A Feedback-Oriented Perspective on Schroth-Based Scoliosis-Specific and General Exercises for Pain and Quality of Life in Adolescents with Idiopathic Scoliosis: A Randomized Controlled Trial

Abstract

Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional spinal deformity associated with pain, altered self-image, and reduced health-related quality of life (HRQoL). While general exercises (GE) are commonly prescribed, they do not specifically address the three-dimensional characteristics of the deformity. Physiotherapeutic Scoliosis-Specific Exercises (PSSE), particularly the Schroth method, aim to correct postural asymmetry, vertebral rotation, and breathing dysfunction through individualized interventions. This prospective randomized controlled trial compared the effects of a structured Schroth-based PSSE program with GE on pain and HRQoL in adolescents with AIS. Eighty participants (56 females, 24 males; mean age 14.3 ± 2.1 years) were randomly assigned to PSSE-Schroth (n = 40) or GE (n = 40), with 66 completing the 12-month intervention. Both groups participated in supervised physiotherapy and home-based exercise programs. Outcomes were assessed at baseline and post-intervention using the Scoliosis Research Society-22 (SRS-22) questionnaire, and appropriate statistical analyses were applied. Significant improvements were observed in all SRS-22 domains in both groups (p ≤ 0.001). The PSSE-Schroth group demonstrated larger effect sizes and significantly greater improvements in self-image and mental health compared to GE (p = 0.018), while pain and functional outcomes improved in both groups with greater clinical gains in the PSSE group. These findings indicate that although both interventions are effective in improving pain and HRQoL in adolescents with AIS, Schroth-based PSSE provides superior benefits, particularly in psychosocial domains, supporting its integration into conservative management strategies. From a feedback-oriented perspective, these results may reflect enhanced sensorimotor integration and postural control mechanisms associated with scoliosis-specific exercises.