Efficacy of a reduced brace wear regimen supported by Schroth exercise in adolescent idiopathic scoliosis: a randomized trial

Objectives: This study aimed to determine whether reducing daily brace wear duration, when compensated by intensive Schroth exercise, yields non-inferior long-term curve correction and superior quality of life compared to standard full-time bracing in AIS. Methods: A total of 52 AIS patients (Cobb angle 25°-40°) were randomly and equally assigned to a control group (full-time brace wear, 20-24 h/day) and an experimental group (part-time brace wear, 14-18 h/day combined with Schroth exercise). Specifically, the Schroth three-dimensional exercise including home-based and supervised outpatient sessions, were performed at least 5 times per week, with a minimum total duration of 4-5 h per week. Evaluations of Cobb angle, angle of trunk rotation (ATR), thoracic expansion, and the Scoliosis Research Society 22-item (SRS-22) questionnaire were conducted baseline and after 6 months of treatment. A subsequent follow-up assessment at 12-months was carried out, with the Cobb angle employed as the primary outcome to evaluate the long-term corrective efficacy between the two groups. Results: < 0.01). Conclusions: This short-term study provides evidence that a protocol prioritizing intensive Schroth exercise combined with part-time bracing achieved superior corrective efficacy compared to full-time bracing alone for adolescent idiopathic scoliosis. These findings support integrating structured Schroth therapy as a core component within a part-time bracing regimen, suggesting a potential to reduce reliance on full-time wear while maintaining efficacy in the short term. Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=201861, identifier ChiCTR2300075910.