Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for c... more Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric spinal stabilization exercises (ASSE) method. Therefore, we hypothesized that, first, there is no difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in the efficiency of SE and no intervention on corresponding variables in treating AIS. Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam's test), and QoL (Scoliosis Research Society-22 questionnaire). Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group (Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the control group (P<.001), whereas the control group remained almost unchanged. Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer treatment periods in future.
Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormaliti... more Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth&#39;s exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS. Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers. Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA&gt;5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA&lt;5˚). Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.
Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidenc... more Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidence about its benefits for bone health and osteoporosis prevention, especially in elite swimmers according to their sex. It is known that sex differences can affect the acquisition of minerals by the bone. Objectives: The aims of this study were to compare the bone mineral density (BMD) of swimmers with that of non-athletes (NA) and compare the corresponding values in male (MS) and female swimmers (FS). Methods: This cross-sectional study was performed on young athletes (18-24 years old) of the Iranian national swimming team, who were training for at least 11 hours per week and NA. To this end, 56 swimmers (14 males, 14 females) and NA (14 males, 14 females) were enrolled in 4 groups. The DEXA device was used to assess BMD (g/cm 2) and T-scores of the proximal femur and lumbar spine. Results: All the swimmers had significantly higher BMD of the femur neck, trochanter, Ward&#39;s triangle, and lumbar spine than NA (males/females) (P &lt; .05). Also, the BMD of FS (except in trochanter and Ward&#39;s triangle) was significantly higher than MS (P &lt; .05). Finally, T-scores of FS in lumbar spine and femur neck areas were significantly higher than MS and NA (P &lt; .05). Conclusions: Unexpectedly, BMD relatively improved by performing competitive swimming. Meanwhile, FS, especially in the femur neck, seemed more adaptable to swimming-related loads and BMD acquisition in comparison to MS. Further studies are needed to determine the definitive response to bone acquisition by sex, given the limitations of the present study.
Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormaliti... more Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth's exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS. Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers. Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA>5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA<5˚). Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.
ackground: The promising results of idiopathic scoliosis for children and adolescent idiopathic s... more ackground: The promising results of idiopathic scoliosis for children and adolescent idiopathic scoliosis found in low-quality in review of literature in Iran.
Aim: The purpose of this study was to investigate the effect of various types of exercises to improve idiopathic scoliosis in terms of reducing Cobb angle and angle of trunk rotation (ATR) in different ages of children and adolescents.
Materials and Methods: Searches were conducted in databases including Cochrane, PubMed, Scopus and Google Scholar during 2005-2021. Inclusion criteria were papers using only corrective exercises (CE) or CEs with braces as an intervention. The PEDro scale was used for evaluating the quality of papers.
Results: Thirteen papers were licensed for review. The papers (PEDro: 4-9) showed the positive effect of the CEs in reducing Cobb angle (eleven papers) and ATR (eight papers) greater than 5° and 3°, respectively. Moreover, two papers (PEDro: 4-7) showed that the physiotherapy scoliosis specific exercises (PSSE) were more effective than the general exercises (GE), while no paper was found to compare one PSSE to another. Two papers (PEDro: 6-9) indicated the greater effectiveness of CEs in childhood than adolescence.
Conclusion: The relative evidence suggested the effect of CEs on improving idiopathic scoliosis, especially in children. However, it seems that the use of SEAS and Schroth methods, depending on the individual nature, can be more effective. High-quality papers are necessary to achieve more accurate results in the future.
Journal of Mazandaran University of Medical Sciences, 2023
Background and purpose: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosi... more Background and purpose: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and the most complex deformity of the spine and trunk with significant complications. In this systematic review, the effectiveness of core stability exercises (CSE) in improving this disorder is discussed. Materials and methods: This review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. Adolescent Idiopathic Scoliosis, Cobb angles, and core stability exercise were our search terms in PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar. The search was limited to articles published in Persian and English between 2005 and 2022. Researches on AIS carried out in adolescents aged 10-18 were studied. In one of the groups, only CSE was done and the size of Cobb's angle (an indicator of the severity of scoliosis) was used as one of the dependent variables. The PEDro scale was used to evaluate the quality of articles in terms of risk of bias. Results: In initial search, 268 articles were found. After removing irrelevant articles and those that did not met the study's inclusion criteria and also qualitative evaluation of the remaining articles, seven articles with an average PEDro score of 6.2 (moderate quality), including 297 participants, were selected. A statistically significant decrease was reported in the Cobb angle in all articles, but only in four articles this decrease was clinically significant (greater than 5˚). Conclusion: CSE are safe, easy and accessible that can be effective in improving AIS, but there is not sufficient evidence to support this hypothesis. Further high-quality studies are required to draw a definite conclusion and making clinical decisions.
