STUDY DESIGN: Randomized controlled trial over one year. OBJECTIVES: Bouldering as a popular climbing discipline might have a therapeutic potential in adolescent idiopathic scoliosis (AIS). This trial examined the effectiveness of an innovative program compared to standard care. METHODS: Patients suffering from mild AIS (13.1 +/- 1.5 yrs, and female; 68%) were weekly treated by scoliosis- specific exercises (SSEs) during bouldering therapy (BT: n = 20, Potsdam model) or physiotherapy (PT: n = 21, Schroth-Method). After 12 months, changes in group-blinded max and sum score of Cobb-Angles as well as angle of trunk rotations (ATRs) were mainly analyzed by use of a mixed-ANOVA. RESULTS: Disregarding group, max Cobb: -1.9degrees +/- 4.9degrees; sum Cobb: -3.7degrees +/- 8.4degrees (excl. one outlier/group); max ATR: -1.3degrees +/- 1.5degrees; sum ATR: -2.6degrees +/- 2.7degrees were reduced significantly (main time effects: p < 0.001 to 0.021, f = 0.39 to 1.05). Post-hoc tests revealed significance in both groups for max and sum ATR (padj < 0.001 to 0.006, d 0.56 to 1.03). A significant group-by-time interaction (p = 0.039, f = 0.202) was found in sum ATR (BT: -3.48degrees versus PT: -1.76degrees). The improvements in ATR but not Cobb-Angle were below measurement error on group level. In each group, 20% improved and 5% deteriorated to a clinically meaningful extent in max Cobb (>= 5degrees). Regarding max ATR, 15% (BT) and 5% (PT) revealed an improvement >= 4degrees. No clinically relevant deterioration was seen. 85.7% wanted to continue with BT after intervention period. Most (74%) did not interpret it as a kind of treatment. CONCLUSIONS: Both, SSEs during BT and PT over one year can prevent potential progression of mild AIS and partly improve deformity. The BT program is suitable for youth and might improve adherence to specific exercises until or even beyond skeletal maturity.

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