Medical Rehabilitation of Children With Idiopathic Scoliosis: Monotherapy or Combined Therapy. A Systematic Literature Review

Background. Idiopathic scoliosis is among the most common spinal disorders diagnosed in 1–3% of children and adolescents. Treatment choice is related to disease severity, with a Cobb angle of 20–40°, a corrective brace or phys­iotherapy can stop its progression. However, insufficient research has shown whether combined treatment is better than monotherapy. Aim. To evaluate the effect of combining bracing and physiotherapy to reduce spinal deformity, improve quality of life and lung function, and compare the results with those of monotherapy. Determine the optimal duration of combined rehabilitation to reduce the angle of deformity. Methods. Relevant articles published from 2014 to 2024 in the databases PubMed, Scopus, Cochrane (CENTRAL), Web of Science, and ScienceDirect were selected based on the PRISMA 2020 guidelines. Paediatric patients (up to 19 years, before skeletal maturity) diagnosed with idiopathic scoliosis (Cobb angle > 10°), undergoing combined bracing and physiotherapy, were studied. Results. Of 2 729 articles, nine were included. The analysis showed a statistically significant change in the combined therapy group: mean difference –2.93 [–4.77; –1.09], p = 0.04, I2 = 57.33%. Long-term treatment effect size was –6.71 [–10.89; –2.53], p < 0.82, I2 = 0%, while short-term treatment showed no statistically significant result. Quality of life improved in the research group, with no significant change in most control group areas. Due to the high risk of bias, lung function changes were not assessed. Conclusions. Combined therapy appears to reduce spinal deformity in children with idiopathic scoliosis and improve health-related quality of life, with better results than monotherapy. Longer treatment may improve Cobb angle correc­tion but evidence is limited. Keywords: scoliosis; adolescent; physical therapy; bracing; systematic literature review