Shahid Beheshti University of Medical Sciences, 2023
Background and Aims Idiopathic scoliosis is a complex three-dimensional deformity affecting the s... more Background and Aims Idiopathic scoliosis is a complex three-dimensional deformity affecting the spine and is more common in adolescents (10-18 years). Failure to pay attention to it can increase its severity and complications. Various exercise methods have been designed for preventing, managing, or correcting adolescent idiopathic scoliosis (AIS). Among them, the Schroth method has attracted the attention of therapists due to its promising results. However, there is still conflicting evidence of its effectiveness. Therefore, this review study aims to investigate the effectiveness of the Schroth method in improving the Cobb angle, trunk rotation angle, and quality of life (QoL) in adolescents with idiopathic scoliosis. Methods This is a systematic review study. A search was conducted in Cochrane, PubMed, Medline, Scopus and Google Scholar databases for finding studies that used Schroth method as an intervention and published from 2005 to December 2021 using the keywords related to AIS. The PEDro scale was used to evaluate the quality of papers. Results Initial search yielded 96 records of which 10 papers with PEDro scale score of 5.8 were selected for the review. Among them, the variables of Cobb angle, QoL, ATR were evaluated in nine, six and four papers, respectively. The outcomes obtained from the papers showed the significant effect of Schroth method on reducing the Cobb angle (>5°, using radiography), trunk rotation (>3°, using scoliometer) and improving the QoL (using the scoliosis research society questionnaire). In only one paper, despite a significant improvement in QoL, no significant reduction in Cobb angle (<5°) was observed. Conclusion There is moderate evidence of the positive effects of the Schroth method on improving Cobb angle, trunk rotation angle and QoL in adolescents with idiopathic scoliosis. This method can used for preventing from the worsening of AIS. It can be used along with other methods such as core stability exercises and Pilates. Since the reviewed studies had moderate quality, high-quality studies are needed in this field.
Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidenc... more Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidence about its benefits for bone health and osteoporosis prevention, especially in elite swimmers according to their sex. It is known that sex differences can affect the acquisition of minerals by the bone. Objectives: The aims of this study were to compare the bone mineral density (BMD) of swimmers with that of non-athletes (NA) and compare the corresponding values in male (MS) and female swimmers (FS). Methods: This cross-sectional study was performed on young athletes (18-24 years old) of the Iranian national swimming team, who were training for at least 11 hours per week and NA. To this end, 56 swimmers (14 males, 14 females) and NA (14 males, 14 females) were enrolled in 4 groups. The DEXA device was used to assess BMD (g/cm 2) and T-scores of the proximal femur and lumbar spine. Results: All the swimmers had significantly higher BMD of the femur neck, trochanter, Ward's triangle, and lumbar spine than NA (males/females) (P < .05). Also, the BMD of FS (except in trochanter and Ward's triangle) was significantly higher than MS (P < .05). Finally, T-scores of FS in lumbar spine and femur neck areas were significantly higher than MS and NA (P < .05). Conclusions: Unexpectedly, BMD relatively improved by performing competitive swimming. Meanwhile, FS, especially in the femur neck, seemed more adaptable to swimming-related loads and BMD acquisition in comparison to MS. Further studies are needed to determine the definitive response to bone acquisition by sex, given the limitations of the present study.
