The Evidence of Physiotherapy Scoliosis-Specific Exercises in Treating Secondary Postural Deviations in Mild and Moderate Idiopathic Scoliosis: A Scoping Review

Idiopathic scoliosis (IS) is a three-dimensional spinal deformity often associated with secondary postural deviations (pelvic asymmetry, altered kyphosis/lordosis, and postural imbalance), which may negatively affect psychological well-being and quality of life (QoL). Physiotherapy interventions designed specifically for scoliosis, known as Physiotherapy scoliosis-specific exercises (PSSE), have shown effectiveness in improving primary structural outcomes such as Cobb angle (CA) and angle of trunk rotation (ATR); however, their influence on secondary postural deviations is still unclear. This scoping review aimed to summarize current evidence of PSSE on secondary postural deviations in children, adolescents, and young adults with mild to moderate IS: Following PRISMA-ScR guidelines, searches were conducted in PEDro, PubMed, Scopus and Google Scholar for studies published in the last 10 years. Eligible studies were appraised using study design-specific quality assessment tools. Randomized controlled trials (RCT) were evaluated using the Physiotherapy Evidence Database Scale (PEDro), the retrospective cohort study was assessed using the Newcastle–Ottawa Scale (NOS), and the prospective observational study was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Outcomes included pelvic asymmetry, spinal deviations, mobility, trunk symmetry/morphology, balance, proprioception, sensorimotor control, and QoL. Six studies involving 230 participants with mild-to-moderate IS5 were included. PSSE was associated with improvements in CA, ATR, postural alignment, spinal mobility, and QoL. Adjunctive interventions, including manual therapy (MT), proprioceptive neuromuscular facilitation (PNF), and hippotherapy, generally produced greater improvements in postural symmetry, pelvic alignment, proprioception, and sensorimotor control than PSSE alone. PSSE appears to improve structural, postural, and functional outcomes in individuals with IS, with adjunctive interventions potentially enhancing these effects. However, current evidence is limited by heterogeneity, highlighting the need for high-quality RCTs with standardized protocols and long-term follow-up.