Comparison of conservative treatment outcomes for adolescent idiopathic scoliosis in swimmers and rhythmic gymnastics athletes

Background. The impact of regular sports activities and specific types of sports on the effectiveness of conservative treatment for adolescent idiopathic scoliosis (AIS) has not been sufficiently studied. Understanding this relationship is essential for personalizing programs of physiotherapeutic specific scoliosis exercises (PSSE) and preventing deformity progression.

The aim of the study — to compare the results of conservative therapy for adolescent idiopathic scoliosis among rhythmic gymnasts, swimmers, and patients not engaged in regular sports activities, as well as to evaluate the influence of sport type on changes in frontal and sagittal trunk balance parameters and flexibility.

Methods. A retrospective analysis was performed on 54 patients: 21 rhythmic gymnasts (Group 1), 11 swimmers (Group 2), and 22 non-athletic patients (Group 3, control). The groups were comparable in terms of key anthropometric and radiological parameters. All patients underwent PSSE according to the BSPTS Rigo method. TLSO bracing was used when indicated. Before and after treatment, the Cobb angle, thoracic kyphosis, lumbar lordosis, sagittal index, angle of trunk inclination (ATI), and flexibility (sit-and-reach test) were assessed.

Results. Significant intergroup differences were found only for the Cobb angle (H = 9.366; p = 0.007) during treatment. Post-hoc analysis revealed that gymnasts showed a statistically significantly greater reduction in Cobb angle compared with the control group (p < 0.0167). Differences between the control group and swimmers, as well as between gymnasts and swimmers, did not reach statistical significance after adjustment. No significant intergroup differences were found for other parameters (thoracic kyphosis, lumbar lordosis, sagittal index, flexibility, body mass, and height). Intragroup analysis demonstrated a statistically significant decrease in Cobb angle and ATI among gymnasts, and improved flexibility in both gymnasts and the control group. Deformity progression greater than 5° occurred less frequently in athletes (3.1%) than in non-athletic patients (27.3%; p = 0.0144).

Conclusion. Conservative treatment based on physiotherapeutic specific scoliosis exercises is effective in all patients with adolescent idiopathic scoliosis. Rhythmic gymnasts demonstrated a more pronounced correction of frontal plane deformity and a greater reduction in trunk inclination compared with non-athletic patients. Swimming did not show advantages for correction of deformities in either the frontal (Cobb angle) or sagittal (lordosis, kyphosis) planes.