Chiropractic Treatments for Idiopathic Scoliosis: A Narrative Review Based on SOSORT Outcome Criteria

Benefits on pain and mental health of manual therapy for idiopathic scoliosis: A meta-analysis

BACKGROUND

Idiopathic scoliosis (IS) is a common spinal disorder. Although several studies have reported the benefits of manual therapy for patients with IS in improving pain, anxiety, depression, and spinal disorders, the efficacy of manual therapy in the management of IS remain controversial. Therefore, this review was conducted to assess effects of manual therapy in the management of IS, primarily on pain and mental health of the patients and secondarily on their spinal disorders.

METHODS

Six electronic databases were searched for randomized controlled trials of manual therapy in the management of IS. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. The meta-analysis was conducted depending on different outcomes and control therapies using Review Manager version 5.3 software.

RESULTS

Seventeen studies were included in the present review. The PEDro scores of the included studies ranged from 5-7 points. The aggregated results indicated that Tuina (a traditional Chinese manipulation technique) had valuable improvement effects on pain (standardized mean difference (SMD), 0.92; 95% confidence interval (CI), 0.59 to 1.25; P<0.00001), negative emotions (SMD, 0.82; 95% CI, 0.51 to 1.13; P<0.00001), and disability (SMD, 1.29; 95% CI, 0.39 to 2.19; P=0.005). For the radiographic outcomes including the Cobb angle and vertebral rotation, Tuina, especially when combined with other conservative therapies, showed potential complementary effects for patients with IS.

CONCLUSIONS

Tuina, as a complementary and alternative therapy, should be considered for the effective management of patients with IS, especially for the improvement of their pain and mental health. More randomized controlled trials are recommended to validate the current evidence.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42020165220.

Manual therapy for idiopathic scoliosis: A protocol for systematic review and meta-analysis

INTRODUCTION

More patients with idiopathic scoliosis (IS) preferred to choose manual therapy as a complementary conservative treatment, but the effects of manual therapy for IS remains controversial. The previous reviews could not draw reliable conclusion due to few eligible studies to perform a meta-analysis. In the last decade, however, several new studies were published that assessed the effects of manual therapy in the management of IS, especially in China. Therefore, the present systematic review and meta-analysis will be performed to examine whether manual therapy is effective for IS primarily in improving patient-centerd symptoms and secondarily in radiographic outcomes.

METHODS AND ANALYSIS

A computerized literature search will be performed in the following electronic databases from their inceptions to June 2020 to identify randomized controlled trials of manual therapy in the management of IS: PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Clinical Trials, China Knowledge Resource Integrated Database, Wanfang Data Information, and Weipu Database for Chinese Technical Periodicals. The quality of included studies will be assessed independently by 2 reviewers using the Physiotherapy Evidence Database scale. The meta-analysis will be performed with the Review Manager Version 5.3 software to assess the effects on patient-centred outcomes and radiographic outcomes of manual therapy for IS. The heterogeneity will be assessed using I statistic and Cochran Q statistic. The subgroup analysis will be conducted based on different control interventions and subpopulations. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation.

ETHICS AND DISSEMINATION

No ethical statement will be required for the performance of this review and meta-analysis. The results of this review will be published in an international peer-reviewed journal.INPLASY registration number: INPLASY202070058.