSSE types have been developed to facilitate a positive patient outcome and/or preclude surgical remediation. Based on other reviews, there has been insufficient evidence published on the efficacy of PSSEs. In addition, the superiority of PSSE over no intervention or compared to other exercise modes has yet to be determined. Methods A comprehensive search of AIS literature, inception through February 2018, was conducted to reveal relevant PSSE articles. Only studies using commonly reported PSSEs were included. Examined databases included PubMed, Scopus, CINAHL Complete, and Physiotherapy Evidence Database (PEDro). Google Scholar search engine was also examined. Article types included randomized or clinical control trials. All articles were published in English or were of English translation. Search parameters were collectively defined by the reviewers and subsequently used to determine included studies. Individual PSSE study methodology quality was determined by the PEDro scale. Effect sizes (Hedge’s g) and their 95% confidence intervals were calculated for Cobb angle between group changes. Results Of the initial 24 articles recovered only eight (33%) met the established search criteria. Patient ages from these sources ranged from 11.4–16.2 including both males and females. Examined papers included two Schroth method and six specifying the Scientific Exercise Approach to Scoliosis (SEAS) method. All articles demonstrated positive between group effect sizes for PSSEs. There were no studies that compared one PSSE to another. Determined PEDro scores indicated an overall moderate quality of these studies. Conclusions There is insufficient evidence to suggest that both Schroth and SEAS methods can effectively improve Cobb angles in patients with AIS compared to no intervention. There is limited evidence that the SEAS method is more effective at reducing Cobb angles compared to traditional exercises in treating AIS. Overall, this review revealed a noticeable lack of contemporary studies that could be used in answering our questions. Evidence-based medicine (EBM) supplies clinicians with verifiable results from well-designed and managed research studies. Consequently, more and varied studies of higher quality are needed before any definitive determination can be made as to the effectiveness of any PSSE let alone the one offering better patient outcomes.http://link.springer.com/article/10.1186/s40945-019-0060-9Scoliosis-specific exerciseAdolescent idiopathic scoliosisCobb angles
spellingShingle Joseph M. Day
Jeremy Fletcher
Mackenzie Coghlan
Terrence Ravine
Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
Archives of Physiotherapy
Scoliosis-specific exercise
Adolescent idiopathic scoliosis
Cobb angles
title Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
title_full Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
title_fullStr Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
title_full_unstemmed Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
title_short Review of scoliosis-specific exercise methods used to correct adolescent idiopathic scoliosis
title_sort review of scoliosis specific exercise methods used to correct adolescent idiopathic scoliosis
topic Scoliosis-specific exercise
Adolescent idiopathic scoliosis
Cobb angles
url http://link.springer.com/article/10.1186/s40945-019-0060-9
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