Schroth Method Exercises for Treating Idiopathic Adolescent Scoliosis; A Narrative Review

Document Type : Review Articles


1 Associate Professor, Musculoskeletal Research Center AND Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc Student, Musculoskeletal Research Center AND Rehabilitation Students Research Center (Treata), Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran



-Introduction: Scoliosis is a 3-dimensional spinal deformity. In recent years, more attention has been paid to scoliosis specific exercises. Among different exercise methods for treating scoliosis, the Schroth’s method is the most recognized and widely used. This study aimed to determine the effect of Schroth’s scoliosis specific exercises on different outcomes and quality of life in patients with idiopathic scoliosis.Materials and Methods: In this narrative review, databases such as PubMed, PEDro, Trip, ScienceDirect, and Google Scholar were searched from 2009 till 2019 using words “schroth AND scoliosis AND (quality of life/ muscle endurance/cobb angle/ respiration/respiratory function) PSSE AND scoliosis, 3 dimensional exercises AND scoliosis.Results: Finally, 15 studies were included. Most of the studies discussed Cobb’s angle changes and other outcomes such as pain, back muscle endurance, respiratory volumes, chest expansion, pulmonary function, cosmetics and patient’s satisfaction, trunk deformities, weight distribution, and quality of life in patients with idiopathic scoliosis.Conclusion: Schroth’s method’s and 3-dimensional exercises had a positive effect on Cobb’s angle, pain, back muscle endurance, respiratory volumes, chest expansion, cosmetics and patient’s satisfaction, trunk deformities, weight distribution, and quality of life in patients with idiopathic scoliosis. However, the effect of such exercises on pulmonary function is controversial.


