SYSTEMATIC REVIEW article
Front. Med.
Sec. Family Medicine and Primary Care
This article is part of the Research TopicLifestyle behaviors and chronic diseases: pathways, interventions, knowledge and public health challengesView all 10 articles
Effect of Exercise Therapy on Adolescent Idiopathic Scoliosis in Mild to Moderate: A Systematic Review and Network Meta-analysis
Provisionally accepted
- 1Shaanxi Normal University, Xi'an, China
- 2Guangxi Normal University, Guilin, China
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Objectives: To identify the most effective exercise for reducing Cobb angle, angle of trunk rotation (ATR), and improving quality of life in adolescents with idiopathic scoliosis (AIS). Methods: A systematic search of EMBASE, Web of Science, PubMed, Cochrane Library, and MEDLINE identified randomized controlled trials (RCTs) on exercise interventions for light to moderate AIS. Eligible studies involved AIS patients receiving exercise therapy, with outcomes measured by Cobb angle, ATR, and quality of life scores. The search included articles published from the inception of these databases until June 2025. Two independent researchers conducted screening, data extraction, and quality assessment using the Cochrane Risk of Bias tool. Network meta-analysis (NMA) was performed with Stata 16.0, reported per PRISMA-NMA guidelines. The protocol was registered in PROSPERO (CRD42024557874). Results: Sixteen RCTs involving 600 participants were included. Compared to controls, Schroth exercise significantly improved Cobb angle [SMD=-1.42, 95% CI (- 2.03, -0.80)] and ATR [SMD=-1.86, 95% CI (-3.05, -0.68)]. The Lyon method showed the most significant improvement in quality of life [SMD=2.64, 95% CI (0.80, 4.49)]. The SEAS exercise also helps improve the Cobb angle, but its effect is weaker. Conclusions: Exercise therapy effectively reduces spinal curvature and enhances quality of life in adolescents with AIS. Schroth exercises are most effective for improving Cobb angle and ATR, while Lyon therapy significantly benefits quality of life. However, due to small sample sizes, substantial between-study heterogeneity, and risk of bias, the overall certainty of evidence is low; results should be interpreted cautiously.
Keywords: Idiopathic scoliosis, Exercise, Adolescent, Network meta-analysis, Exercise Intervention
Received: 19 Sep 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Zhu, Li, Tian and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiang Zhang, zhangqiang@gxnu.edu.cn
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