Effects of Specific Exercise Therapy on Adolescent Patients with Idiopathic Scoliosis: A Prospective Controlled Cohort Study

STUDY DESIGN: A prospective controlled cohort study. OBJECTIVE: To explore the interventional effect of exercise therapy on idiopathic scoliosis (IS) and identify an optimal intervention window. SUMMARY OF BACKGROUND DATA: Early conservative treatment is helpful for IS. In addition to bracing, current evidence suggests that exercise can play an important role. METHODS: We included 99 patients with IS who were treated at the Guangdong Xinmiao Scoliosis Center from August 2013 to September 2017. The inclusion criteria were: 1) new IS diagnosis, 2) Cobb angle 10-25 degrees , 3) Risser 0-3 grade, 4) only treated with the Xinmiao treatment system (XTS; >3 days/week, >1 h/day), and 5) follow-up longer than 1 year. Patients were divided into three age groups: A: /=5 degrees ), stability (Cobb angle change x +/-5 degrees ), and progression (Cobb angle increase >/=5 degrees ) were compared. RESULTS: The groups showed significant differences for major curve correction, Risser sign, first referral, and final follow-up of the main curve (all p < 0.05). The major curve in group A decreased significantly by 6.8 degrees (44% correction), compared to 3.1 degrees (18% correction) and 1.5 degrees (9% correction) in groups B and C, respectively. In group A, 69.0% (20/29) had curve improvement, 27.6% (8/29) stabilized and 3.4% (1/29) progressed. In group B, 45.8% (11/24) improved, 50% (12/24) stabilized, and 4.2% (1/24) progressed. In group C, 26.1% (12/46) improved, 63.0% (29/46) stabilized, and 10.9% (5/46) progressed. There was also a significant difference in final Risser grade among the groups (p < 0.05). CONCLUSION: For IS patients with Cobb angles between 10 degrees and 25 degrees , our exercise protocol can effectively control or improve curve progression. Younger patients with a lower Risser grade are most likely to respond. LEVEL OF EVIDENCE: 2.