EFFECTS OF PHYSIOTHERAPY ON ADOLESCENT IDIOPATHIC SCOLIOSIS. A SYSTEMATIC REVIEW (original) (raw)
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Physiotherapy Quarterly
Introduction. Physiotherapy Scoliosis Specific Exercises (PSSE) is a conservative approach for the management of adolescent idiopathic scoliosis (AiS) designed according to the guidelines of the international Society on Scoliosis orthopaedic and Rehabilitation Treatment (SoSoRT). Hence the aim of the study is to evaluate the effectiveness of PSSE and conservative management strategies for patients with AiS. Methods. A systematic review was conducted and searches were carried out on a virtual database. The primary outcome measure analysed in this paper was Cobb angle and angle of trunk rotation, while the secondary outcome included functional capacity. A total of twelve studies were included in the review, which was analysed to determine the effects of conservative management of spinal scoliosis among adolescent aged children. Results. The study was conducted on patients who had developed idiopathic scoliosis and had a Cobb angle of greater than 10°. The significance of the conservative management protocol was estimated based on the reduction of Cobb angle by > 5° postintervention. Conclusions. This review concluded that therapeutic exercises alone have added to the noninvasive standard of care in reducing magnitude of Cobb angle among AiS patients. The studies reviewed in this paper provide significant evidence that a minimum of sixteen weeks of the exercise-based protocol has been able to produce a statistically and clinically significant result in Cobb angle reduction by almost 5° to 8°.
2018
Objectives The aim of this study is to examine the effectiveness of diverse exercise regimes used in multiple Randomized Control Trials as the only conservative management strategy for increased Cobb angle among Adolescent Idiopathic Scoliosis. Methods Database such as Google Scholar, Medline, and BioMed Central was reconnoitered for the purpose of research articles of interest. Studies in which the effects of conservative management of scoliosis on the magnitude of Cobb angle were calculated were scrutinized procedurally, studies fulfilling the inclusion criteria were retrieved and encompassed in the present study. Result A total of 698 cases of AIS that were included in 17 controlled trials are part of this meta-analysis. The pool effects were measured using a standardized mean difference between the experimental and control group at 95% of confidence interval using Hedges’g statistics. Outcomes analyzed, reveals favorable for exercises based experimental group in term of standard...
Evidence-Based of Nonoperative Treatment in Adolescent Idiopathic Scoliosis
2015
Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology, Iranian Orthopaedic Association, 2024
Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric spinal stabilization exercises (ASSE) method. Therefore, we hypot hesized that, first, there is no difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in the efficiency of SE and no intervention on corresponding variables in treating AIS. Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam's test), and QoL (Scoliosis Research Society-22 questionnaire). Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group (Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the control group (P<.001), whereas the control group remained almost unchanged. Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer treatment periods in future.
Asian spine journal, 2016
Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine which is usually not symptomatic and which can progress during growth and cause a surface deformity. In adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Although surgery is usually recommended for curvatures exceeding 40° to 50° to stop curvature progression, recent reviews have shed some light on the long-term complications of such surgery and to the lack of evidence for such complicated procedures within the scientific literature. Furthermore, a number of patients are very fearful of having surgery and refuse this option or live in countries where specialist scoliosis surgery is not available. Other patients may be unable to afford the cost of specialist scoliosis surgery. For these patients the only choice is an alternative non-surgical treatment option. To examine the impact of different management opt...
