Simon C Mordecai1, Harshad V Dabke. 1. Department of Trauma and Orthopaedics, Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ, UK. Simon_mordecai@yahoo.com
Abstract
PURPOSE: Current evidence regarding the use of exercise therapy in the treatment of adolescent idiopathic scoliosis (AIS) was assessed with a review of published literature. METHODS: An extensive literature search was carried out with commonly used medical databases. A total of 155 papers were identified out of which only 12 papers were deemed to be relevant. RESULTS: There were nine prospective cohort studies, two retrospective studies and one case series. All studies endorsed the role of exercise therapy in AIS but several shortcomings were identified--lack of clarity of patient recruitment and in the method of assessment of curve magnitude, poor record of compliance, and lack of outcome scores. Many studies reported "significant" changes in the Cobb angle after treatment, which were actually of small magnitude and did not take into account the reported inter or intra-observer error rate. All studies had poor statistical analysis and did not report whether the small improvements noted were maintained in the long term. CONCLUSIONS: This unbiased literature review has revealed poor quality evidence supporting the use of exercise therapy in the treatment of AIS. Well-designed randomised controlled studies are required to assess the role of exercise therapy in AIS.
PURPOSE: Current evidence regarding the use of exercise therapy in the treatment of adolescent idiopathic scoliosis (AIS) was assessed with a review of published literature. METHODS: An extensive literature search was carried out with commonly used medical databases. A total of 155 papers were identified out of which only 12 papers were deemed to be relevant. RESULTS: There were nine prospective cohort studies, two retrospective studies and one case series. All studies endorsed the role of exercise therapy in AIS but several shortcomings were identified--lack of clarity of patient recruitment and in the method of assessment of curve magnitude, poor record of compliance, and lack of outcome scores. Many studies reported "significant" changes in the Cobb angle after treatment, which were actually of small magnitude and did not take into account the reported inter or intra-observer error rate. All studies had poor statistical analysis and did not report whether the small improvements noted were maintained in the long term. CONCLUSIONS: This unbiased literature review has revealed poor quality evidence supporting the use of exercise therapy in the treatment of AIS. Well-designed randomised controlled studies are required to assess the role of exercise therapy in AIS.
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Authors: Stefano Negrini; Sabrina Donzelli; Angelo Gabriele Aulisa; Dariusz Czaprowski; Sanja Schreiber; Jean Claude de Mauroy; Helmut Diers; Theodoros B Grivas; Patrick Knott; Tomasz Kotwicki; Andrea Lebel; Cindy Marti; Toru Maruyama; Joe O'Brien; Nigel Price; Eric Parent; Manuel Rigo; Michele Romano; Luke Stikeleather; James Wynne; Fabio Zaina Journal: Scoliosis Spinal Disord Date: 2018-01-10
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