Background/Purpose: The efficacy of the most common conservative treatments for adolescent idiopathic scoliosis (AIS) is controversial. The purpose of this paper is to determine whether scoliosis-specific exercise (SSE) is as effective as bracing on the outcomes of curve progression and reduction as measured by the Cobb angle. Case Description: The patient was an 11 year old female prescribed a Boston brace and referred to physical therapy for treatment of AIS. Her clinical characteristics indicated that she was at high risk for curve progression and possible need for surgery. The patient was upset at having to wear a brace and seemed unlikely to fully comply with brace treatment, making it worthwhile to investigate whether SSE might be of benefit. Outcomes: As this author was unable to undergo training in SSE while treating this patient, the patient was treated with exercises to strengthen the paraspinal musculature on the convex sides of the curves and to stretch the shortened paraspinal musculature on the concave sides of the curves in an attempt to stabilize or reduce the deformity, as well as additional exercises to address other impairments. The patient was close to meeting all physical therapy goals at the time of her final treatment by this author, however the effect of the intervention on Cobb angle was not able to be determined as radiographic evaluation of the patient was not indicated at this time. Discussion: Strong evidence indicates that bracing is more effective than observation, and low level evidence indicates that SSE is likely more effective than observation. It is unclear at this time whether SSE or bracing is a more effective intervention. Given the preliminary evidence supporting SSE and the fact that the patient was unlikely to be fully compliant with bracing, it is likely that the patient would have benefitted from SSE if she proved compliant with an exercise intervention.
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scoliosis, bracing, exercise, Cobb angle, adolescent idiopathic scoliosis
Charter, Alexi. "Effect of Specific Exercise versus Bracing on Cobb Angle in Moderate Adolescent Idiopathic Scoliosis." (2015). http://digitalrepository.unm.edu/dpt/109