# Effects of Bracing Combined With Tele‐Rehabilitation‐Guided Family Physiotherapeutic Scoliosis‐Specific Exercises on Adolescent Idiopathic Scoliosis

## TL;DR

Combining bracing with digitally supervised exercises improves spinal deformity in adolescents with scoliosis more effectively than self-guided exercises.

## Contribution

This study introduces tele-rehabilitation as a novel method to enhance the effectiveness of bracing in treating adolescent idiopathic scoliosis.

## Key findings

- Tele-rehabilitation improved Cobb angle outcomes more than self-guided exercises.
- Supervised exercises reduced spinal rotation and improved patient-reported outcomes significantly.
- Digital supervision lowered the risk of curve progression in scoliosis patients.

## Abstract

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.

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.

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).

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.

For adolescents with idiopathic scoliosis, tele‐rehabilitation‐guided physiotherapeutic scoliosis‐specific exercises combined with the Chêneau brace can effectively improve the degree of spinal deformity. This new strategy may be a reliable and efficient conservative treatment.