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Outcomes of 12 weeks of Schroth and asymmetric spinal stabilization exercises on Cobb angle, angle of trunk rotation, and quality of life in adolescent boys with idiopathic scoliosis: a randomized-controlled trial
Khaledi A, Minoonejad H, Daneshmandi H, Akoochakian M, Gheitasi M
The Archives of Bone and Joint Surgery 2024 Nov;12(1):26-35
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 hypothesized that, first, there is no difference in the efficiency of the combined exercises (SE plus 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 to 18-year-old boys) divided into three groups: SE (n = 15), SE plus 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 plus ASSE group (Cobb = 16.45degree to 9.01degree; ATR = 4.93degree to 1.33degree) compared to the SE group (p < 0.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb = 15.09degree to 9.77degree; ATR = 4.23degree to 2.17degree) compared to the control group (p < 0.001), 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.

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