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology, Iranian Orthopaedic Association, 2024
Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for c... more Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric spinal stabilization exercises (ASSE) method. Therefore, we hypot hesized that, first, there is no difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in the efficiency of SE and no intervention on corresponding variables in treating AIS. Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam's test), and QoL (Scoliosis Research Society-22 questionnaire). Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group (Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the control group (P<.001), whereas the control group remained almost unchanged. Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer treatment periods in future.
Objectives: Sport is one of the best ways to prevent osteoporosis; however, not all sports have t... more Objectives: Sport is one of the best ways to prevent osteoporosis; however, not all sports have the same impact on bones, for instance, swimming (SW) may have no effect or be harmful. Elite athletes are the best choice to detect the effects of any sport. Thus, this study was conducted firstly to compare the bone mineral density (BMD) and bone mineral content (BMC) of elite athletes in volleyball (VB), basketball (BB), and long-distance running (LR) together, and secondly to compare those corresponding values in SW athletes with those of non-athletes (NA). Methods: The subjects (n=58) of this cross-sectional study included elite male athletes (members of Iran's national teams, with a minimum of 12-15 hours of training per week) and NA (control; C) who were divided into BB, VB, LR, SW (n=12 for each), and C (n=10) groups. The DEXA scan measured the amount of BMD and BMC values in the lumbar spine (LS; L2-L4) and proximal femur (PF; neck, trochanter, and Ward's triangle) areas. Results: In the LS areas, LR had significantly higher BMD than the BB, VB, SW, and C groups (P<0.001), while for BMC, both LR and VB were significantly superior to other groups (P<0.001). Moreover, the BMD and BMC of the PF areas of VB and BB were significantly higher than those of the LR, SW, and C groups (P<0.001). Finally, in all areas, SW showed significantly higher BMD and BMC, compared to the C group (except for trochanter and femur neck BMC) (P<0.05). Conclusion: LR athletes showed the most bone acquisition in the LS areas and VB players in the PF areas, while BB players ranked third in osteoporosis prevention in the mentioned regions. Unexpectedly, SW athletes also had better BMD and BMC than NA; therefore, after weight-bearing sports, this type of sport can be effective in bone acquisition.
Background: The role of exercise in osteoporosis prevention has been proven. Nevertheless, there ... more Background: The role of exercise in osteoporosis prevention has been proven. Nevertheless, there is no consensus about the types of sports, especially at professional levels. Non-impact sports such as swimming may have a negative effect or no effect. Objectives: Thus, the present study aimed to compare the effect of different sports on bone mineral content (BMC) and bone mineral density (BMD) of elite female athletes. Methods: This was a cross-sectional study consisting of 48 athletes in five groups of long-distance running, volleyball, basketball, swimming (n = 12 for each), and ten control subjects. For measuring the lumbar spine (L2 - L4) and proximal femur (femoral neck, trochanter, and Ward’s triangle), the dual-energy X-ray absorptiometry (DEXA) method was applied. Results: Indicated that the running, basketball, and volleyball groups had a significantly higher lumbar spine and proximal femur BMD than the swimming and control groups (P < 0.05). Running resulted in significa...
Purpose: Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis and the most ... more Purpose: Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis and the most complex deformity of the spine. The promising results of Schroth and Scientific Exercise Approach to Scoliosis (SEAS), among other methods of exercise therapy, have attracted the attention of many researchers and therapists. However, there is still vague evidence of their effectiveness and their superiority. Therefore, this review aimed to evaluate and compare the effects of Schroth and SEAS exercises on correcting AIS. Methods: Searching was conducted in databases, including Cochrane, MEDLINE, PubMed, Scopus, and Google Scholar from 2005 to December 2021 using keywords related to AIS. Inclusion criteria were the papers using Schroth and SEAS exercises as an intervention. The PEDro scale was used for evaluating the quality of the papers. Results: Ten papers with an average PEDro score of 6.2 were licensed to enter the study. Five Randomized Controlled Trials (RCT) and one Clinical Contro...
Purpose: Many non-pharmaceutical methods have been proposed for the treatment of non-specific chr... more Purpose: Many non-pharmaceutical methods have been proposed for the treatment of non-specific chronic low back pain (NCLBP), including online exercise at home (OEH), hydrotherapy, and physiotherapy approaches that have shown significant effects. Nevertheless, there are ambiguities in choosing the best option. Therefore, the present study was designed to compare these methods. Methods: This randomized clinical trial included 60 patients with NCLBP (25-45 yrs). After selection, they were randomly divided into three groups (20 patients in each) of OEH (including core stability exercises and education), hydrotherapy, and physiotherapy (including hot pack, ultrasound, and TENS), and then, received interventions for 12 weeks. The Visual Analog Scale (VAS) was used to evaluate pain before and after treatment. The ANOCOVA and paired t-test were used to analyze the data and a significant level of P<0.05. Results: The results showed that all three treatments used in this study had a signif...
1. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish Int... more 1. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish International Campus, University of Tehran, Kish, Iran. 2. Assistant Professor, Sports Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran. 3. Assistant Professor, Department of Health & Sport Rehabilitation, Faculty of Sport Science & Health, University of Shahid Beheshti, Tehran, Iran.
1. Assistant Professor, Department of Health and Sport Rehabilitation, Faculty of Sport Science a... more 1. Assistant Professor, Department of Health and Sport Rehabilitation, Faculty of Sport Science and Health, University of Shahid Beheshti, Tehran, Iran 2. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish International Campus, University of Tehran, Kish, Iran 3. Assistant Professor of Biomechanics and Corrective Exercise, Department of Physical Education and Sport Sciences, East Tehran Branch, Islamic Azad University,Tehran, Iran
Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for c... more Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric spinal stabilization exercises (ASSE) method. Therefore, we hypothesized that, first, there is no difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in the efficiency of SE and no intervention on corresponding variables in treating AIS. Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam's test), and QoL (Scoliosis Research Society-22 questionnaire). Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group (Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the control group (P<.001), whereas the control group remained almost unchanged. Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer treatment periods in future.
Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormaliti... more Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth&#39;s exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS. Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers. Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA&gt;5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA&lt;5˚). Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.
Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidenc... more Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidence about its benefits for bone health and osteoporosis prevention, especially in elite swimmers according to their sex. It is known that sex differences can affect the acquisition of minerals by the bone. Objectives: The aims of this study were to compare the bone mineral density (BMD) of swimmers with that of non-athletes (NA) and compare the corresponding values in male (MS) and female swimmers (FS). Methods: This cross-sectional study was performed on young athletes (18-24 years old) of the Iranian national swimming team, who were training for at least 11 hours per week and NA. To this end, 56 swimmers (14 males, 14 females) and NA (14 males, 14 females) were enrolled in 4 groups. The DEXA device was used to assess BMD (g/cm 2) and T-scores of the proximal femur and lumbar spine. Results: All the swimmers had significantly higher BMD of the femur neck, trochanter, Ward&#39;s triangle, and lumbar spine than NA (males/females) (P &lt; .05). Also, the BMD of FS (except in trochanter and Ward&#39;s triangle) was significantly higher than MS (P &lt; .05). Finally, T-scores of FS in lumbar spine and femur neck areas were significantly higher than MS and NA (P &lt; .05). Conclusions: Unexpectedly, BMD relatively improved by performing competitive swimming. Meanwhile, FS, especially in the femur neck, seemed more adaptable to swimming-related loads and BMD acquisition in comparison to MS. Further studies are needed to determine the definitive response to bone acquisition by sex, given the limitations of the present study.
Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormaliti... more Background: Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities, appearing far into puberty. Schroth's exercises (SE) and core-stabilization exercises (CE) have become very prominent among the specialized and general methods to scoliosis treatment. However, their effects are still unclear and there is insufficient evidence of superiority between them. Therefore, we aimed to evaluate and compare the effectiveness of these methods on Cobb angles (CA) in AIS. Methods: A systematic review was performed on SE and CE papers. The databases included PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar from January 2005 to June 2022. The physiotherapy evidence database (PEDro) scale assessed the quality and provided internal validity and the statistical information of the papers. Results: After screening 410 papers, nine papers (SE=5, CE=3 and SE vs. CE=1), with 339 participants, were admitted for review (PEDro=6). Among them, three (SE=moderate evidence) and two papers (CE=limited evidence) reported clinically significant reductions in CA>5˚, alone or compared to control or other exercise methods, while only one paper (very limited evidence) showed the relative superiority of SE (-7.16˚) compared to CE (-3.27˚). However, three papers did not show clinically significant results (CA<5˚). Conclusion: Moderate and limited evidence suggests that both SE and CE can effectively improve CA, respectively. There is very limited evidence to suggest that SE is more effective than CE in treating AIS. Thus, the definitive answers to the questions, especially concerning the superiority between these two methods, remained unclear. Further high-quality studies must be conducted in the future.
ackground: The promising results of idiopathic scoliosis for children and adolescent idiopathic s... more ackground: The promising results of idiopathic scoliosis for children and adolescent idiopathic scoliosis found in low-quality in review of literature in Iran.
Aim: The purpose of this study was to investigate the effect of various types of exercises to improve idiopathic scoliosis in terms of reducing Cobb angle and angle of trunk rotation (ATR) in different ages of children and adolescents.
Materials and Methods: Searches were conducted in databases including Cochrane, PubMed, Scopus and Google Scholar during 2005-2021. Inclusion criteria were papers using only corrective exercises (CE) or CEs with braces as an intervention. The PEDro scale was used for evaluating the quality of papers.
Results: Thirteen papers were licensed for review. The papers (PEDro: 4-9) showed the positive effect of the CEs in reducing Cobb angle (eleven papers) and ATR (eight papers) greater than 5° and 3°, respectively. Moreover, two papers (PEDro: 4-7) showed that the physiotherapy scoliosis specific exercises (PSSE) were more effective than the general exercises (GE), while no paper was found to compare one PSSE to another. Two papers (PEDro: 6-9) indicated the greater effectiveness of CEs in childhood than adolescence.
Conclusion: The relative evidence suggested the effect of CEs on improving idiopathic scoliosis, especially in children. However, it seems that the use of SEAS and Schroth methods, depending on the individual nature, can be more effective. High-quality papers are necessary to achieve more accurate results in the future.
Journal of Mazandaran University of Medical Sciences, 2023
Background and purpose: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosi... more Background and purpose: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and the most complex deformity of the spine and trunk with significant complications. In this systematic review, the effectiveness of core stability exercises (CSE) in improving this disorder is discussed. Materials and methods: This review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. Adolescent Idiopathic Scoliosis, Cobb angles, and core stability exercise were our search terms in PubMed, Scopus, MEDLINE, Cochrane Library, CINAHL, and Google Scholar. The search was limited to articles published in Persian and English between 2005 and 2022. Researches on AIS carried out in adolescents aged 10-18 were studied. In one of the groups, only CSE was done and the size of Cobb's angle (an indicator of the severity of scoliosis) was used as one of the dependent variables. The PEDro scale was used to evaluate the quality of articles in terms of risk of bias. Results: In initial search, 268 articles were found. After removing irrelevant articles and those that did not met the study's inclusion criteria and also qualitative evaluation of the remaining articles, seven articles with an average PEDro score of 6.2 (moderate quality), including 297 participants, were selected. A statistically significant decrease was reported in the Cobb angle in all articles, but only in four articles this decrease was clinically significant (greater than 5˚). Conclusion: CSE are safe, easy and accessible that can be effective in improving AIS, but there is not sufficient evidence to support this hypothesis. Further high-quality studies are required to draw a definite conclusion and making clinical decisions.
