| Abstract [eng] |
Relevance of the problem: idiopathic scoliosis is among the most common spinal disorders in children and adolescents. Additional 8413 cases of scoliosis were diagnosed in Lithuania in 2023 among children aged 7-17 years. Treatment choice is closely related to disease severity. If the Cobb angle is between 20 and 40 degrees, a corrective brace or muscle strengthening exercises can stop progression before bone maturity. However, not enough research has been done to show whether combined treatment is better than monotherapy with a brace or physiotherapy. Objectives: analyze selected databases and determine the effect of bracing combined with physiotherapy to reduce the angle of spinal deformity, improve quality of life and lung function. Compare the results of the combined therapy with those of the monotherapy in relation to the research data found. Find out what is the best rehabilitation duration for combined rehabilitation to reduce the angle of deformity. Data sources: scientific articles published in ,,PubMed“, ,,Scopus“, ,,Cochrane Central Register of Controlled Trials“ (CENTRAL), ,,Web of Science“ and ,,ScienceDirect“ databases from 2014-2024. Methods: relevant scientific publications were selected based on the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Pediatric patients (up to 19 years of age, before the bone maturity of the spine) diagnosed with idiopathic scoliosis, a measured Cobb angle more than 10 degrees, undergoing combined bracing and physiotherapy for scoliosis rehabilitation were studied. One independent researcher performed the search, inclusion and exclusion of articles. Results: 2729 articles were found, of which only 9 were included in the final review. The analysis showed a statistically significant change in the combined therapy group: mean difference between treatment and control groups was -2.75 [-5.88; 0.38], I2=68.53%, P<0.01. Long-term treatment between-group effect size was -6.71 [-10.89; -2.53], P<0.82, I2= 0%, while short-term treatment showed no statistically significant result. Health-related quality of life improvement in the research group, with no significant change in most areas of the control group. Due to the high risk of bias in one study, changes in lung function were not assessed. Conclusions: combined therapy reduces spinal deformity in children with idiopathic scoliosis and positively affects health-related quality of life. The combination of bracing and physiotherapy was statistically significantly better in terms of scoliosis curvature management and quality of life than monotherapy. Patients treated for more than a year showed better Cobb angle correction than those treated for under 6 months. |
