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The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis.

Abstract

Background

Adolescent idiopathic scoliosis (AIS) is one of the most common structural spinal deformities in adolescents, becoming apparent around the time of puberty. Schroth scoliosis-specific exercises have demonstrated promising results in reducing the progression of AIS.

Objectives

The aim of this study was to identify, critically appraise and establish the best available evidence for the effectiveness of Schroth exercises in comparison to non-surgical management to reduce the progression of AIS.

Methodology

Seven databases were searched in April 2018. Main key search terms included AIS, Schroth exercises, physiotherapy, exercise, electrical stimulation, yoga, Pilates, tai chi and bracing. The quality of the trials was critically appraised according to the PEDro scale. Revman© Review Manager Software was used to pool the quality of life (QOL) results.

Results

Four randomised control trials with an average PEDro score of 6.75/10 were included in this study. Results indicated that Schroth exercises had a significant effect in decreasing the Cobb angle (p < 0.05) in comparison to non-surgical management. The pooled effect on QOL showed a significant result in favour of Schroth exercises at 12 weeks (p < 0.002) and at 24 weeks (p < 0.0004).

Conclusion

Level II evidence suggests that Schroth exercises have a significant effect on reducing the Cobb angle and improving QOL in adolescents with idiopathic scoliosis.

Clinical implications

This review's findings should be considered with caution for physiotherapy practice because of the limited number of identified articles and their methodologic limitations. Based on the current available and limited evidence, clinicians could combine supervised Schroth exercises with conventional physiotherapy care (observation, exercise, bracing and manual therapy) when treating adolescents with idiopathic scoliosis.

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  • Authors+Show Affiliations

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    ,

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31206094

    Citation

    Burger, Marlette, et al. "The Effectiveness of Schroth Exercises in Adolescents With Idiopathic Scoliosis: a Systematic Review and Meta-analysis." The South African Journal of Physiotherapy, vol. 75, no. 1, 2019, p. 904.
    Burger M, Coetzee W, du Plessis LZ, et al. The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis. S Afr J Physiother. 2019;75(1):904.
    Burger, M., Coetzee, W., du Plessis, L. Z., Geldenhuys, L., Joubert, F., Myburgh, E., ... Vermeulen, N. (2019). The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis. The South African Journal of Physiotherapy, 75(1), p. 904. doi:10.4102/sajp.v75i1.904.
    Burger M, et al. The Effectiveness of Schroth Exercises in Adolescents With Idiopathic Scoliosis: a Systematic Review and Meta-analysis. S Afr J Physiother. 2019;75(1):904. PubMed PMID: 31206094.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis. AU - Burger,Marlette, AU - Coetzee,Wilna, AU - du Plessis,Lenka Z, AU - Geldenhuys,Larissa, AU - Joubert,Francois, AU - Myburgh,Elzanne, AU - van Rooyen,Chante, AU - Vermeulen,Nicol, Y1 - 2019/06/03/ PY - 2018/10/10/received PY - 2019/02/05/accepted PY - 2019/6/18/entrez PY - 2019/6/18/pubmed PY - 2019/6/18/medline KW - Cobb angle KW - Schroth exercises KW - adolescent idiopathic scoliosis KW - meta-analysis KW - physiotherapy KW - quality of life KW - systematic review SP - 904 EP - 904 JF - The South African journal of physiotherapy JO - S Afr J Physiother VL - 75 IS - 1 N2 - Background: Adolescent idiopathic scoliosis (AIS) is one of the most common structural spinal deformities in adolescents, becoming apparent around the time of puberty. Schroth scoliosis-specific exercises have demonstrated promising results in reducing the progression of AIS. Objectives: The aim of this study was to identify, critically appraise and establish the best available evidence for the effectiveness of Schroth exercises in comparison to non-surgical management to reduce the progression of AIS. Methodology: Seven databases were searched in April 2018. Main key search terms included AIS, Schroth exercises, physiotherapy, exercise, electrical stimulation, yoga, Pilates, tai chi and bracing. The quality of the trials was critically appraised according to the PEDro scale. Revman© Review Manager Software was used to pool the quality of life (QOL) results. Results: Four randomised control trials with an average PEDro score of 6.75/10 were included in this study. Results indicated that Schroth exercises had a significant effect in decreasing the Cobb angle (p < 0.05) in comparison to non-surgical management. The pooled effect on QOL showed a significant result in favour of Schroth exercises at 12 weeks (p < 0.002) and at 24 weeks (p < 0.0004). Conclusion: Level II evidence suggests that Schroth exercises have a significant effect on reducing the Cobb angle and improving QOL in adolescents with idiopathic scoliosis. Clinical implications: This review's findings should be considered with caution for physiotherapy practice because of the limited number of identified articles and their methodologic limitations. Based on the current available and limited evidence, clinicians could combine supervised Schroth exercises with conventional physiotherapy care (observation, exercise, bracing and manual therapy) when treating adolescents with idiopathic scoliosis. SN - 2410-8219 UR - https://www.unboundmedicine.com/medline/citation/31206094/The_effectiveness_of_Schroth_exercises_in_adolescents_with_idiopathic_scoliosis:_A_systematic_review_and_meta-analysis L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31206094/ DB - PRIME DP - Unbound Medicine ER -