Shahid Beheshti University of Medical Sciences, 2023
Background and Aims Idiopathic scoliosis is a complex three-dimensional deformity affecting the s... more Background and Aims Idiopathic scoliosis is a complex three-dimensional deformity affecting the spine and is more common in adolescents (10-18 years). Failure to pay attention to it can increase its severity and complications. Various exercise methods have been designed for preventing, managing, or correcting adolescent idiopathic scoliosis (AIS). Among them, the Schroth method has attracted the attention of therapists due to its promising results. However, there is still conflicting evidence of its effectiveness. Therefore, this review study aims to investigate the effectiveness of the Schroth method in improving the Cobb angle, trunk rotation angle, and quality of life (QoL) in adolescents with idiopathic scoliosis. Methods This is a systematic review study. A search was conducted in Cochrane, PubMed, Medline, Scopus and Google Scholar databases for finding studies that used Schroth method as an intervention and published from 2005 to December 2021 using the keywords related to AIS. The PEDro scale was used to evaluate the quality of papers. Results Initial search yielded 96 records of which 10 papers with PEDro scale score of 5.8 were selected for the review. Among them, the variables of Cobb angle, QoL, ATR were evaluated in nine, six and four papers, respectively. The outcomes obtained from the papers showed the significant effect of Schroth method on reducing the Cobb angle (>5°, using radiography), trunk rotation (>3°, using scoliometer) and improving the QoL (using the scoliosis research society questionnaire). In only one paper, despite a significant improvement in QoL, no significant reduction in Cobb angle (<5°) was observed. Conclusion There is moderate evidence of the positive effects of the Schroth method on improving Cobb angle, trunk rotation angle and QoL in adolescents with idiopathic scoliosis. This method can used for preventing from the worsening of AIS. It can be used along with other methods such as core stability exercises and Pilates. Since the reviewed studies had moderate quality, high-quality studies are needed in this field.
Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidenc... more Background: Despite the many therapeutic benefits of swimming, there is still conflicting evidence about its benefits for bone health and osteoporosis prevention, especially in elite swimmers according to their sex. It is known that sex differences can affect the acquisition of minerals by the bone. Objectives: The aims of this study were to compare the bone mineral density (BMD) of swimmers with that of non-athletes (NA) and compare the corresponding values in male (MS) and female swimmers (FS). Methods: This cross-sectional study was performed on young athletes (18-24 years old) of the Iranian national swimming team, who were training for at least 11 hours per week and NA. To this end, 56 swimmers (14 males, 14 females) and NA (14 males, 14 females) were enrolled in 4 groups. The DEXA device was used to assess BMD (g/cm 2) and T-scores of the proximal femur and lumbar spine. Results: All the swimmers had significantly higher BMD of the femur neck, trochanter, Ward's triangle, and lumbar spine than NA (males/females) (P < .05). Also, the BMD of FS (except in trochanter and Ward's triangle) was significantly higher than MS (P < .05). Finally, T-scores of FS in lumbar spine and femur neck areas were significantly higher than MS and NA (P < .05). Conclusions: Unexpectedly, BMD relatively improved by performing competitive swimming. Meanwhile, FS, especially in the femur neck, seemed more adaptable to swimming-related loads and BMD acquisition in comparison to MS. Further studies are needed to determine the definitive response to bone acquisition by sex, given the limitations of the present study.
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology, Iranian Orthopaedic Association, 2024
Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for c... more Objectives: The available evidence on the efficiency of well-known Schroth's exercises (SE) for correcting adolescent idiopathic scoliosis (AIS) is limited, especially in combination with the asymmetric spinal stabilization exercises (ASSE) method. Therefore, we hypot hesized that, first, there is no difference in the efficiency of the combined exercises (SE+ASSE) and SE alone in improving Cobb angle, angle of trunk rotation (ATR), and quality of life (QoL) in AIS. Second, there is no difference in the efficiency of SE and no intervention on corresponding variables in treating AIS. Methods: This randomized controlled trial (RCT) consisted of 40 patients with mild AIS (10-18-year-old boys) divided into three groups: SE (n=15), SE+ASSE (n=15), and a waitlist control group (n=10). For 12 weeks (three days a week), both experimental groups performed SE, the combined group additionally received ASSE, and the control group received no intervention. The assessment included Cobb angle (photogrammetry), ATR (Adam's test), and QoL (Scoliosis Research Society-22 questionnaire). Results: It was found that Cobb angle, ATR, and QoL improved significantly in the combined SE+ASSE group (Cobb=16.45° to 9.01°; ATR=4.93° to 1.33°) compared to the SE group (P<.001). In addition, the SE group showed significant amelioration in the mentioned variables (Cobb=15.09° to 9.77°; ATR=4.23° to 2.17°) compared to the control group (P<.001), whereas the control group remained almost unchanged. Conclusion: Based on the obtained results, the combination of SE and ASSE provided more benefits than SE alone, and the SE results were efficient compared to the no-intervention group regarding the correction of scoliosis and related problems. However, patients with moderate to severe scoliosis should also be investigated in longer treatment periods in future.
