The Effect of Physiotherapeutic Scoliosis-specific Exercises (psses) Combined With Bracing Versus Bracing Alone on Pulmonary Function in Adolescents With Moderate Idiopathic Scoliosis: a Systematic Review
Year: 2024
Type: review
Study design: Systematic Review
Abstract: Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that can impair pulmonary function due to thoracic structural changes.Bracing is a common nonoperative intervention, but its restrictive impact on lung function remains a concern.Physiotherapeutic scoliosis-specific exercises (PSSEs), particularly Schroth therapy, have been proposed to mitigate these effects.The additional role of three-dimensional braces, such as the Chêneau brace, in optimizing respiratory function is also gaining attention.Objective: This systematic review evaluates the impact of bracing alone versus bracing combined with Schroth therapy on pulmonary function in adolescents with moderate AIS.It also explores the influence of brace design on respiratory outcomes, focusing on Forced vital capacity (FVC) and Forced expiratory volume in one second (FEV1).Methods: A systematic search of PubMed, MEDLINE, Cochrane Library, and CINAHL was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.Studies included Randomized controlled trial (RCTs) and observational studies assessing pulmonary outcomes in AIS patients treated with bracing alone or in combination with Schroth therapy.Risk of bias was assessed using Risk Of Bias In Nonrandomized Studies of Interventions (ROBINS-I) and Cochrane Risk of Bias 2 Tool (RoB 2).Results: Eight studies met the inclusion criteria.Rigid bracing alone was linked to reductions in FVC, FEV1, and Total lung capacity (TLC).In contrast, Schroth therapy combined with bracing improved Inspiratory vital capacity (IVC) (+2.56%),FVC (+3.99%), and FEV1 (+2.36%) (p < 0.05).The Chêneau brace showed less pulmonary restriction than traditional rigid braces.Bias concerns were noted in observational studies.Conclusion: Bracing restricts pulmonary function in AIS, while Schroth therapy improves it.Combined with flexible 3D braces such as the Chêneau brace, it may offer superior outcomes.Further RCTs are needed to validate these findings.
DOI: 10.31407/ijees15.212
Authors: Luljeta Stanaj, Tirana, Albania, Enkeleda Sinaj, Selda V. Sokoli, Endrit Mone, Sebastjan Mjekaj, Julian Kraja, Muneeba Gul, Independent Researcher; Risalpur, Pakistan;
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410216619