Background
Methods
Search strategy
Inclusion criteria
Exclusion criteria
Evidence hierarchy and methodological appraisal
Results
Search results
Evidence hierarchy and methodological appraisal
Characteristics of included studies
Study | Study Design | Sample Size | Gender | Age (mean ± SD)/ range | Initial Cobb angles | Curve magnitudes | Bone Maturity (Risser sign) | Intervention Protocols | ||
---|---|---|---|---|---|---|---|---|---|---|
Female | Male | Study group | Control group | |||||||
Liu et al [40] | CCT | 99 | 66 | 33 | 7–15 | 10°-24° | 3 Rt. thoracic, 10 Lt. thoracic, 4 Rt. Lumbar, 13 Lt. Lumbar, 49 Rt. Thoracic with Lt. Lumbar, 20 Lt. Thoracic with Rt. lumbar | 0: n = 37 1–2: n = 23 3: n = 39 | Alternative SSE method (Xinmiao): corrective postures + corrective exercise: 40 min/session, education for 2 days then independently performed daily at home. | No control |
RCT | 30 | 30 | 0 | 12–16 | 20°-45° | Rt. thoracic Lt. Lumbar: n = 16 Single thoracolumbar: n = 14 | 2: n = 14 3: n = 16 | Brace + SEAS* Supervised session: 40 min/session; once per week Home Program: 20 min/day | Brace + core muscle strengthen exercise same dosage with the study group | |
RCT | 20 | 20 | 0 | 10–16 | 20°-45° | King classification: type 1: n = 5, type 2: n = 10, type 3: n = 3, type 4: n = 2 | 1: n = 2 2: n = 11 3: n = 7 | Basic Body Awareness Therapy (BBAT) + Traditional Exercise + brace: home exercise 1 h/session, 5sessions/week | Traditional Exercise only + brace same dosage with the study group | |
Zheng et al [48] | RCT | 53 | 41 | 12 | 10–14 | 21°-36° | Not reported | Not Reported | SEAS: supervised exercise in clinic: 40 min/week + home exercise: 10-15 min/day | Brace: 23 h/day |
Kwan et al [38] | CCT | 48 | 38 | 10 | 10–14 | 25°-40° | Thoracic major: 21% vs 33% Thoracolumbar/lumbar major: 79% vs 67% | 0–1: 54% vs 79% 2: 29% vs 17% 3–5: 17% vs 4% | Brace + Schroth: 8-week outpatient program + home exercise + revisit every two months + 18 h/day of bracing. | Brace alone: 18 h/day |
RCT | 15 | 10 | 5 | 13–23 | 16°-40° | Not reported | Not reported | Schroth + Respiratory muscle exercise: 15 min of Resp + 40 min Schroth/session; 3 sessions/week; | Schroth only: 1 h/session; 3 sessions/week | |
RCT | 50 | 47 | 3 | 13–14 | 10°-45° | 3C: n = 7 3CP: n = 15 4C: n = 5 4CP: n = 23 | Mean: 1.76 vs 1.44 | Schroth: 5 × 60 min of outpatient sessions delivered first 2 weeks, then 60 min 1×/week + 30 to 45 min of daily home sessions for 6 months. | Standard care, consisting of observation or bracing if the SRS bracing criteria were met. | |
RCT | 24 | 24 | 0 | 14–17 | 10°-27° | Not reported | Not reported | Schroth: 60 min, 3x/week for 12 weeks. | Pilates exercise: 60 min, 3x/week for 12 weeks. | |
Kuru et al [37] | RCT | 45 | 39 | 6 | 11–14 | 20°-50° | Not reported | Mean: 1.5 vs 1.4 vs 1.0 | Group 1: supervised Schroth + asymmetric position rotational breathing: 1.5 h/day, 60 min, 3x/week for 6 weeks + home program. Group 2: home Schroth exercise + asymmetric position rotational breathing, 18 sessions for 6 weeks. | Observation only. |
Monticone et al | RCT | 110 | 80 | 20 | 10–14 | 10°-25° | Thoracic: n = 16 Lumbar: n = 27 Thoracolumbar: n = 41 S-shaped: 26 | 0: n = 50 1: n = 60 | SEAS+ cognitive behavioral strategies + ergonomic education. 60 min of outpatient sessions delivered once a week + 30 min of home sessions 2x/week. Mean time on treatment = 42.8 months (SD 9.1). | General exercises for spinal mobilization. 60 min of outpatient sessions. Once a week + 30 min of home program sessions 2x/week at home. |
Study | Study period | Exercise compliance | Outcome measurements | Results | Evaluation of interaction effects | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Cobb | Trunk asymmetry | QoL | Others | Age | Bone maturity | Curve magnitudes | Exercise compliance | ||||
