Objective: Adolescent idiopathic scoliosis (AIS) necessitates multimodal management strategies integrating orthotic intervention and physiotherapeutic scoliosis-specific exercises (PSSE). This study aimed to compare the clinical efficacy of brace therapy combined with tele-rehabilitation-guided PSSE versus brace treatment with self-guided home-based PSSE in mitigating spinal deformity progression.
Methods: A cohort of 67 treatment-naïve AIS patients from a tertiary scoliosis center (July 2021–July 2023) was stratified into two intervention groups: (1) tele-rehabilitation (real-time digitally supervised PSSE) and (2) autonomous practice (self-guided home PSSE). Longitudinal evaluations at baseline, 6, 12, and 24-month intervals included radiographic Cobb angle quantification, scoliometric angle of trunk rotation (ATR) assessment, and Scoliosis Research Society-22 (SRS-22) patient-reported outcomes. Treatment success was categorized as improvement (Cobb reduction ≥ 5°), stability (change < 5°), or progression (increase ≥ 5°). Data were analyzed using paired and independent t-tests, Mann–Whitney U test, and Pearson's χ2 test.
Results: At 24-month follow-up, the tele-rehabilitation group exhibited significantly higher Cobb angle improvement rates (70.6% vs. 57.6%, p < 0.05) and lower progression rates (2.9% vs. 6.1%) compared to the autonomous practice group. Axial rotation correction demonstrated superior outcomes in the supervised cohort (final ATR: 6.9° ± 1.9° vs. baseline, p < 0.01). All SRS-22 domains showed clinically meaningful improvements (p < 0.05).
Conclusion: Tele-rehabilitation-guided PSSE combined with bracing demonstrates enhanced efficacy over self-guided protocols in achieving three-dimensional deformity correction, stabilizing curve progression, and optimizing patient-centered outcomes. Structured digital supervision emerges as a critical adjunct to orthotic management, advocating for technology-integrated conservative strategies in adolescent spinal deformity care.
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2026 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.
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