Effect of Schroth therapy on adolescent idiopathic scoliosis: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Masen ^1,2 , HU Qiaoqiao ^1,3 , CUI Jing ⁴ ,  SUN Yuliang ⁵

1. Department of Physical Education, Northwestern Polytechnical University, Xi’an 710072, P. R. China;
2. School of Life Sciences, Northwestern Polytechnical University, Xi’an 710072, P. R. China;
3. School of Public Policy and Administration, Northwestern Polytechnical University, Xi’an 710072, P. R. China;
4. School of Nursing and Rehabilitation, Xi’an Fanyi University, Xi’an 710105, P. R. China;
5. School of Physical Education, Shaanxi Normal University, Xi’an 710119, P. R. China;

Corresponding?author：

SUN Yuliang, Email: ysun@snnu.edu.cn

Keywords：

Adolescent idiopathic scoliosis; Physical therapy; Schroth; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202502064

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effect of Schroth therapy on adolescent idiopathic scoliosis. Methods The PubMed, EBSCO, Embase, Cochrane Library, Web of Science, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. Results A total of 14 RCTs involving 589 patients were included. The results of meta-analysis showed that Schroth therapy significantly reduced patients' Cobb angle (MD=?3.21, 95%CI ?3.87 to ?2.55, P<0.01) and angle of trunk rotation (ATR) (MD=?2.39, 95%CI ?3.07 to ?1.71, P<0.01), and improved SRS-22 quality of life score (MD=0.16, 95%CI 0.01 to 0.30, P=0.04) compared with the control group. Subgroup analysis results showed that Schroth therapy had a better effect on improving the quality of life in moderate patients. Schroth therapy for 1.5-3 months, 5-7 times therapy a week, and a single 30 minute and 40-60 minutes therapy showed better improvement in patients' quality of life. Conclusion ?Current evidence shows that Schroth therapy can effectively improve Cobb angle, ATR, and quality of life in adolescents with idiopathic scoliosis. The improvement effect on quality of life is influenced by the intervention period, frequency, and duration of each intervention.

Citation： ZHANG Masen, HU Qiaoqiao, CUI Jing, SUN Yuliang. Effect of Schroth therapy on adolescent idiopathic scoliosis: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2025, 25(9): 1033-1038. doi: 10.7507/1672-2531.202502064 Copy

