ISICO (Italian Scientific Spine Institute), Milan, Italy.
Spine (Phila Pa 1976). 2013 Jun 15;38(14):E883-93. doi: 10.1097/BRS.0b013e31829459f8.
Systematic review of interventions.
To evaluate the efficacy of scoliosis-specific exercise (SSE) in adolescent patients with adolescent idiopathic scoliosis (AIS).
AIS is a 3-dimensional deformity of the spine. Although AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of SSEs to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial.
The following databases (up to March 30, 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SPORTDiscus (from January 1975), PsycINFO (from January 1887), and PEDro (from January 1929). We screened reference lists of articles and conducted an extensive hand search of gray literature.
randomized controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises.
Two review authors independently selected studies, assessed risk of bias and extracted data.
Two studies (154 participants) were included. There is low-quality evidence from 1 randomized controlled study that exercises as an adjunctive to other conservative treatments to increase the efficacy of these treatments (thoracic curve reduced: mean difference 9.00, [95% confidence interval, 5.47-12.53]; lumbar curve reduced: mean difference 8.00, [95% confidence interval, 5.08-10.92]). There is very low-quality evidence from a prospective controlled cohort study that SSEs structured within an exercise program can reduce brace prescription (risk ratio, 0.24; [95% confidence interval, 0.06-1.04]) as compared with "usual physiotherapy" [many different kinds of general exercises according to the preferences of the single therapists within different facilities]).
There is a lack of high-quality evidence to recommend the use of SSE for AIS. One very low-quality study suggested that these exercises may be more effective than electrostimulation, traction, and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice.
干预措施的系统评价。
评估脊柱侧弯特定运动（SSE）在青少年特发性脊柱侧弯（AIS）患者中的疗效。
AIS 是脊柱的三维畸形。尽管 AIS 在生长过程中可能会进展并导致表面畸形，但通常不会出现症状。然而，在成年期，如果最终脊柱曲率超过一定的临界阈值，健康问题和曲线进展的风险会增加。使用 SSE 来减少 AIS 的进展并推迟或避免其他更具侵袭性的治疗方法存在争议。
截至 2011 年 3 月 30 日，对以下数据库（无语言限制）进行了搜索：CENTRAL（Cochrane 图书馆 2011 年第 2 期）、MEDLINE（自 1966 年 1 月起）、EMBASE（自 1980 年 1 月起）、CINHAL（自 1982 年 1 月起）、SPORTDiscus（自 1975 年 1 月起）、PsycINFO（自 1887 年 1 月起）和 PEDro（自 1929 年 1 月起）。我们筛选了文章的参考文献列表，并对灰色文献进行了广泛的手工搜索。
比较运动与无治疗、其他治疗、手术和不同类型运动的随机对照试验和前瞻性队列研究，有对照组。
两位综述作者独立选择研究、评估偏倚风险并提取数据。
纳入了两项研究（154 名参与者）。一项随机对照研究提供了低质量证据，表明运动作为其他保守治疗的辅助手段可以增加这些治疗的疗效（胸椎曲线减少：平均差异 9.00，[95%置信区间，5.47-12.53]；腰椎曲线减少：平均差异 8.00，[95%置信区间，5.08-10.92]）。一项前瞻性对照队列研究提供了极低质量证据，表明在运动计划中进行 SSE 可以减少支具的使用（风险比，0.24；[95%置信区间，0.06-1.04]），与“常规物理治疗”相比[许多不同种类的一般运动，根据不同设施中每位治疗师的偏好]）。
目前缺乏高质量证据来推荐使用 SSE 治疗 AIS。一项极低质量的研究表明，这些运动可能比电刺激、牵引和姿势训练更有效，可以避免脊柱侧弯进展，但需要进行更高质量的研究，才能在临床实践中推荐使用 SSE。
2。
