Intervenções fisioterápicas para tratamento da escoliose idiopatica no adolescente: uma revisão narrativa da literatura

Abstract

Introduction: The most up-to-date concept of Adolescent Idiopathic Scoliosis (AIS) is defined as a three-dimensional spinal deformity that occurs in healthy puberty children and adolescents. The treatment for AIS is still widely discussed and recommendations are changing over time. In the last few decades there have been changes in the management of scoliosis for all stakeholders. In the absence of effective conservative treatment, a line of treatment based on specific exercises for scoliosis began to emerge. Objective: The purpose of this narrative literature review was to investigate the efficacy of specific exercises for AIS considering recent studies published in the past 6 years. Methods: The literature search was carried out in the electronic databases of PEDro and MEDLINE via Pubmed in the period from January to February 2020. The studies considered eligible were only randomized clinical trials published in the last 6 years, conducted with adolescents diagnosed with AIS, with age between 10 and 18 years, who used the Cobb angle (> 5 °) as outcome, quality of life, pain intensity and perception of body self-image. Results: Sixclinical trials were included in this review. Among the four clinical trials that investigated exercises based on the Schroth Method, three studies were effective in correcting the Cobb angle. Two clinical trials investigated exercises based on the SEAS Method and were able to reduce the Cobb angle. One trial investigated other types of exercises such as the effectiveness of core muscle stabilization training, and was unable to demonstrate significant differences for Cobb angle and trunk asymmetry. In addition to the Cobb angle (primary outcome), the results show improvements in secondary outcomes (quality of life, pain, self-image and perception of the spine). Conclusion: Randomized clinical trials have provided evidence that specific exercises can be effective in treating patients with AIS with mild and moderate curves. Despite the growing evidence of high quality, there is a need for standardization of research methods recognized by SOSORT and SRS because most studies do not specifically focus on multidimensional risk factors associated with AIS. Future high-quality clinical trials are needed to confirm the efficacy of specific exercises for treatment of AIS.