Core Stabilization Exercises vs. Schroth's Three Dimensional Exercises to Treat Adolescent Idiopathic Scoliosis: A Systematic Review

Arash Khaledi; Hooman Minoonejad; Mahdieh  Akoochakian; Mehdi  Gheitasi

doi:10.18502/ijph.v53i1.14685

Arash Khaledi Department of Sport Sciences, Kish International Campus, University of Tehran, Kish, Iran
Hooman Minoonejad Department of Sports Injury and Biomechanics, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
Mahdieh Akoochakian Department of Sport Sciences, Kish International Campus, University of Tehran, Kish, Iran
Mehdi Gheitasi Department of Health & Sport Rehabilitation, Faculty of Sport Science & Health, University of Shahid Beheshti, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v53i1.14685

Keywords: Systematic review; Scoliosis; Exercise therapy; Core stabilization; Schroth method

Abstract

Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth’s exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS.

Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers.

Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA>5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA<5˚).

Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.