Priority 1 from the Scoliosis PSP

UNCERTAINTY: What are the best strategies for reducing or preventing the curve from getting worse, combining treatment and self-management approaches to avoid the need for surgery? (JLA PSP Priority 1)
Overall ranking	1
JLA question ID	0059/1
Explanatory note	Not available for this PSP
Evidence	Previous related research studies - Williams MA, Heine PJ, Williamson EM, Toye F, Dritsaki M, Petrou S, Crossman R, Lall R, Barker KL, Fairbank J, Harding I, Gardner A, Slowther AM, Coulson N, Lamb SE. Active Treatment for Idiopathic Adolescent Scoliosis (ACTIvATeS): a feasibility study. Health Technology Assessment 2015; 19(55) Marco Monticone et al. 2016 Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial European Spine Journal, Volume 25, Issue 10, pp 3120–3129. Josette Bettany-Saltikov, Hans-Rudolf Weiss, Nachiappan Chockalingam, Razvan Taranu, Shreya Srinivas, Julie Hogg, Victoria Whittaker, Raman V Kalyan & Tracey Arnell. (2015) Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Back and Neck Group, The Cochrane Library. Romano M, Minozzi S, Zaina F, Bettany-Saltikov J, Chockalingam N, Kotwicki T, Maier-Hennes A, Negrini S. Exercises for adolescent idiopathic scoliosis, a Cochrane systematic review. Spine 2013; 38(14): E883-E893 Harvey A, Baker L, Williams K. Non-surgical prevention and management of scoliosis for children with Duchenne muscular dystrophy: what is the evidence? Journal of Paediatrics and Child Health 2014; 50(10): E3-E9
Health Research Classification System category	Musculoskeletal

Extra information provided by this PSP
Original uncertainty examples	Does the schroth method reduce the cobb angle of patients over 45 degrees? ~ What are the effects of spinal bracing for adolescent idiopathic scoliosis in preventing surgery? ~ In children with neurodisability, is there a role for hydrotherapy/physiotherapy/massage/chiropractice in the delay of onset and worsening of scoliosis? ~ Does regular activity and sporting activity in particular aid scoliosis, or at least stop progression if actively targeted towards scoliosis? ~ What physical therapies are proven to help the symptoms and are any actually helpful in improving the curve?

Extra information provided by this PSP

Original uncertainty examples

Does the schroth method reduce the cobb angle of patients over 45 degrees? ~ What are the effects of spinal bracing for adolescent idiopathic scoliosis in preventing surgery? ~ In children with neurodisability, is there a role for hydrotherapy/physiotherapy/massage/chiropractice in the delay of onset and worsening of scoliosis? ~ Does regular activity and sporting activity in particular aid scoliosis, or at least stop progression if actively targeted towards scoliosis? ~ What physical therapies are proven to help the symptoms and are any actually helpful in improving the curve?

PSP information
PSP unique ID	0059
PSP name	Scoliosis
Total number of uncertainties identified by this PSP.	54 (To see a full list of all uncertainties identified, please see the PSP final report held on the JLA website)
Date of priority setting workshop	4 November 2017