Electroacupuncture-augmented breaststroke vs. breaststroke alone for mild AIS: superior correction in a retrospective cohort

Background In China, acupuncture is commonly used for adolescent idiopathic scoliosis (AIS), but it requires combination with other therapies. In clinical practice, orthopedic surgeons often recommend swimming for mild AIS patients with Cobb angle <25°. However, owing to the paucity of high-quality evidence and standardized protocols, the efficacy of swimming for AIS remains controversial. The objective of this study was to evaluate the efficacy and safety of breaststroke combined with electroacupuncture vs. breaststroke alone in skeletally immature patients with mild AIS. Methods This was a single-center retrospective cohort study. One hundred seventeen mild AIS patients with Risser ≤3 treated from January 2020 to March 2024 were divided into two groups according to different treatments. During the 1-year treatment period, the breaststroke combined with electroacupuncture group (BE-group) received 3 months of electroacupuncture and 12 months of supervised 800-meter breaststroke training, whereas the breaststroke group (B-group) received 12 months of breaststroke training alone. Radiographic parameters, quality of life, and the Walter Reed Visual Assessment Scale (WRVAS) score were evaluated in both cohorts at baseline, 3-month, and 12-month follow-up intervals. Results The study included 56 patients in the BE-group and 61 in the B-group. At last follow-up, the BE-group demonstrated superior deformity correction to the B-group in Cobb angle ( p = 0.003) and WRVAS ( p < 0.001). Intragroup analysis revealed that, after 12 months of treatment, the BE-group presented significant improvements in Cobb angle ( p < 0.001), SRS-22 self-image ( p = 0.003), mental health ( p = 0.014), WRVAS ( p < 0.001), as well as a significant reduction in thoracic kyphosis ( p = 0.014). The B-group demonstrated no significant deformity correction, but maintained curve stability. Both groups showed significant improvements in the SRS-22 pain ( p < 0.001, p = 0.005). For thoracic-dominant AIS, the treatment outcomes showed no significant intergroup difference ( p = 0.112). However, for thoracolumbar/lumbar-dominant AIS, the BE-group demonstrated superior corrective efficacy ( p < 0.001). Conclusions This study demonstrated that both breaststroke monotherapy and the combined therapy had protective effects on skeletally immature patients with mild AIS. Combining breaststroke with electroacupuncture achieved deformity correction, whereas breaststroke alone merely halted curve progression. Furthermore, the combined therapy was particularly beneficial for thoracolumbar/lumbar-dominant curves.