Objectives: Sport is one of the best ways to prevent osteoporosis; however, not all sports have t... more Objectives: Sport is one of the best ways to prevent osteoporosis; however, not all sports have the same impact on bones, for instance, swimming (SW) may have no effect or be harmful. Elite athletes are the best choice to detect the effects of any sport. Thus, this study was conducted firstly to compare the bone mineral density (BMD) and bone mineral content (BMC) of elite athletes in volleyball (VB), basketball (BB), and long-distance running (LR) together, and secondly to compare those corresponding values in SW athletes with those of non-athletes (NA). Methods: The subjects (n=58) of this cross-sectional study included elite male athletes (members of Iran's national teams, with a minimum of 12-15 hours of training per week) and NA (control; C) who were divided into BB, VB, LR, SW (n=12 for each), and C (n=10) groups. The DEXA scan measured the amount of BMD and BMC values in the lumbar spine (LS; L2-L4) and proximal femur (PF; neck, trochanter, and Ward's triangle) areas. Results: In the LS areas, LR had significantly higher BMD than the BB, VB, SW, and C groups (P<0.001), while for BMC, both LR and VB were significantly superior to other groups (P<0.001). Moreover, the BMD and BMC of the PF areas of VB and BB were significantly higher than those of the LR, SW, and C groups (P<0.001). Finally, in all areas, SW showed significantly higher BMD and BMC, compared to the C group (except for trochanter and femur neck BMC) (P<0.05). Conclusion: LR athletes showed the most bone acquisition in the LS areas and VB players in the PF areas, while BB players ranked third in osteoporosis prevention in the mentioned regions. Unexpectedly, SW athletes also had better BMD and BMC than NA; therefore, after weight-bearing sports, this type of sport can be effective in bone acquisition.
Background: The role of exercise in osteoporosis prevention has been proven. Nevertheless, there ... more Background: The role of exercise in osteoporosis prevention has been proven. Nevertheless, there is no consensus about the types of sports, especially at professional levels. Non-impact sports such as swimming may have a negative effect or no effect. Objectives: Thus, the present study aimed to compare the effect of different sports on bone mineral content (BMC) and bone mineral density (BMD) of elite female athletes. Methods: This was a cross-sectional study consisting of 48 athletes in five groups of long-distance running, volleyball, basketball, swimming (n = 12 for each), and ten control subjects. For measuring the lumbar spine (L2 - L4) and proximal femur (femoral neck, trochanter, and Ward’s triangle), the dual-energy X-ray absorptiometry (DEXA) method was applied. Results: Indicated that the running, basketball, and volleyball groups had a significantly higher lumbar spine and proximal femur BMD than the swimming and control groups (P < 0.05). Running resulted in significa...
Purpose: Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis and the most ... more Purpose: Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis and the most complex deformity of the spine. The promising results of Schroth and Scientific Exercise Approach to Scoliosis (SEAS), among other methods of exercise therapy, have attracted the attention of many researchers and therapists. However, there is still vague evidence of their effectiveness and their superiority. Therefore, this review aimed to evaluate and compare the effects of Schroth and SEAS exercises on correcting AIS. Methods: Searching was conducted in databases, including Cochrane, MEDLINE, PubMed, Scopus, and Google Scholar from 2005 to December 2021 using keywords related to AIS. Inclusion criteria were the papers using Schroth and SEAS exercises as an intervention. The PEDro scale was used for evaluating the quality of the papers. Results: Ten papers with an average PEDro score of 6.2 were licensed to enter the study. Five Randomized Controlled Trials (RCT) and one Clinical Contro...