1.	封玉琨, 劉介生, 呂振, 等. 青少年特發性脊柱側凸運動康復治療的研究進展. 中國脊柱脊髓雜志, 2021, 31(11): 1039-1043.
2.	張威, 卜淑敏, 王濤, 等. 運動干預對青少年輕、中度特發性脊柱側彎患者療效的Meta分析. 中國循證醫學雜志, 2022, 22(8): 896-900.
3.	王歡, 頡強, 陸清達, 等. 青少年特發性脊柱側凸患者骨骼生長發育評價的研究進展. 中國脊柱脊髓雜志, 2023, 33(2): 174-178.
4.	柯竟悅, 馬圣楠, 張曉慧, 等. 青少年特發性脊柱側凸患者靜態站立及步行時生物力學變化的Meta分析. 中國康復理論與實踐, 2022, 28(10): 1178-1189.
5.	施冬冬, 陳前芬. 青少年特發性脊柱側凸病因學的研究進展. 中國學校衛生, 2021, 42(2): 316-320.
6.	徐帥, 蘇永佳, 王振波, 等. 中國大陸中小學生脊柱側凸的患病特點: 關于72項研究的Meta分析. 中國脊柱脊髓雜志, 2021, 31(10): 901-910.
7.	張桂芳, 黃煥杰, 葛樂, 等. 青少年特發性脊柱側凸患者的社會心理行為分析及應對措施探討. 中國康復醫學雜志, 2023, 38(12): 1656-1662.
8.	Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord, 2018, 13(3): 1-48.
9.	王陽陽, 李楊. 特定運動療法在特發性脊柱側凸患者中的應用及效果研究進展-以Schroth療法為例. 中國康復醫學雜志, 2019, 34(11): 1378-1382.
10.	Büyükturan ?, Kaya MH, Alkan H, et al. Comparison of the efficacy of Schroth and Lyon exercise treatment techniques in adolescent idiopathic scoliosis: a randomized controlled, assessor and statistician blinded study. Musculoskelet Sci Pract, 2024, 72(1): 102952.
11.	Kocaman H, Bek N, Kaya MH, et al. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: a single-blind, randomized-controlled trial. PLoS One, 2021, 16(4): e0249492.
12.	Hwangbo PN. Psychological and physical effects of Schroth and pilates exercise on female high school students with idiopathic scoliosis. J Korean Phys Ther, 2016, 28(6): 364-368.
13.	Kim G, HwangBo PN. Effects of Schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis. J Phys Ther Sci, 2016, 28(3): 1012-1015.
14.	Ceballos-Laita L, Carrasco-Uribarren A, Cabanillas-Barea S, et al. The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis. Eur J Phys Rehabil Med, 2023, 59(2): 228-236.
15.	Dimitrijevi? V, ??epanovi? T, Jevti? N, et al. Application of the Schroth method in the treatment of idiopathic scoliosis: a systematic review and meta-analysis. Int J Environ Res Public Health, 2022, 19(24): 16730.
16.	Chen C, Xu J, Li H. Effects of Schroth 3D exercise on adolescent idiopathic scoliosis: a systematic review and meta-analysis. Children (Basel), 2024, 11(7): 806.
17.	Park JH, Jeon HS, Park HW. Effects of the Schroth exercise on idiopathic scoliosis: a meta-analysis. Eur J Phys Rehabil Med, 2018, 54(3): 440-449.
18.	Czaprowski D, Kotwicki T, Biernat R, et al. Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures. Eur Spine J, 2012, 21(6): 1099-1105.
19.	曾憲濤, 劉同族, 田國祥. 應用STATA做meta分析. 北京: 軍事醫學科學出版社, 2014.
20.	Akyurek E, Zengin Alpozgen A, Akgul T. The preliminary results of physiotherapy scoliosis-specific exercises on spine joint position sense in adolescent idiopathic scoliosis: a randomized controlled trial. Prosthet Orthot Int, 2022, 46(5): 510-517.
21.	Kurak K, Altunhan A, Acak M, et al. The effect of electrical muscle stimulation (ems) enhanced Schroth method training on cobb angle and quality of life in patients with scoliosis. Pakistan J Med Health Sci, 2022, 16(1): 566-570.
22.	Kuru T, Yeldan ?, Dereli EE, et al. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil, 2016, 30(2): 181-190.
23.	Mohamed RA, Yousef AM. Impact of Schroth three-dimensional vs. proprioceptive neuromuscular facilitation techniques in adolescent idiopathic scoliosis: a randomized controlled study. Eur Rev Med Pharmacol Sci, 2021, 25(24): 7717-7725.
24.	Schreiber S, Parent EC, Khodayari Moez E, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better Cobb angle outcomes in adolescents with idiopathic scoliosis - an assessor and statistician blinded randomized controlled trial. PLoS One, 2016, 11(12): e0168746.
25.	Zapata KA, Dieckmann RJ, Hresko MT, et al. A United States multi-site randomized control trial of Schroth-based therapy in adolescents with mild idiopathic scoliosis. Spine Deform, 2023, 11(4): 861-869.
26.	許銳. "三步七法"推拿在青少年特發性脊柱側彎中的應用效果. 中國當代醫藥, 2022, 29(10): 135-139.
27.	葉勇智. 輕度特發性脊柱側凸患者應用: 柱側凸特定運動療法的可行性. 中外醫學研究, 2018, 16(28): 19-21.
28.	Schreiber S, Parent EC, Moez EK, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". Scoliosis, 2015, 10(1): 1-12.
29.	Tombak K, Yüksel ?, Ozsoy U, et al. A comparison of the effects of supervised versus home schroth exercise programs with adolescent idiopathic scoliosis. Children (Basel), 2024, 11(3): 354.
30.	Cheung JPY, Cheung PWH, Yeng WC, et al. Does curve regression occur during underarm bracing in patients with adolescent idiopathic scoliosis. Clin Orthop Relat Res, 2020, 478(2): 334-345.
31.	楊麗虹, 劉少南, 吳大嶸, 等. 最小臨床意義差值的概念及其估算方法. 中國循證醫學雜志, 2020, 20(11): 1345-1352.
32.	常贏, 扈盛, 趙祥虎, 等. 脊柱側凸特定運動療法治療青少年特發性脊柱側凸效果的Meta分析. 中國脊柱脊髓雜志, 2024, 34(6): 602-609.
33.	Berdishevsky H, Lebel VA, Bettany-Saltikov J, et al. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. Scoliosis Spinal Disord, 2016, 11(20): 1-52.
34.	Sato K, Ito T, Endo T, et al. Novel assessment of physiotherapy outcomes in adults with structural spinal disorders. Eur Spine J, 2023, 32(6): 1887-1894.
35.	張娟娟, 蔣楠楠, 吳亞軍, 等. Schroth療法聯合核心力量訓練改善輕度青少年特發性脊柱側凸患者的側凸角度. 中國組織工程研究, 2025, 29(1): 1-7.
36.	李明, 王傳鋒, 賀石生, 等. 簡體中文版脊柱側凸研究學會22項問卷表(SRS-22)的信度和效度評價. 第二軍醫大學學報, 2008, 29(2): 203-205.
37.	陳紹豐, 李博, 周瀟逸, 等. 青少年特發性脊柱側凸相關生活質量評價量表現狀. 第二軍醫大學學報, 2020, 41(11): 1188-1192.
38.	Crawford CH, Glassman SD, Bridwell KH, et al. The minimum clinically important difference in SRS-22R total score, appearance, activity and pain domains after surgical treatment of adult spinal deformity. Spine (Phila Pa 1976), 2015, 40(6): 377-381.
39.	肖斌, 張延斌, 閻凱, 等. 青少年特發性脊柱側凸患者與家屬對治療前SRS-22量表評分認知的一致性及影響因素. 中國脊柱脊髓雜志, 2021, 31(8): 699-704.
40.	Park J, So WY. The effect of the Schroth rehabilitation exercise program on spinal and feet alignment in adolescent patients with idiopathic scoliosis: a pilot study. Healthcare (Basel), 2022, 10(2): 398.

1. 封玉琨, 劉介生, 呂振, 等. 青少年特發性脊柱側凸運動康復治療的研究進展. 中國脊柱脊髓雜志, 2021, 31(11): 1039-1043.
2. 張威, 卜淑敏, 王濤, 等. 運動干預對青少年輕、中度特發性脊柱側彎患者療效的Meta分析. 中國循證醫學雜志, 2022, 22(8): 896-900.
3. 王歡, 頡強, 陸清達, 等. 青少年特發性脊柱側凸患者骨骼生長發育評價的研究進展. 中國脊柱脊髓雜志, 2023, 33(2): 174-178.
4. 柯竟悅, 馬圣楠, 張曉慧, 等. 青少年特發性脊柱側凸患者靜態站立及步行時生物力學變化的Meta分析. 中國康復理論與實踐, 2022, 28(10): 1178-1189.
5. 施冬冬, 陳前芬. 青少年特發性脊柱側凸病因學的研究進展. 中國學校衛生, 2021, 42(2): 316-320.
6. 徐帥, 蘇永佳, 王振波, 等. 中國大陸中小學生脊柱側凸的患病特點: 關于72項研究的Meta分析. 中國脊柱脊髓雜志, 2021, 31(10): 901-910.
7. 張桂芳, 黃煥杰, 葛樂, 等. 青少年特發性脊柱側凸患者的社會心理行為分析及應對措施探討. 中國康復醫學雜志, 2023, 38(12): 1656-1662.
8. Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord, 2018, 13(3): 1-48.
9. 王陽陽, 李楊. 特定運動療法在特發性脊柱側凸患者中的應用及效果研究進展-以Schroth療法為例. 中國康復醫學雜志, 2019, 34(11): 1378-1382.
10. Büyükturan ?, Kaya MH, Alkan H, et al. Comparison of the efficacy of Schroth and Lyon exercise treatment techniques in adolescent idiopathic scoliosis: a randomized controlled, assessor and statistician blinded study. Musculoskelet Sci Pract, 2024, 72(1): 102952.
11. Kocaman H, Bek N, Kaya MH, et al. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: a single-blind, randomized-controlled trial. PLoS One, 2021, 16(4): e0249492.
12. Hwangbo PN. Psychological and physical effects of Schroth and pilates exercise on female high school students with idiopathic scoliosis. J Korean Phys Ther, 2016, 28(6): 364-368.
13. Kim G, HwangBo PN. Effects of Schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis. J Phys Ther Sci, 2016, 28(3): 1012-1015.
14. Ceballos-Laita L, Carrasco-Uribarren A, Cabanillas-Barea S, et al. The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis. Eur J Phys Rehabil Med, 2023, 59(2): 228-236.
15. Dimitrijevi? V, ??epanovi? T, Jevti? N, et al. Application of the Schroth method in the treatment of idiopathic scoliosis: a systematic review and meta-analysis. Int J Environ Res Public Health, 2022, 19(24): 16730.
16. Chen C, Xu J, Li H. Effects of Schroth 3D exercise on adolescent idiopathic scoliosis: a systematic review and meta-analysis. Children (Basel), 2024, 11(7): 806.
17. Park JH, Jeon HS, Park HW. Effects of the Schroth exercise on idiopathic scoliosis: a meta-analysis. Eur J Phys Rehabil Med, 2018, 54(3): 440-449.
18. Czaprowski D, Kotwicki T, Biernat R, et al. Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures. Eur Spine J, 2012, 21(6): 1099-1105.
19. 曾憲濤, 劉同族, 田國祥. 應用STATA做meta分析. 北京: 軍事醫學科學出版社, 2014.
20. Akyurek E, Zengin Alpozgen A, Akgul T. The preliminary results of physiotherapy scoliosis-specific exercises on spine joint position sense in adolescent idiopathic scoliosis: a randomized controlled trial. Prosthet Orthot Int, 2022, 46(5): 510-517.
21. Kurak K, Altunhan A, Acak M, et al. The effect of electrical muscle stimulation (ems) enhanced Schroth method training on cobb angle and quality of life in patients with scoliosis. Pakistan J Med Health Sci, 2022, 16(1): 566-570.
22. Kuru T, Yeldan ?, Dereli EE, et al. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil, 2016, 30(2): 181-190.
23. Mohamed RA, Yousef AM. Impact of Schroth three-dimensional vs. proprioceptive neuromuscular facilitation techniques in adolescent idiopathic scoliosis: a randomized controlled study. Eur Rev Med Pharmacol Sci, 2021, 25(24): 7717-7725.
24. Schreiber S, Parent EC, Khodayari Moez E, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better Cobb angle outcomes in adolescents with idiopathic scoliosis - an assessor and statistician blinded randomized controlled trial. PLoS One, 2016, 11(12): e0168746.
25. Zapata KA, Dieckmann RJ, Hresko MT, et al. A United States multi-site randomized control trial of Schroth-based therapy in adolescents with mild idiopathic scoliosis. Spine Deform, 2023, 11(4): 861-869.
26. 許銳. "三步七法"推拿在青少年特發性脊柱側彎中的應用效果. 中國當代醫藥, 2022, 29(10): 135-139.
27. 葉勇智. 輕度特發性脊柱側凸患者應用: 柱側凸特定運動療法的可行性. 中外醫學研究, 2018, 16(28): 19-21.
28. Schreiber S, Parent EC, Moez EK, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". Scoliosis, 2015, 10(1): 1-12.
29. Tombak K, Yüksel ?, Ozsoy U, et al. A comparison of the effects of supervised versus home schroth exercise programs with adolescent idiopathic scoliosis. Children (Basel), 2024, 11(3): 354.
30. Cheung JPY, Cheung PWH, Yeng WC, et al. Does curve regression occur during underarm bracing in patients with adolescent idiopathic scoliosis. Clin Orthop Relat Res, 2020, 478(2): 334-345.
31. 楊麗虹, 劉少南, 吳大嶸, 等. 最小臨床意義差值的概念及其估算方法. 中國循證醫學雜志, 2020, 20(11): 1345-1352.
32. 常贏, 扈盛, 趙祥虎, 等. 脊柱側凸特定運動療法治療青少年特發性脊柱側凸效果的Meta分析. 中國脊柱脊髓雜志, 2024, 34(6): 602-609.
33. Berdishevsky H, Lebel VA, Bettany-Saltikov J, et al. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. Scoliosis Spinal Disord, 2016, 11(20): 1-52.
34. Sato K, Ito T, Endo T, et al. Novel assessment of physiotherapy outcomes in adults with structural spinal disorders. Eur Spine J, 2023, 32(6): 1887-1894.
35. 張娟娟, 蔣楠楠, 吳亞軍, 等. Schroth療法聯合核心力量訓練改善輕度青少年特發性脊柱側凸患者的側凸角度. 中國組織工程研究, 2025, 29(1): 1-7.
36. 李明, 王傳鋒, 賀石生, 等. 簡體中文版脊柱側凸研究學會22項問卷表(SRS-22)的信度和效度評價. 第二軍醫大學學報, 2008, 29(2): 203-205.
37. 陳紹豐, 李博, 周瀟逸, 等. 青少年特發性脊柱側凸相關生活質量評價量表現狀. 第二軍醫大學學報, 2020, 41(11): 1188-1192.
38. Crawford CH, Glassman SD, Bridwell KH, et al. The minimum clinically important difference in SRS-22R total score, appearance, activity and pain domains after surgical treatment of adult spinal deformity. Spine (Phila Pa 1976), 2015, 40(6): 377-381.
39. 肖斌, 張延斌, 閻凱, 等. 青少年特發性脊柱側凸患者與家屬對治療前SRS-22量表評分認知的一致性及影響因素. 中國脊柱脊髓雜志, 2021, 31(8): 699-704.
40. Park J, So WY. The effect of the Schroth rehabilitation exercise program on spinal and feet alignment in adolescent patients with idiopathic scoliosis: a pilot study. Healthcare (Basel), 2022, 10(2): 398.

Chinese Journal of Evidence-Based Medicine

Effect of Schroth therapy on adolescent idiopathic scoliosis: a meta-analysis

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