Effectiveness of Individual Exercise Versus Group Exercise in the Integration of Orthotic Treatment for Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial.

Abstract

This study evaluated the compliance and effectiveness of individual exercise (IE) and group exercise (GE) in patients with adolescent idiopathic scoliosis (AIS) undergoing orthotic treatment. Forty patients with moderate AIS were randomized to IE (one-to-one supervision) or GE (3-4 patients per physiotherapist). Both followed the same orthotic protocol during a one-month adaptation period, six-month supervised exercise, and six-month follow-up. Outcomes included spinal deformity, compliance (self-report, digital-record), and quality of life (QoL). Baseline Cobb angles were 28.0±4.5° for IE and 27.2±4.3° for GE (P=0.546). Both groups had a similar curve type distribution: 10 thoracic, 4 thoracolumbar, and 6 lumbar curves. At the end of the study, the GE group showed a significantly smaller out-of-orthosis Cobb angle than the IE group (23.0±12.3° vs. 30.5±10.1°, P=0.041). Both groups showed higher compliance with exercise and orthosis wear during the supervision period than during follow-up. Patients in the GE group reported significantly better self-esteem (P=0.004) and emotional well-being (P=0.011) than those in the IE group. A supervised GE regimen was associated with better compliance, improved spinal deformity control, and enhanced psychosocial well‑being. Further research is warranted to confirm these benefits in larger cohorts and in the longer term.