Compliance of Physiotherapeutic Scoliosis-Specific Exercise in Adolescent Idiopathic Scoliosis: A Scoping Review.

Abstract

<b>Background</b>: Non-surgical management of adolescent idiopathic scoliosis (AIS) includes physiotherapeutic scoliosis-specific exercise (PSSE). Determining the efficacy of PSSE in AIS has been challenging as the clinical effect is closely linked to exercise compliance (a dose-response relationship), with home exercise programs (HEPs) showing a general trend for decreased participation over time. The existing literature reports contradictory definitions and parameters of appropriate PSSE compliance in AIS. As such, this scoping review is necessary for therapists to identify PSSE prescription consistency, enabling clear guidelines for improved PSSE compliance. <b>Methods</b>: A scoping review of the literature was conducted to synthesize original research from inception to November 2024 and reference lists were examined for studies reporting compliance, adherence, or motivational strategies for PSSE in AIS. <b>Results</b>: Fifteen articles with a focus on PSSE in AIS were included in this review. The results demonstrate that compliance (C) and adherence (A) are terms commonly used interchangeably, only half of the studies clearly define compliance and/or adherence, and some utilize motivational strategies; however, outcomes of compliance/adherence were often not reported in the Results section or reflected in the discussion of results. <b>Conclusions</b>: Compliance and/or adherence are inconsistently reported within studies and numerous variations exist in (1) the section of the paper it is mentioned, (2) whether the inclusion criteria hinged on patient compliance/adherence, and (3) whether motivational strategies were employed and outcomes reported. Notably, there was a lack of compliance or adherence reporting in Results and Discussion sections of papers. The definition of appropriate compliance and any effective motivational strategies to improve compliance to achieve the desired results for treatment of AIS remain undetermined.