Exercises in Adolescent Idiopathic Scoliosis
Exercises in Adolescent Idiopathic Scoliosis
The purpose of this study was to investigate the effectiveness of two different exercises in
 adolescent idiopathic scoliosis. In total, 28 subjects with adolescent idiopathic scoliosis
 were randomly divided into two groups: Schroth (n = 14) and stabilization group (n = 14). The
 Schroth group received Schroth exercises in addition to traditional rehabilitation, and the
 stabilization group received core stabilization in addition to traditional rehabilitation for
 10 weeks. The outcome measures were based on Cobb angle, angle of trunk rotation, spinal
 mobility, cosmetic trunk deformity, muscle strength, and quality of life.
Adolescent idiopathic scoliosis (AIS) is a progressive growth disease with unknown etiology,
 characterized by a three-dimensional deformity of the spine (frontal translation, sagittal
 modification, and torsion of the spinous processes on the concave side of the scoliotic curve
 on radiographs).

 In patients with AIS, in addition to curve progression there are many problems commonly occur
 such as; muscular imbalance, functional limitations, altered posture, gait deviations,
 reduced flexibility of the spine, back pain, negative physico-social, body image effects, and
 in severe cases pulmonary symptoms. The asymmetry of the trunk and pelvis are affected
 related to the shape and angle of scoliosis, and the weight distribution position changes
 depending on the shape and the Cobb angle of scoliosis. To deal with these complications and
 more, various treatment approaches have been proposed for AIS, including exercise, bracing,
 casting, traction, biofeedback, surgery, and simple observation to prevent, correct or halt
 the progression of the deformity. Conservative treatment methods including physiotherapy and
 bracing are accepted in Central Europe.

 In literature, exercises are recommended to decrease progression, to improve spine and
 thoracic cage flexibility, muscle strengths, and elasticity, to correct postural behavior,
 and neuro-motor control, spine stability. In general, traditional exercises (TE) including
 postural training, stretching, and strengthening exercises for spinal musculature,
 respiratory exercises have been used for many years for scoliosis. Except for the traditional
 exercises, there are several exercise concepts including Schroth, Side Shift, Dobomed
 methods... etc. Schroth exercises are asymmetric scoliosis-specific postural exercises that
 aim to improve the curve, function, posture, self-image, and pain. Schroth exercises target
 strength and endurance training of the back, abdominal, and leg muscles. Also one of the aim
 of Schroth exercises is to improve motor control of the posture by repeating corrective
 movements with progressively less feedback. Schroth exercises are the most studied scoliosis
 exercises but there are limited randomized controlled studies on Schroth exercises.

 Recently general physiotherapeutic exercises including, Core stabilization (CS) exercises,
 Pilates have been used in the conservative treatment of idiopathic scoliosis. CS exercises
 are described as therapy techniques that improve postural control, and functional stability
 through increasing neuromuscular control, the strength of trunk stabilization muscles, the
 endurance of postural muscles around the spine, the balance between pelvis and spine.
 However, limited studies are determining CS exercises' effect on patients with AIS. In a
 study CS exercises found to be more effective in reducing pain and rotational deformity than
 traditional exercises in the conservative rehabilitation of AIS.

 A recent systematic review showed that therapeutic exercise had been effective to reduce
 symptoms, Cobb's angle, trunk rotation, craniovertebral angle, and body asymmetries, and to
 improve muscular endurance, pulmonary function, and functional capacity of patients with AIS.
 Corrective, therapeutic exercises appear to have positive effects by improving function and
 reducing symptoms, as well as various angles and body asymmetries. However, further studies
 with better methodological quality are required to confirm these outcomes and detect the best
 therapeutic exercise intervention. And also there is a need for randomized controlled studies
 on different methods of exercise to choose the most effective exercise in clinical practice.

 There was no research compared to the effects of the Schroth method and CS exercises in
 patients with AIS. And also there was no research examining the effects of the Schroth method
 on peripheral muscle strengths. This study aimed to investigate the effects of the Schroth
 versus CS exercises in addition to traditional exercises, on Cobb angle, trunk rotation,
 peripheral muscle strengths, spine mobility, cosmetic deformity, and health-related quality
 of life in patients with AIS.
Inclusion Criteria:

 -  Having a diagnosis of adolescent idiopathic scoliosis,

 -  A Cobb angle of 10 to 30 degrees

 -  Having Lenke type 1 curve

 -  No other treatment which might affect scoliosis

 Exclusion Criteria:

 -  Non-idiopathic scoliosis

 -  Prescribed brace

 -  Surgical correction history

 -  Who were unable to participate in the supervised sessions,or those who refused to
 follow treatment were excluded.

 -  Contraindications to exercise -Accompanying mental problems, neurological- muscular or
 rheumatic diseases,