Physiotherapeutic Scoliosis-Specific Exercise for the treatment of adolescent idiopathic scoliosis: A systematic review and network meta-analysis

Abstract Objective To compare the rehabilitative efficacy of different physiotherapy scoliosis-specific exercises (PSSE) for adolescent idiopathic scoliosis (AIS) 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 PRISMA statement and was registered on the PROSPERO platform (No. CRD42022379206). Results Seventeen RCTs involving 857 patients were included. The meta-analysis showed that PSSE therapy improved Cobb's angle than conventional rehabilitation therapy (standardized mean difference [SMD] = -0.7; 95% confidence interval [CI] = -0.95, -0.44; p = 0.001), angle of trunk rotation (ATR; SMD = -1.05; 95% CI = -1.52, -0.58; p < 0.001), and quality of life (QoL; SMD = 0.61; 95% CI = 0.16, 1.07; p < 0.001). Network meta-analysis showed that Schroth + Scientific Exercise Approach to Scoliosis (SEAS) was the most effective in improving Cobb angle and ATR, while Schroth alone was most effective in improving the QoL. Conclusion The combination of Schroth and SEAS improved the body posture and trunk deformity in patients with AIS, while Schroth alone improved the QoL. The effectiveness of combining different PSSE techniques supports future evidence-based research on AIS treatment.