Scoliosis, 2010
Introduction and objectives: Physical deformities caused by adolescent idiopathic scoliosis (AIS) coupled with conservative treatment of AIS with orthesis unavoidably impacts on patients' quality of life (QoL). The present study aimed at evaluating the QoL in patients affected by AIS treated with brace. The study also sought to determine the ability of different QoL questionnaires to monitor QoL over the course of treatment. Materials and methods: Data were collected in 108 consecutive patients (96 females, 16 males) affected by AIS admitted to the outpatient orthopaedic clinic of the Catholic University of the Sacred Heart in Rome (Italy). Patients were subjected to full-time (i.e., 22 hrs per day) conservative treatment with the progressive action short brace (PASB), the Lyon brace or a combination of PASB + Lyon brace. Three instruments were used for QoL determination: the Scoliosis Research Society 22 (SRS-22), Bad Sobernheim Stress Questionnaire (BSSQ) and the Brace Questionnaire (BrQ). Results: A significant correlation was detected among the 3 scores (p < 0.001). The BrQ possesses a higher capacity to detect changes in QoL in relation to the patient gender, type of brace, curve severity at baseline and at the completion of treatment, and curve type. Overall, boys displayed a higher QoL than girls. In all 3 questionnaires, higher QoL scores were determined in patients treated with the PASB compared with those using the Lyon brace. QoL scores were significantly correlated with the curve severity. Higher QoL scores were obtained by participants with thoraco-lumbar curves as compared with those with other curves. Conclusions: The 3 questionnaires are effective in capturing changes in QoL in AIS patients subjected to conservative treatment. However, the BrQ possesses a higher discriminatory capacity compared with the other questionnaires tested. PASB-based treatment is associated with better QoL than the Lyon bracing. Figure 4 Correlations between curve severity at the time of questionnaire administration and summary scores at the BSSQ (A), SRS-22 (B) and BrQ (C).
Cureus, 2022
Adolescent idiopathic scoliosis (AIS) is an abnormal curvature of the spine that appears in late childhood or adolescence. The aim of this systematic review was to present and synthesize the most relevant therapeutic advice and evidence on the efficacy of physiotherapy exercises for preventing the growth of spinal curvature caused by adolescent idiopathic scoliosis. "Adolescent idiopathic scoliosis," "exercise," "Cobb angle," and "physiotherapy" were the sole keywords used for the published research. Using these keywords and a combination of them, electronic resources such as PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Elton B. Stephens Company (EBSCO) host, and ScienceDirect (Elsevier) were searched. The search was restricted to studies that were conducted in English between 2010 and 15 January 2022 that were controlled, randomized, and non-randomized. Studies were selected based on their titles and abstracts, with the exception of any that did not pertain to the study's goals. The Cobb angle was the important outcome measure. For each intervention, the Cobb angle's mean change score, the difference between the final and baseline scores, was determined. Nine studies were evaluated to be of outstanding quality out of a total of 20 studies that were reviewed for eligibility. With an exercise regimen of at least seven weeks, controls on lowering the Cobb angle in patients with AIS would provide encouraging outcomes. It also shows that bracing can strengthen the Cobb angle compared to exercise in the community. However, long-term orthotic activity ultimately results in trunk resistance and muscle loss in the center of the back. The combination of techniques and treatment methods seems to have better results in treating scoliosis, particularly using exercises involving the Schroth and scientific exercise approach to scoliosis (SEAS).
Qulaity of life after conservative treatment of adolescent idiopathic scoliosis
Studies in health technology and informatics
As an important consideration in medical care, health-related quality of life (HRQoL) refers to the patient's ability to enjoy normal life activities. When assessing the effectiveness of conservative treatment of AIS, HRQoL variables are more important than the radiographic results or pulmonary function. The present study examines the impact of conservative treatment in HRQoL of the AIS patients. Thirty-two female patients with a mean age of 13.5 (range 12-16) years, a mean Cobb angle of 29.4 degrees (range 21-38 degrees ) and a mean angle of trunk inclination (ATI) 7.9 degrees (range 5 degrees -18 degrees ) were treated with a full time application of a modified Boston brace and occasionally physiotherapy, for a minimum of 2 years. HRQoL was measured with the Brace Questionnaire (BrQ) at baseline and at the end of treatment. Correlations were determined by the Pearson correlation coefficient, with p < 0.05 considered significant. AIS patients scored lower in all the domains of BrQ at the end of treatment. This difference was statistically significant for the mean overall score of BrQ and for the domains of general health perception, physical functioning, emotional functioning, self-esteem and aesthetics, bodily pain and social functioning. The scores in the domains of vitality and school activity were not affected. The HRQoL immediately after the end of conservative treatment of AIS is found to have been negatively affected. Because of limitations in study design, this finding does not necessarily implicate the conservative treatment itself, but highlights the importance of HRQoL measurement in assessing how AIS patients perceive the impact of their disease.