Manual therapy treatment for adolescent idiopathic scoliosis.

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common orthopedic condition with a prevalence of 2%-3% in children aged 10-16 years. Conservative interventions remain controversial and are usually based on physical therapy exercises and treatments. Manual therapy techniques may also serve as adequate treatments for AIS due to their ability to improve range of motion and decrease muscle tone and pain.

OBJECTIVE: To critically assess the current literature on the effectiveness of manual therapy methods used to treat AIS.

METHODS: PubMed, PEDro, BioMed Central, and Google Scholar databases were searched from inception until December 2016 using keywords associated with scoliosis and manual therapy. Criteria for inclusion were studies investigating the effect of manual therapy methods on AIS treatment. We analyzed all published material with an emphasis on randomized controlled trials (RCT). Trials of any methodological quality written in English were included in the review.

MAJOR FINDINGS: Fourteen papers were reviewed, all presenting manual therapy treatments such as manipulation, mobilization, and soft tissue techniques used to treat AIS. All case studies showed a significant improvement, post-treatment, in most measured parameters. Observational studies showed mixed results. Only one RCT concluded manual therapy techniques were ineffective in improving trunk morphology and spine flexibility in AIS patients.

CONCLUSION: Case reports and small-scale clinical trials of poor methodological quality presented in this review did not allow us to draw a clear conclusion about the effectiveness of manual therapy in the treatment of AIS. On the other hand, they provide us a basis to assume that manual therapy techniques such as myofascial release and spinal manipulative techniques may potentially be effective in treating AIS in conjunction with other conservative treatments. Further high-quality studies are essential to determine the effectiveness of the different manual therapy techniques.