2.08 years | Not Reported | √ | × | × | × | 1.Significant Cobb reduction (6.8 ± 5.5° vs 1.5 ± 4.8°, p < 0.01) between the group A (age < 10 years, Risser 0) and the group C (age > 13 years, Risser 3). 2. Significant Cobb reduction was noted in subjects aged 10–12 (3.1 ± 4.2°). | Yes (* < 13 years) | Yes (*Risser: 0) | Unknown | N/A | |
4 months | Study: 64% Control:62% | √ | √ ATR POTSI WRVS | √ SRS-22 (initial mean: 4.0) | × | 1. D-value of Cobb: −5.3 ± 2.2° vs −4.8 ± 2.6° in thoracic; − 4.1 ± 2.5° vs − 3.5 ± 3.0 in lumbar; P > 0.05 between groups. 1. No difference of ATR, POTSI, WRVAS between groups. 2. Pain domain was only improved in the control group (4.7 vs 4.3). | Unknown | Unknown | Yes No difference | Unknown | |
10 weeks | Study:69% Control:88% | √ | √ ATR POTSI WRVS | √ SRS-22 (initial mean:3.9) | × | 1. Significant difference of D-value in Thoracic Cobb reduction between groups (− 7.33 ± 2.78° vs 0.63 ± 4.34°). 2. Body asymmetry was only improved in the study group (ATR: −4.3 vs − 4.2). 3. SRS-22 was unchanged in both groups. | Unknown | Unknown | Yes (* Thoracic) | Unknown | |
1 year | Study: 59 ± 0.2% Control: 58 ± 0.27% | √ | √ Shoulder-balance TAPS ATI | √ SRS-22 (initial mean:4.2) | × | 1. Greater Cobb reduction in the bracing group (5.58 ± 6.37° vs 2.24 ± 3.19°). 2. Shoulder balance was only improved in the bracing group. 3. Significant difference of functional domain (4.9 vs 4.7), mental domain (4.5 vs 4.2) between groups. | Unknown | Unknown | N/A | Unknown | |
18.1 ± 6.2 months | Study:77% Control:79% | √ | √ ATR | √ SRS-22 (initial mean:4.2) | × | 1. 17% improved, 62% stabilized and 21% worsened in the study group; 4% improved, 46% stabilized and 50% worsened in the control group. 2. No difference in the ATR between groups. 3. The SRS-22 result favored the exercise group (function domain: 4.8 vs 4.6). | Unknown | Unknown | Unknown | Unknown | |
8 weeks | Not reported | √ | × | × | √ Pulmonary function | 1. Significant Cobb reduction between groups (D-value of Cobb angle: 4.26 ± 1.36 vs 2.69 ± 1.11, p < 0.05) 2. Significant peak expiratory flow between groups (D-value of PEF: −1.30 ± 0.87 vs −0.17 ± 0.68, p < 0.05) | Unknown | N/A | N/A | N/A | |
6 months | Supervised:76%. Home program: 73% | √ | × | × | × | 1. Significantly (D-value of Cobb: −3.5° vs + 2.3°, p < 0.01) smaller largest curve and sum of curves (decreased 0.4°, p < 0.05) between groups. | Unknown | Unknown | Unknown | Unknown | |
3 months | Not reported | √ | × | × | √ Weight distribution | 1. Significant (P < 0.05) inter−/intra-group Cobb reduction: Schroth group: 23.6 ± 1.5° to 12.0 ± 4.7°; Pilate group: 24.0 ± 2.6° to 16.0 ± 6.9° 2. No difference of weight distribution in the control whereas significant (P < 0.05) improvement was noted in the study group. | Unknown | Unknown | N/A | N/A | |
24 weeks | Not reported | √ | √ ATR, height of hump, waist-asymmetry | √ SRS-23 (initial mean:3.9) | × | 1. Greater improvements in Cobb angle (−2.53°, P < 0.001), ATR (−4.23°, P < 0.001), height of hump (−68.66 cm, P < 0.01) and waist asymmetry (P < 0.01) were observed in the supervised exercise group compared with the home exercise group and control at 24-week. 2. No difference of QoL between groups (4.4 vs 3.9 vs 4.1). | Unknown | Unknown | N/A | N/A | |
Monticone et al.a,b | 42.8 months | Not reported | √ | √ ATR | √ SRS-22 (initial mean:3.8) | × | 1. Significant (−5.3° vs + 1.7°, p < 0.001) improvement of Cobb angles between groups at skeletal maturity and at 1-year follow up. 2. Significant difference of ATR between groups (−3.5° vs −0.4°, p < 0.001). 3. The Seas group showed significant (P < 0.001) improvements in all domains of the SRS-22 at skeletal maturity (1-year follow-up: 4.8 vs 4.0). | Yes (* ≥ 13 years) | Unknown | Unknown | N/A |