Physiotherapeutic Scoliosis-Specific Exercises (PSSE-Schroth) can reduce the risk for progression during early growth in curves below 25°: prospective control study.
Nikos Karavidas, Paris Iakovidis, Ioanna Chatziprodromidou and 4 others
PMID 38502554WHAT IT FOUND
Adolescents with mild scoliosis who did specific exercises five times a week had a 12.9% progression rate and 9.8% brace need, compared to 74.1% progression and 67.2% brace need in controls.
Compliance was key: fully compliant patients had only 7.7% progression.
Key findings
01The exercise group had significantly lower progression and brace prescription rates than the control group, with a success rate of 87.1% versus 25.9%.
02Fully compliant patients had a 94.8% success rate and only 5.1% brace prescription, significantly better than poorly compliant patients.
03Primary radiological outcomes showed significant improvement in lumbar curves but not thoracic curves, though clinical appearance and quality of life scores improved significantly.
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
The study was not randomized; patients were assigned to the exercise group if they sought treatment, creating potential selection bias. The control group was retrospective and may overestimate progression because patients with stable curves might not have returned for follow-up. Risser sign was used to determine skeletal maturity, which is less accurate than the Sanders scale, potentially misclassifying some patients' growth status. Dropouts were excluded from the primary efficacy analysis, although a worst-case analysis was also performed. The control group did not receive a standardized 'no treatment' intervention but rather 'general or no exercises' as advised by their previous doctors, making it difficult to isolate the effect of the specific PSSE-Schroth method from the effect of receiving any structured physiotherapy.
Declared interests
No conflicts of interest were reported in the provided text.
The easy way to misread this
Do not assume that PSSE-Schroth is superior to all other scoliosis-specific exercise methods, as this study compared it only to general or no exercise, not to other specific programs like SEAS or BSPTS. Additionally, the lack of randomization means the control group may not be truly comparable, so the magnitude of the benefit might be overestimated.