Effect of therapeutic exercise combined with the use of an orthopedic brace on chronic pain, progression of the Cobb angle and quality of life in adolescent idiopathic scoliosis: a systematic review with meta-analysis

• Grant number: 25/00410-1
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2025
• End date: May 31, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Ana Paula Ribeiro
• Grantee: Guilherme Castro Santos
• Host Institution: Universidade de Santo Amaro (UNISA). São Paulo , SP, Brazil

Abstract

Introduction: The International Society for Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) recommends specific therapeutic exercises combined with the use of a brace to prevent the progression of adolescent idiopathic scoliosis (AIS). However, a recent study has shown that 70% of adolescents affected by AIS have chronic pain associated with the presence of kinesiophobia and exercise catastrophizing, along with symptoms of anxiety. Given this challenging context, it is imperative to evaluate studies with an intervention strategy with therapeutic exercises combined with the use of a brace that verify the reduction of the Cobb angle, but also the chronic pain and associated emotional symptoms and the quality of life of patients, given the importance of the approach in the biopsychosocial model of patients with musculoskeletal diseases, especially those of the spine, as is the case with scoliosis. Objective: To verify the effect of therapeutic exercise combined with the use of an orthopedic brace on Chronic Pain, Cobb Angle Progression and Quality of Life in Adolescent Idiopathic Scoliosis. Methods: The study design will be a systematic review with meta-analysis. A comprehensive search will be performed using the MEDLINE, EMBASE, BIREME, PUBMED, Pedro, Scielo and Cochrane Library databases and the reference lists of existing review articles and relevant studies from January to December 2000 to 2024. Study selection will be performed by independently selected reviewers through the titles, abstracts and full texts of the articles, using pre-defined criteria. Then, a systematic review of randomized controlled trials (RCTs) will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and also of intention-to-treat cohort studies. Two reviewers will independently extract data and assess methodological quality. Risk of bias will be assessed according to the PEDro scale and certainty of evidence will be assessed using the GRADE scale. Statistical Analysis: Mean differences with 95% confidence interval-CI in the effects of interventions and control will be calculated, as well as the risk rate for scoliosis progression.