Purpose: Many non-pharmaceutical methods have been proposed for the treatment of non-specific chr... more Purpose: Many non-pharmaceutical methods have been proposed for the treatment of non-specific chronic low back pain (NCLBP), including online exercise at home (OEH), hydrotherapy, and physiotherapy approaches that have shown significant effects. Nevertheless, there are ambiguities in choosing the best option. Therefore, the present study was designed to compare these methods. Methods: This randomized clinical trial included 60 patients with NCLBP (25-45 yrs). After selection, they were randomly divided into three groups (20 patients in each) of OEH (including core stability exercises and education), hydrotherapy, and physiotherapy (including hot pack, ultrasound, and TENS), and then, received interventions for 12 weeks. The Visual Analog Scale (VAS) was used to evaluate pain before and after treatment. The ANOCOVA and paired t-test were used to analyze the data and a significant level of P<0.05. Results: The results showed that all three treatments used in this study had a signif...
1. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish Int... more 1. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish International Campus, University of Tehran, Kish, Iran. 2. Assistant Professor, Sports Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran. 3. Assistant Professor, Department of Health & Sport Rehabilitation, Faculty of Sport Science & Health, University of Shahid Beheshti, Tehran, Iran.
1. Assistant Professor, Department of Health and Sport Rehabilitation, Faculty of Sport Science a... more 1. Assistant Professor, Department of Health and Sport Rehabilitation, Faculty of Sport Science and Health, University of Shahid Beheshti, Tehran, Iran 2. Ph. D. Student in sport injury and corrective exercises, Department of Sport Science, Kish International Campus, University of Tehran, Kish, Iran 3. Assistant Professor of Biomechanics and Corrective Exercise, Department of Physical Education and Sport Sciences, East Tehran Branch, Islamic Azad University,Tehran, Iran
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Aim: The purpose of this study was to investigate the effect of various types of exercises to improve idiopathic scoliosis in terms of reducing Cobb angle and angle of trunk rotation (ATR) in different ages of children and adolescents.
Materials and Methods: Searches were conducted in databases including Cochrane, PubMed, Scopus and Google Scholar during 2005-2021. Inclusion criteria were papers using only corrective exercises (CE) or CEs with braces as an intervention. The PEDro scale was used for evaluating the quality of papers.
Results: Thirteen papers were licensed for review. The papers (PEDro: 4-9) showed the positive effect of the CEs in reducing Cobb angle (eleven papers) and ATR (eight papers) greater than 5° and 3°, respectively. Moreover, two papers (PEDro: 4-7) showed that the physiotherapy scoliosis specific exercises (PSSE) were more effective than the general exercises (GE), while no paper was found to compare one PSSE to another. Two papers (PEDro: 6-9) indicated the greater effectiveness of CEs in childhood than adolescence.
Conclusion: The relative evidence suggested the effect of CEs on improving idiopathic scoliosis, especially in children. However, it seems that the use of SEAS and Schroth methods, depending on the individual nature, can be more effective. High-quality papers are necessary to achieve more accurate results in the future.
Aim: The purpose of this study was to investigate the effect of various types of exercises to improve idiopathic scoliosis in terms of reducing Cobb angle and angle of trunk rotation (ATR) in different ages of children and adolescents.
Materials and Methods: Searches were conducted in databases including Cochrane, PubMed, Scopus and Google Scholar during 2005-2021. Inclusion criteria were papers using only corrective exercises (CE) or CEs with braces as an intervention. The PEDro scale was used for evaluating the quality of papers.
Results: Thirteen papers were licensed for review. The papers (PEDro: 4-9) showed the positive effect of the CEs in reducing Cobb angle (eleven papers) and ATR (eight papers) greater than 5° and 3°, respectively. Moreover, two papers (PEDro: 4-7) showed that the physiotherapy scoliosis specific exercises (PSSE) were more effective than the general exercises (GE), while no paper was found to compare one PSSE to another. Two papers (PEDro: 6-9) indicated the greater effectiveness of CEs in childhood than adolescence.
Conclusion: The relative evidence suggested the effect of CEs on improving idiopathic scoliosis, especially in children. However, it seems that the use of SEAS and Schroth methods, depending on the individual nature, can be more effective. High-quality papers are necessary to achieve more accurate results in the future.