Effectiveness of Schroth Therapy in Improving Self-Perception, Body Image, and Quality of Life in Patients with Adolescent Idiopathic Scoliosis: A Systematic Review

Abstract

Introduction: Adolescent idiopathic scoliosis is a structural spinal deformity that not only affects physical health but also has significant psychosocial consequences, such as body image disturbances, reduced self-perception, and diminished quality of life (QoL). Schroth therapy, a physiotherapeutic intervention designed to address scoliosis through three-dimensional exercises, has shown promise in managing these outcomes. This systematic review aims to evaluate the effectiveness of Schroth therapy in improving self-perception, body image, and QoL in adolescents with AIS.

Methods: A systematic review was conducted following PRISMA guidelines. Studies published between 2015 and 2024 were identified using PubMed, Embase, and Cochrane Library databases. Randomised controlled trials (RCTs) involving adolescents aged 10-18 years with AIS, receiving Schroth therapy as the primary intervention, were included. Outcomes measured were self-perception, body image, and QoL, assessed using tools like the SRS-22/23 and WRVAS. The risk of bias was evaluated using the Pedro scale.

Results: Six studies, with sample sizes ranging from 28 to 60 participants, were included in this review. The Schroth therapy group demonstrated significant improvements in self-perception, as measured by the Walter Reed Visual Assessment Scale (WRVAS), with a between-group difference of 6.5 points (95% CI: 3.2 to 9.9, p < 0.01, F = 169.5) reported by Buyukturan et al. (2024). Additionally, improvements in the self-image domain of the SRS-22 questionnaire were observed, with a mean change of 0.149 (95% CI: 0.001 to 0.297, p = 0.049) noted by Zhang et al. (2024). In terms of quality of life (QoL), one study by Kocaman et al. (2021) found a 15% increase in overall SRS-22 scores (p = 0.02), while the combined SE + ASSE group exhibited significant improvements in QoL compared to the SE-only group (p = 0.019) as shown by Khaledi et al. (2024). While other measures, such as Cobb angle and back muscle endurance, showed significant results, the focus of this review highlights the notable benefits of Schroth therapy on self-perception and QoL.

Conclusions: Schroth therapy appears effective in enhancing self-perception, body image, and quality of life in adolescents with AIS. While current evidence supports its psychosocial benefits, further long-term studies with larger sample sizes and more sensitive assessment tools are needed to validate these findings.