BACKGROUND: Physiotherapeutic scoliosis-specific exercise (PSSE) is recommended by SOSORT as the first step in the treatment of adolescent idiopathic scoliosis (AIS). However, a thorough summary and meta-analysis of the evidence for the effectiveness of PSSE is lacking. OBJECTIVE: To summarise the up-to-date evidence on the efficacy of PSSE in AIS compared with the other non-surgical therapies. DATA SOURCES: The PubMed, Web of Science, Cochrane, Scopus, Embase and CNKI databases were systematically searched from 1 January 2012 to 1 November 2022. STUDY SELECTION: Controlled trials comparing the effects of PSSE and other non-surgical therapies on improving Cobb angle and quality of life in young people aged 6 to 18 years were included. DATA SYNTHESIS: Three researchers independently extracted data and evaluated methodological quality. Meta-analysis was performed where possible; otherwise, descriptive syntheses were reported. RESULTS: Seventeen studies with a total of 930 participants (76% female) were included. Among them, ten studies were RCTs. Six studies were of excellent quality. Thirteen studies were included in the meta-analysis. PSSE corrected the Cobb angle in patients better than other non-surgical therapies (I2 82%, MD -2.82, 95% CI -4.17 to -1.48, p < 0.01). PSSE was more effective than brace in improving patients' pain, self-image and mental health. Patients with a Risser grade of 0 to 3 or who had never received brace therapy had better outcomes. CONCLUSION: Evidence from higher quality studies suggests that PSSE was superior to general exercise and conventional therapy for correcting the Cobb angle in AIS. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO ID CRD42022345157.

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