The effects of exercise on patients with moderate adolescent idiopathic scoliosis : a systematic review and meta-analysis.

Purpose: The effectiveness of exercise therapy for moderate adolescent idiopathic scoliosis and its potential benefits when combined with other treatments require further investigation. This systematic review and meta-analysis evaluated the efficacy of exercise therapy as a conservative management strategy for AIS. Methods: Following PRISMA guidelines, we searched PubMed, Cochrane Library, Embase, and Web of Science up to June 4, 2024, for RCTs. Eligible studies included AIS patients (10-18 years, Cobb angle 20°-45°) undergoing various exercise therapies, such as scoliosis-specific exercises and core stabilization training. Primary outcomes included Cobb angle, ATR, trunk appearance, QoL, and respiratory function. Data extraction and risk-of-bias assessment followed Cochrane guidelines, and study quality was evaluated using the 11-item PEDro scale. Meta-analyses were conducted based on standardized mean differences. Results: Eight RCTs with nine intervention groups were analyzed. At six months, exercise alone showed no significant advantage over bracing in improving Cobb angle, ATR, QoL, or trunk appearance (p < 0.05). However, exercise combined with other therapies significantly improved Cobb angle (MD = -6.11, 95% CI: -9.21 to -3.02), QoL (SMD = 0.89, 95% CI: 0.27 to 1.51), and lung function (SMD = 0.46, 95% CI: 0.13 to 0.80) at three months. These effects persisted for Cobb angle at six months (MD = -4.87, 95% CI: -8.77 to -0.98). Conclusions: Low to moderate evidence suggests exercise alone is comparable to bracing for AIS, while exercise combined with other therapies offers short-term benefits for Cobb angle, QoL, and lung function.