Effects of exercise interventions on adolescents with mild to moderate scoliosis: a meta-analysis
TL;DR
Exercise therapy demonstrates significant potential as a fundamental conservative intervention for improving spinal morphology, function, and quality of life in adolescents with idiopathic scoliosis.
Abstract
Background Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity that impairs physical function and quality of life. While supervised exercise is recommended for moderate cases, its effectiveness remains debated. This meta-analysis evaluates the impact of exercise therapy on Cobb angle, trunk rotation (ATR), and quality of life (QoL) in AIS patients. Methods We systematically searched PubMed, Web of Science, EBSCO and China National Knowledge Infrastructure (CNKI) databases from inception to October 2025 for randomized controlled trials (RCTs) investigating exercise in AIS. Study quality was assessed using the PEDro scale. Data synthesis involved pooling effect sizes, conducting subgroup analyses, and assessing publication bias using Stata 18. Results A total of 26 studies (21 RCT and five controlled trials) were included in the meta-analysis. The exercise intervention demonstrated statistically significant improvements across multiple functional domains: reduced the Cobb angle (Hedge’s = 1.22, 95% CI [0.90–1.53]), improved the ATR (Hedge’s systematically searched 1.25, 95% CI [0.74–1.76]), and enhanced QoL (Hedge’s systematically searched 0.73, 95% CI [0.38–1.09]). Subgroup analyses further indicated that Schroth-based training (Hedge’s = 1.304) and combined approaches (e.g., exercise with orthotic management) yielded the most favorable outcomes. Importantly, both short-term (≤12 weeks, 1–2 sessions/week) and long-term (≥25 weeks, ≥5 sessions/week) intervention durations demonstrated significant clinical efficacy. Conclusion Exercise therapy demonstrates significant potential as a fundamental conservative intervention for improving spinal morphology, function, and quality of life in adolescents with idiopathic scoliosis. The current evidence supports its integration into primary clinical management protocols. Future research should focus on conducting multi-center randomized controlled trials to validate long-term efficacy and to establish optimal, individualized intervention protocols.