title: Exercises for adolescent idiopathic scoliosis: a Cochrane systematic review.
abstract: METHODS
  Systematic review of interventions.
  
  
  OBJECTIVE
  To evaluate the efficacy of scoliosis-specific exercise (SSE) in adolescent patients with adolescent idiopathic scoliosis (AIS).
  
  
  BACKGROUND
  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.
  
  
  METHODS
  
  
  
  METHODS
  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.
  
  
  METHODS
  randomized controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises.
  
  
  METHODS
  Two review authors independently selected studies, assessed risk of bias and extracted data.
  
  
  RESULTS
  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]).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  2.
authors.affiliation: ISICO (Italian Scientific Spine Institute), Milan, Italy. michele.romano@isico.it
authors.forename: Michele
authors.initials: M
authors.lastname: Romano
authors.forename: Silvia
authors.initials: S
authors.lastname: Minozzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Zaina
authors.forename: Josette Bettany
authors.initials: JB
authors.lastname: Saltikov
authors.forename: Nachiappan
authors.initials: N
authors.lastname: Chockalingam
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kotwicki
authors.forename: Axel Maier
authors.initials: AM
authors.lastname: Hennes
authors.forename: Stefano
authors.initials: S
authors.lastname: Negrini
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D018450:Disease Progression; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012600:Scoliosis / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires