A 13-year-old boy is seen in his first orthopaedic clinic visit due to a growing angle of curvature of his spine (Cobb angle of 25°). His mother is concerned about the long-term effects of spinal surgery on his growth, and the boy is unwilling to use an uncomfortable brace. Since the boy is still physically active and mobile, you wonder if effective and targeted physiotherapy at an early stage would be sufficient in controlling the boy’s idiopathic scoliosis and help improve his quality of life. This could include minimising pain and limiting the impact of the boy’s condition on his mental health.

Can physiotherapy alone (intervention) reduce spinal curvature (outcome) in patients with idiopathic scoliosis (patient/condition)?

Cochrane Library search in March 2022 with the terms “idiopathic scoliosis” yielded 9 results, 2 of which were relevant.

PubMed search with the terms “Exercise”[Mesh] AND “Scoliosis”[Mesh]. This search was filtered to include only randomised control trials (RCTs) and systematic reviews (SRs), yielding 18 results, 5 of which were relevant.

NHS Evidence search for “idiopathic scoliosis” AND “exercise” yielded 55 results, 9 of which were relevant.

Three systematic reviews have been included in this critical appraisal, consisting of 30 primary studies (28 unique studies, 2 studies are included twice in different systematic reviews,1 2 duplicate studies account for 9.3% of the information). These reviews are summarised in Table 1.

Prompt management of AIS is …