{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:15:43Z","timestamp":1791566143036,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The Schroth method is considered potentially valuable as an alternative intervention to control curve progression in mild to moderate adolescent idiopathic scoliosis. However, patients are often dependent on the subjective experience of the physiotherapist when practicing, as changes in spinal alignment and muscle activation are unknown. The aim of this study was to evaluate the effectiveness of the Schroth method for spinal alignment and muscle activation in adolescents with idiopathic scoliosis (AIS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cross\u2010sectional study, conducted at the Scoliosis Engineering Center of Guangzhou Sport University (January 2020\u2013October 2022), enrolled 36 AIS (4 males, 32 females; age 13.2\u2009\u00b1\u20091.8\u2009years) presenting major thoracic curvature (Cobb angle: 10\u00b0\u201340\u00b0, Risser stage 0\u20134). Participants underwent a standardized 1\u2010week pretraining protocol before performing four Schroth exercises (\u201c50\u2009\u00d7\u2009Pezziball,\u201d sail, muscle cylinder, and corrected standing). Real\u2010time spinal ultrasound angles (SUAs) and paraspinal muscle activation (via surface electromyography, sEMG) were quantified during habitual standing (baseline) and exercise conditions. Normality was verified using Kolmogorov\u2013Smirnov tests. Within\u2010group comparisons employed paired <jats:italic>t<\/jats:italic>\u2010tests (effect sizes: Cohen's <jats:italic>d<\/jats:italic>; 95% CIs), while proximal thoracic (PT) compensation frequencies were assessed via chi\u2010squared tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All four Schroth exercises significantly reduced the SUA of the primary thoracic curve compared to habitual standing (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The lumbar curve SUA decreased specifically after \u201c50\u2009\u00d7\u2009Pezziball\u201d and muscle cylinder exercises (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). PT curve compensation frequency rose from 16.7% (6\/36) in habitual standing to 33.3% (12\/36) and 30.6% (11\/36) during \u201c50\u2009\u00d7\u2009Pezziball\u201d and sail exercises, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). sEMG demonstrated reduced paravertebral muscle (PSM) activation asymmetry at the thoracic apex (T8) during corrective standing, \u201c50\u2009\u00d7\u2009Pezziball,\u201d and sail exercises (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). However, \u201c50\u2009\u00d7\u2009Pezziball\u201d and sail exercises triggered compensatory left\u2010dominant PSM imbalance at T2 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). At lumbar levels (L2\u2013L5), performing 50\u2009\u00d7\u2009Pezziball exercise exacerbated asymmetry (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), whereas muscle cylinder exercises reversed the activation patterns of the PSM (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While Schroth exercises effectively reduced thoracic curvature and improved T8 muscle symmetry, caution is warranted during \u201c50\u2009\u00d7\u2009Pezziball\u201d and sail exercises due to increased PT compensation and lumbar\/T2 muscle imbalances. Muscle cylinder exercises may mitigate adverse lumbar effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70096","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:55:04Z","timestamp":1749534904000},"page":"2150-2158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Immediate Effects of the Schroth Method on Spinal Curvature and Paravertebral Muscle Activation in Adolescent Idiopathic Scoliosis"],"prefix":"10.1111","volume":"17","author":[{"given":"Xiaohui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinmiao","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianglan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiyan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinzi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bagen","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Rehabilitation Engineering Center for Adolescent Idiopathic Scoliosis Guangzhou Sport University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion Guangzhou Sport University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181bcc835"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-024-08276-9"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0442-7"},{"key":"e_1_2_13_5_1","first-page":"447","article-title":"Curve Progression in Idiopathic Scoliosis","volume":"65","author":"Weinstein S. 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