Guidelines for the conservative treatment of spinal deformities - Questionnaire for a Delphi consensus.
Elif E Dereli, Shaopeng Gong, Tuğba Kuru Çolak and 1 others
PMID 34957343WHAT IT FOUND
130 international clinicians agreed on 46 conservative treatment statements for spinal deformities.
They favoured specific scoliosis exercises and bracing over general approaches, with rigid braces preferred to soft ones, and treatment intensity matched to growth risk.
Key findings
01Experts agreed that scoliosis therapy requires specific methods rather than general exercises, and that clinicians must be trained in these targeted interventions.
02Consensus favoured rigid braces over soft braces, and agreed that brace effectiveness increases with compliance and wearing time.
03Experts agreed on matching treatment intensity to growth risk, recommending observation for low-risk curves and physical rehabilitation plus bracing for high progression risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a consensus of expert opinion, not a trial of patient outcomes, so it cannot tell you whether these treatments work better than alternatives. The guideline was derived from the Schroth Best Practice protocol, and the authors who developed that protocol clarified the disputed statements, which may have introduced bias toward their own approach. Two of the 46 statements never reached the 80% threshold and were accepted by the authors despite falling short. Respondents were self-selected international clinicians with a special interest in spinal deformities; views of those who declined to participate may differ. Participation dropped from 130 to 94 in round two, and the composition of the remaining respondents may not have matched the first round. No patient outcomes, adverse events, or cost data were collected or analysed.
Declared interests
The article text does not include a funding or conflict of interest declaration. The guideline being validated was developed by the Schroth Best Practice Experts, and the study authors sought clarifications from those same experts for disputed statements.
The easy way to misread this
Do not read this as evidence that the Schroth method or these specific brace protocols produce better patient outcomes than alternatives. The study reports agreement among clinicians who already treat spinal deformities and who were asked to validate a pre-existing protocol; it measured opinion consensus, not treatment efficacy.