Abstract

Background: To systematically evaluate and analyse the effect of different exercise types on the intervention of adolescent idiopathic scoliosis. The improvement effect was influenced by which type of exercise had a positive significance in improving Cobb angle (Cobb angle), angle of trunk rotation (ATR), and quality of life (QoL).

Methodology: Embase, Web of Science, PubMed, The Cochrane Library, Wanfang, Wipu, and China Knowledge Network databases were searched from the time of library construction to June 2024, and randomised controlled trials of literature screening of the health effects of different types of exercise on adolescents with scoliosis were conducted independently by 2 experimenters. PEDro was used for quality assessment, RevMan 5.4.1 and Stata 17.0 were used for Meta-analysis and publication bias test, respectively, and GRADEPro was used for quality of evidence evaluation of outcome indicators. Standardised mean difference (SMD) and 95% CI were used as effect statistics.

Results: A total of 35 papers (1864 patients) with 9 different exercise types were included in this study. Meta-analysis showed that for Cobb's Corner, resistance exercise [I ² =0%, SMD=-0.35, 95% CI(-0.69,-0.02), P=0.04], Pilates [I ² =0%, SMD=-0.72, 95% CI(- 1.02,-0.41), P<0.01], and suspension exercise (Sling exercise training (SET) [I ² =0%, SMD=-0.70, 95% CI (-1.01,-0.39), P<0.01], exercise was more effective in adolescents with adolescent Cobb's angle in idiopathic scoliosis, however, SET training's effect values were close and significant. For ATR, Pilates [I ² =0%, SMD=0.12, 95% CI (-0.37,0.61), P=0.63] had a better effect on the marker ATR when it was performed. For QoL, core stability training [I ² =32%, SMD=1.00, 95% CI (0.36,1.63), P< 0.01] had a better effect on marker QoL.

Conclusions: Thirty-five papers were included in this study, with a mean PEDro score of 6.2, and the quality of the literature was good. Subgroup analyses and sensitivity analyses of QoL, ATR, and Cobb's Corner metrics failed to identify sources of article heterogeneity, which is a limitation. Publication bias tests for QoL, ATR, and Cobb angle indicators suggested that there was no significant publication bias. Therefore, intermediate quality of evidence was given for QoL, ATR, and Cobb angle indicators. Different types of exercise have more significant improvement effects on QoL, ATR, and Cobb angle indicators, which can provide evidence-based medical evidence for clinical rehabilitation of adolescents with idiopathic scoliosis.