Abstract

Background: In China, acupuncture is a common adjuvant therapy for adolescent idiopathic scoliosis (AIS), though it is typically combined with other interventions. Swimming is frequently recommended for mild AIS (Cobb angle <25°), yet its efficacy remains uncertain due to limited evidence and lack of standardized protocols. This study aimed to evaluate the effectiveness and safety of breaststroke combined with electroacupuncture versus breaststroke alone in skeletally immature mild AIS patients.
Methods: In this single-center retrospective cohort study, 117 AIS patients (Risser sign ≤3) treated between January 2020 and March 2024 were allocated to two groups. The breaststroke combined with electroacupuncture group (BE-group, n=56) received 3 months of electroacupuncture and 12 months of supervised 800-meter breaststroke training, while the breaststroke group (B-group, n=61) underwent 12 months of breaststroke training only. Radiographic parameters, SRS-22 scores, and Walter Reed Visual Assessment Scale (WRVAS) results were assessed at baseline, 3 months, and 12 months.
Results: At 12 months, the BE-group showed significantly better deformity correction than the B-group. Intra-group analysis revealed that the BE-group achieved significant improvements in Cobb angle (p<0.001), angle of trunk rotation (ATR, p=0.018), WRVAS (p<0.001), and SRS-22 self-image score (p=0.003), whereas the B-group maintained curve stability without significant correction. Both groups exhibited improvements in SRS-22 pain and mental health domains (p<0.05), as well as reduced thoracic kyphosis (p<0.05). Subgroup analysis indicated that the combined therapy was especially effective for thoracolumbar/lumbar curves (p<0.001), while no significant intergroup difference was observed in thoracic-dominant AIS (p=0.112).
Conclusion: Both breaststroke monotherapy and its combination with electroacupuncture had protective effects in skeletally immature mild AIS. While breaststroke alone may halt curve progression, combining it with electroacupuncture offers superior corrective outcomes, particularly in patients with thoracolumbar/lumbar curves.

Keywords

Adolescent idiopathic scoliosis, electroacupuncture, swimming, conservative treatment, traditional Chinese medicine