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Effect of Bracing and Other Conservative Interventions in the Treatment of Idiopathic Scoliosis in Adolescents: A Systematic Review of Clinical Trials

M-LB Lenssinck, PT, BC, is Physiotherapist and Research Assistant, Department of General Practice, Erasmus Medical Centre Rotterdam, Rotterdam, the Netherlands
AC Frijlink, PT, BC, is Physiotherapist, Department of Physiotherapy, Hogeschool Rotterdam, Rotterdam, the Netherlands
MY Berger, PhD, MD, is Epidemiologist and Senior Researcher, Department of General Practice, Erasmus Medical Centre Rotterdam
SMA Bierma-Zeinstra, PT, PhD, is Physiotherapist and Associate Professor, Department of General Practice, Erasmus Medical Centre Rotterdam
K Verkerk, PT, MSc, is Physiotherapist and Assistant Professor, Department of Physiotherapy, Hogeschool Rotterdam
AP Verhagen, PT, PhD, is Physiotherapist, Epidemiologist, and Senior Researcher, Department of General Practice, Erasmus Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, the Netherlands (a.verhagen{at}eramusmc.nl).

Address all correspondence to Dr Verhagen

Background and Purpose. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in adolescents by systematically reviewing the literature. Methods. The literature was searched in the PubMed, CINAHL, Cochrane, and PEDro databases. Studies were selected if the design was a randomized clinical trial or a controlled clinical trial, if all patients had an idiopathic scoliosis, if all patients were less than 18 years of age during the intervention, and if the type of intervention was a conservative one. Two reviewers independently assessed the methodological quality using the Delphi list and performed data extraction. Analysis was based on the levels of evidence. Results. Thirteen studies met the final inclusion criteria, showing a wide range of interventions such as bracing, electrical surface stimulation, and exercises. Discussion and Conclusion. The authors conclude that the effectiveness of bracing and exercises is not yet established, but might be promising. They found no evidence of the effectiveness of electrical stimulation.

Key Words: Back pain • Bracing • Evidence-based practice • Exercise movement techniques • Idiopathic scoliosis • Immobilization • Pediatrics • Rehabilitation • Scoliosis • Spinal curvatures • Systematic review • Treatment outcome