Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice.

Abstract

Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.