Innovative Interventions for Adolescent Idiopathic Scoliosis: Combining 3D Orthoses with Schroth Exercises to Improve the Angle of Trunk Rotation, Balance, Respiratory Function, and Quality of Life

Introduction: Adolescent idiopathic scoliosis (AIS) is a three-dimensional (3D) spinal deformity affecting posture, respiratory function, and quality of life. Combining customized 3D orthoses with Schroth exercises may improve both structural and functional outcomes, yet evidence on short-term physiological adaptations remains limited. Objective: The aim was to examine the short-term effects of combined 3D spinal orthosis and Schroth exercise therapy on trunk rotation, respiratory function, dynamic balance, and quality of life in adolescents with AIS. Methods: Thirty adolescents with AIS (aged 10–18 years) participated in this study. All had a primary Cobb angle between 26° and 40°, while smaller compensatory curves were excluded. Each participant was fitted with a custom-made thoracolumbosacral orthosis designed via 3D scanning and wore it at least 18 hours daily. Schroth exercises were performed three times weekly for 4 weeks after a 3-day adaptation period. Assessments included trunk rotation (scoliometer), spirometry (forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow), dynamic balance (Y Balance Test), and quality of life (Scoliosis Research Society-22 questionnaire). Data were analyzed using repeated-measures analysis of variance ( P < 0.05). Data were analyzed using repeated-measures analysis of variance with Bonferroni post hoc corrections, paired samples t tests, and effect size calculations ( P < 0.05). Results: Trunk rotation in thoracic and lumbar regions decreased significantly ( P < 0.001), exceeding the 2° measurement error threshold. Respiratory parameters improved significantly ( P < 0.05, moderate to large effect sizes). Dynamic balance scores slightly declined ( P < 0.05), indicating short-term adaptation. Scoliosis Research Society-22 questionnaire scores improved in all domains, especially pain, self-image, and satisfaction ( P < 0.05). Conclusions: Combined 3D orthosis and Schroth therapy produced meaningful short-term improvements in spinal alignment, respiratory function, and quality of life, while minor balance decline reflected transient postural adaptation. Clinical Relevance Statement: The results of this study provide evidence for the clinical application of combined 3D thoracolumbosacral orthoses and Schroth-based exercises to facilitate early gains in trunk rotation, respiratory function, and overall quality of life by informing the creation of conservative treatment plans during the early stages of adaptation to those treatments in adolescents diagnosed with idiopathic scoliosis. ( J Prosthet Orthot . 2026;X:XX–XX)