Guidelines for physical activity for individuals with scoliosis

Objective: To provide evidence-based guidelines regarding the appropriateness of physical activity (PA) for those with scoliosis.

Design: Systematic review of the literature followed by consensus panel recommendations.

Methods: A systematic review of PubMed, CINAHL, Index to Chiropractic Literature, and the National Guidelines Clearinghouse from the earliest date of each database through July 2008 was performed. Websites of respected organizations were searched for position papers on scoliosis and PA. Papers were rated and recommendations for PA were made using criteria established by the Oxford Centre for Evidence-based Medicine. These were assessed by a nine member volunteer committee of health professionals.

Results: Recommendations were made from 3Level 3b studies and 8 Level 5 studies. Brace-treated and surgically-treated patients have demonstrated that they can participate in PA at the same level as non-surgical patients. Non-surgically treated patients are encouraged to participate in PA. Scoliosis is not a contraindication to participation in most sports (Grade D). Brace-treated scoliosis patients are encouraged to exercise with their brace on and off (Grade D). PA may be commenced following surgery for scoliosis, however, there is no high quality evidence to inform the timing of return to PA (Grade D). A potential association between elite level competition in specific sports at an early age and an increased prevalence of scoliosis has been reported (Grade C). The recommendations are in preparation at the National Guidelines Clearinghouse.

Conclusion: Evidence-based guidelines are available to health care providers and to patients with scoliosis for making decisions to participate in PA.