Effects of Schroth method combined with scapular stabilization exercises on shoulder imbalance, scapular position and Cobb angle in adolescent idiopathic scoliosis: a randomized controlled trial

Background Adolescent idiopathic scoliosis (AIS) is frequently accompanied by shoulder and scapular asymmetry.Objective The aim of this study was to investigate the effect of scapular stabilization exercises (SSE) combined with Schroth exercises on scoliosis severity, scapula position and shoulder imbalance in individuals with AIS. We hypothesized that this combined exercise protocol would significantly reduce scoliosis severity and improve both scapular positioning and shoulder balance.Methods Twenty-six individuals with AIS and Lenke Type 1 main thoracic curvature were included. Participants were recruited from a scoliosis rehabilitation clinic and randomly assigned to one of two groups: the Scapular Stabilization Exercises Group (SSEG) (n = 13) or the Schroth Exercises Group (SchEG) (n = 13). While both groups underwent a Schroth exercise program, the SSEG additionally performed SSE three times per week for eight weeks. Outcome measures assessed at baseline and post-intervention (Week 8) included Cobb angle (radiography), trunk rotation (scoliometer), scapular position (Lateral Scapular Slide Test, Scapular Index), periscapular muscle strength, and shoulder imbalance (radiographic/clinical assessments).Results At the end of the 8-week intervention, SSE combined with Schroth exercises were found to be more effective than Schroth exercises alone in reducing neck tilt (F = 4.701, p = .042, η2 = 0.183) and scapular angle (F = 7.165, p = .014, η2 = 0.254). Moreover, the SSEG demonstrated significant improvements from baseline across the majority of outcome measures at week 8 (p < .05). In contrast, in the SchEG, significant improvements were observed in thoracic trunk rotation, convex-side upper trapezius strength, and concave-side serratus anterior strength at the end of 8 weeks (p < .05).Conclusion In individuals with AIS, SSE combined with Schroth exercises appear to be an effective way to reduce shoulder imbalance. However, the effectiveness of this combination on the Cobb angle and scapula position is limited. Studies with larger sample sizes and longer follow-up periods are needed.