Skip to main content
  • Oral presentation
  • Open access
  • Published:

End growth results of exercise treatment to avoid bracing in adolescents with idiopathic scoliosis: a prospective cohort controlled study


Doubts on the efficacy of exercise treatment for adolescents with Idiopathic Scoliosis (IS) still exists.


To verify the effectiveness of exercises in everyday clinics.


Prospective observational controlled cohort study nested in a prospective database started in March 2003.


Setting: outpatient tertiary referral clinics.

Participants: consecutive patients from start of the database to 31/12/2010. Inclusion criteria: IS; Risser 0-2; 11° to 20° Cobb; age 10 years or more; first evaluation. Exclusion criteria: consultations only; immediate prescription of a brace.

Groups: Physiotherapic Specific Scoliosis Exercises - SEAS school (PSSE: at least 45 min/week, 3 cognitive-behavioral sessions/year); Controls (CON: less than 15 min/week); Usual Physiotherapy (UP: other institutes/protocols).

End-Of-Treatment (EOT): medical prescription, bracing, Risser 3.

Failures: bracing for scoliosis; EOT above 30°.

Statistical analysis: intent-to-treat (ITT: drop-outs included as failures) and efficacy (EA: only EOT patients). Relative Risk of failure (RR), 95% Confidence Interval (CI), and clinical and radiographic changes have been calculated.


Out of 327 patients, 34 (10%) were excluded due to bracing at first evaluation. We included 293 adolescents: 145 PSSE, 95 UP, 53 CON, with no differences at baseline. Physicians prescribed bracing (failure) without differences among groups.

Failures and drop-outs were 84 (28.7%) and 47 (16.0%) respectively: 21.4% and 18.6% in PSSE; 33.7% and 9.5% in UP; 39.6% and 20.8% in CON.

Efficacy analysis (RR): CON vs PSSE 1.90 (IC 1.48-2.33); UP vs PSSE 1.42 (1.01-1.82); CON vs UP: not significant.

Intent-to-treat (RR): CON vs PSSE 1.51 (1.21-1.80); CON vs UP 1.40 (1.08-1.72); UP vs PSSE: not significant.

At the end of exercises, aesthetics (TRACE) improved statistically in PSSE (1.8 points out of 12) and UP (1.5), not in CON; only PSSE improvement was statistically better than CON.


Patients performing UP or nothing (CON), compared to those treated with PSSE (SEAS), increase the risk of failure (bracing and/or 30° at EOT) 1.9 and 1.4 times respectively (EA).

Author information

Authors and Affiliations


Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Negrini, S., Donzelli, S., Negrini, A. et al. End growth results of exercise treatment to avoid bracing in adolescents with idiopathic scoliosis: a prospective cohort controlled study. Scoliosis 9 (Suppl 1), O71 (2014).

Download citation

  • Published:

  • DOI: