Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that requires effective conservative management. Physiotherapeutic scoliosis-specific exercises (PSSE) have been widely used; however, evidence regarding their effectiveness according to therapist supervision intensity remains limited. Therefore, this study aimed to evaluate the effects of PSSE in patients with AIS and to examine differences according to supervision intensity. Design: Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in accordance with the PRISMA 2020 guidelines. Materials and Methods: RCTs involving patients with AIS (aged 10–18 years, Cobb angle 10–45°) were included if PSSE was applied alone or in combination with other conservative treatments. The primary outcomes were Cobb angle, angle of trunk rotation (ATR), and Scoliosis Research Society-22 (SRS-22). Effect sizes were calculated as standardized mean differences (SMDs) using a random-effects model. Subgroup analyses were performed according to supervision intensity. Results: A total of 10 RCTs (n = 600) were included. The pooled analysis demonstrated that PSSE significantly reduced Cobb angle (SMD = −0.52, 95% CI −0.79 to −0.25, p < 0.001) and ATR (SMD = −1.01, 95% CI −1.53 to −0.48, p < 0.001) compared with control interventions. In subgroup analyses, fully supervised interventions showed larger and more consistent effects, with statistically significant improvements in both Cobb angle (SMD = −0.70) and ATR (SMD = −1.33), whereas hybrid approaches did not demonstrate statistically significant effects. However, statistical support for subgroup differences was stronger for ATR than for Cobb angle. SRS-22 scores showed a trend toward improvement but did not reach statistical significance. Moderate to high heterogeneity was observed in some analyses, and risk-of-bias concerns were identified in several studies. Conclusions: PSSE may be an effective conservative intervention for improving structural curvature and trunk rotation in patients with AIS. Subgroup findings suggest that closer therapist supervision may be associated with more favorable effects, particularly for ATR; however, these findings should be interpreted cautiously because of heterogeneity and potential risk of bias. Large-scale, high-quality trials are warranted to confirm the magnitude and long-term sustainability of clinical effects.
Lee et al. (Wed,) studied this question.