  1. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, et al. 2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 2018; 13: 3.
  2. Kleinberg S. The operative treatment of scoliosis. Arch Surg 1922; 5(3): 631-45.
  3. Burwell RG, James NJ, Johnson F, Webb JK, Wilson YG. Standardised trunk asymmetry scores. A study of back contour in healthy school children. J Bone Joint Surg Br 1983; 65(4): 452-63.
  4. James JI. The management of infants with scoliosis. J Bone Joint Surg Br 1975; 57(4): 422-9.
  5. Schreiber S, Parent EC, Moez EK, Hedden DM, Hill D, Moreau MJ, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". Scoliosis 2015; 10: 24.
  6. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013; 7(1): 3-9.
  7. Scoliosis Research Society. Adolescent Idiopathic Scoliosis [Online]. [cited 2019]; Available from: URL:
  8. Sanders JO, Browne RH, McConnell SJ, Margraf SA, Cooney TE, Finegold DN. Maturity assessment and curve progression in girls with idiopathic scoliosis. J Bone Joint Surg Am 2007; 89(1): 64-73.
  9. Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: A follow-up mean of 16 years after maturity. Spine (Phila Pa 1976) 2007; 32(20): 2198-207.
  10. Negrini S, Hresko TM, O'Brien JP, Price N. Recommendations for research studies on treatment of idiopathic scoliosis: Consensus 2014 between SOSORT and SRS non-operative management committee. Scoliosis 2015; 10: 8.
  11. Dolan LA, Wright JG, Weinstein SL. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 2014; 370(7): 681.
  12. Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J 2014; 23(6): 1204-14.
  13. Goldberg CJ, Gillic I, Connaughton O, Moore DP, Fogarty EE, Canny GJ, et al. Respiratory function and cosmesis at maturity in infantile-onset scoliosis. Spine (Phila Pa 1976) 2003; 28(20): 2397-406.
  14. Marty-Poumarat C, Scattin L, Marpeau M, Garreau de Loubresse C, Aegerter P. Natural history of progressive adult scoliosis. Spine (Phila Pa 1976) 2007; 32(11): 1227-34.
  15. Zaina F, Negrini S, Atanasio S. TRACE (Trunk Aesthetic Clinical Evaluation), a routine clinical tool to evaluate aesthetics in scoliosis patients: Development from the Aesthetic Index (AI) and repeatability. Scoliosis 2009; 4: 3.
  16. Aulisa AG, Giordano M, Falciglia F, Marzetti E, Poscia A, Guzzanti V. Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner. Scoliosis 2014; 9: 6.
  17. Fortin C, Feldman DE, Cheriet F, Labelle H. Validity of a quantitative clinical measurement tool of trunk posture in idiopathic scoliosis. Spine (Phila Pa 1976) 2010; 35(19): E988-E994.
  18. Negrini S, Aulisa L, Ferraro C, Fraschini P, Masiero S, Simonazzi P, et al. Italian guidelines on rehabilitation treatment of adolescents with scoliosis or other spinal deformities. Eura Medicophys 2005; 41(2): 183-201.
  19. Weiss HR, Negrini S, Rigo M, Kotwicki T, Hawes MC, Grivas TB, et al. Indications for conservative management of scoliosis (SOSORT guidelines). Stud Health Technol Inform 2008; 135: 164-70.
  20. Kotwicki T, Durmala J, Czaprowski D, Glowacki M, Kolban M, Snela S, et al. Conservative management of idiopathic scoliosis--guidelines based on SOSORT 2006 Consensus. Ortop Traumatol Rehabil 2009; 11(5): 379-95.
  21. Berdishevsky H, Lebel VA, Bettany-Saltikov J, Rigo M, Lebel A, Hennes A, et al. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. Scoliosis Spinal Disord 2016; 11: 20.
  22. Myers E. Analyzing Scoliosis: The Pilates instructor's guide to scoliosis. 1st ed. CreateSpace Independent Publishing Platform; 2019. p. 25-36.
  23. HwangBo PN. Psychological and physical effects of Schroth and Pilates exercise on female high school students with idiopathic scoliosis. J Kor Phys Ther 2016; 28(6): 364-8.
  24. Kim G, HwangBo PN. Effects of schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis. J Phys Ther Sci 2016; 28(3): 1012-5.
  25. Fishman L, Monroe M, Iyengar BKS. Yoga and scoliosis: A journey to health and healing. New York, NY: Springer Publishing Company; 2011.
  26. Miller EB, Heraty NDL, McCann S, Ornellas T. Yoga for scoliosis: A path for students and teachers. 2016. p. 20-30.
  27. Hacquebord JH, Leopold SS. In brief: The Risser classification: A classic tool for the clinician treating adolescent idiopathic scoliosis. Clin Orthop Relat Res 2012; 470(8): 2335-8.
  28. Lehnert-Schroth C, Mohr C, Reeves A. Three-dimensional treatment for scoliosis: a physiotherapeutic method for deformities of the spine. Palo Alto, CA: Martindale Press; 2000.
  29. Fusco C, Zaina F, Atanasio S, Romano M, Negrini A, Negrini S. Physical exercises in the treatment of adolescent idiopathic scoliosis: An updated systematic review. Physiother Theory Pract 2011; 27(1): 80-114.
  30. Otman S, Kose N, Yakut Y. The efficacy of Schroth`s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Neurosciences (Riyadh) 2005; 10(4): 277-83.
  31. Rigo M, Reiter C, Weiss HR. Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil 2003; 6(3-4): 209-14.
  32. Schreiber S, Parent EC, Khodayari ME, Hedden DM, Hill DL, Moreau M, et al. Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better Cobb angle outcomes in adolescents with idiopathic scoliosis - an assessor and statistician blinded randomized controlled trial. PLoS One 2016; 11(12): e0168746.
  33. Kwan KYH, Cheng ACS, Koh HY, Chiu AYY, Cheung KMC. Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis: results from a preliminary study-SOSORT Award 2017 Winner. Scoliosis Spinal Disord 2017; 12: 32.
  34. Kuru T, Yeldan I, Dereli EE, Ozdincler AR, Dikici F, Colak I. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil 2016; 30(2): 181-90.
  35. Wibmer C, Groebl P, Nischelwitzer A, Salchinger B, Sperl M, Wegmann H, et al. Video-game-assisted physiotherapeutic scoliosis-specific exercises for idiopathic scoliosis: Case series and introduction of a new tool to increase motivation and precision of exercise performance. Scoliosis Spinal Disord 2016; 11: 44.
  36. Kim KD, HwangBo PN. Effects of the Schroth exercise on the Cobb's angle and vital capacity of patients with idiopathic scoliosis that is an operative indication. J Phys Ther Sci 2016; 28(3): 923-6.
  37. Kim MJ, Park DS. The effect of Schroth's three-dimensional exercises in combination with respiratory muscle exercise on Cobb's angle and pulmonary function in patients with idiopathic scoliosis. Phys Ther Rehabil Sci 2017; 6: 113-9.
  38. Schreiber S, Parent EC, Hill DL, Hedden DM, Moreau MJ, Southon SC. Schroth physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis: How many patients require treatment to prevent one deterioration? - Results from a randomized controlled trial - "SOSORT 2017 Award Winner". Scoliosis Spinal Disord 2017; 12: 26.
  39. Park JH, Jeon HS, Park HW. Effects of the Schroth exercise on idiopathic scoliosis: A meta-analysis. Eur J Phys Rehabil Med 2018; 54(3): 440-9.
  40. Anwer S, Alghadir A, Abu SM, Anwar D. Effects of exercise on spinal deformities and quality of life in patients with adolescent idiopathic scoliosis. Biomed Res Int 2015; 2015: 123848.
  41. Payne WK 3rd, Ogilvie JW, Resnick MD, Kane RL, Transfeldt EE, Blum RW. Does scoliosis have a psychological impact and does gender make a difference? Spine (Phila Pa 1976) 1997; 22(12): 1380-4.
  42. Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis 2012; 7(1): 7.
  43. Kostuik JP, Bentivoglio J. The incidence of low-back pain in adult scoliosis. Spine (Phila Pa 1976) 1981; 6(3): 268-73.
  44. Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet 2008; 371(9623): 1527-37.
  45. Bradford DS, Tay BK, Hu SS. Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976) 1999; 24(24): 2617-29.
  46. Borysov M, Mogiliantseva T. Rehabilitation of adolescents with scoliosis during growth - preliminary results using a novel standardized approach in Russia. (Methodology). Curr Pediatr Rev 2016; 12(1): 31-5.