Scoliosis-specific exercise programmes and Evidence-Based Practice: An overview of systematic and critical reviews
Journal Title: Rehabilitacja Medyczna - Year 2012, Vol 16, Issue 4
Abstract
Objectives: The prevalence of adolescent idiopathic scoliosis is estimated at 2-3% of 10-16 year olds. The deformity may follow with pulmonary complications, decreased physical capacity, and an impaired health-related quality of life. Both surgical and conservative treatments are debatable. The paper presents an appraisal of systematic and critical reviews regarding scoliosis-specific exercises con¬ducted in individuals with adolescent idiopathic scoliosis - studies representing the highest level of evidence, according to the prin¬ciples of Evidence-Based Practice.Search strategy: MEDLINE/PubMed, as well as specific databases of systematic reviews: Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness (DARE), and Physiotherapy Evidence Database (PEDro), were examined. Then a hand search of the reference lists of included papers was conducted.Selection criteria: Based on titles and abstracts, and then on full texts, systematic reviews (with or without a meta-analysis) or reviews with a critical appraisal of included studies, were selected as eligible. Narrative reviews, expert opinions, clinical practice guidelines, original studies, and papers not dealing with scoliosis-specific exercises were excluded.Findings: Eighteen reports, out of 161 retrieved, met the selection criteria. The best reviews (according to the SIGN criteria of the levels of evidence) did not report on any convincing evidence for or against the effectiveness of scoliosis-specific exercises. The less rigorous reviews are more positive, although the more critical papers also have flaws. Conclusions: Despite the fact that the first systematic analysis on this subject of interest was published twenty years ago, and recently a rigorous Cochrane review has been released, the effectiveness of scoliosis-specific exercises remains questionable, while the clinical evidence for these interventions continues to be poor.
Authors and Affiliations
Maciej Płaszewski
Keywords
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