Abstract
AIM: The aim of this study was to investigate the efficacy of balanced jar therapy combined with the Flexible Corrective Appropriate Technology (FCAT) in adolescent idiopathic scoliosis (AIS). METHODS: This randomized, single-blind study enrolled adolescents with AIS from October 2022 to September 2024. Participants were divided into control and observation groups. The control group received flexible bracing for at least 6 months, while the observation group received an additional 2-week course of balanced cupping therapy-including flash, kneading, pushing, retention, and removal cupping techniques. Primary outcomes, which include the reduction in Cobb angle and apical transverse rotation (ATR), were assessed at 3- and 6-months post-intervention. Secondary outcomes, including gait parameters, plantar pressure measures, spinal mobility, adverse events, and quality of life, were also evaluated at the same timepoints. RESULTS: The observation group demonstrated significantly greater reduction in Cobb angle (24.16 ± 3.25 vs. 26.98 ± 3.87, P = 0.007) and ATR (10.24 ± 1.66 vs. 11.79 ± 1.83, P = 0.003) at 3 months. The plantar pressure indices, particularly the center of pressure excursion index (CPEI), showed significantly greater improvement in the observation group (8.87 ± 2.17 vs. 10.54 ± 2.21, P = 0.020). Changes in apical vertebral rotation (AVR) (P = 0.001) and the distance of the apical vertebral translation (AVT) (P < 0.001) were observed within the observation group, but between-group comparisons showed no statistical significance. No statistically significant differences were observed between groups for gait parameters and spinal mobility measurements (P > 0.05). The combined treatment showed favorable safety (8.00% vs. 14.46%, P = 0.37) and significantly better quality of life outcomes (P < 0.001). Significant Group × Time interactions were found for Cobb angle (F = 8.93, P < 0.001, η(2) = 0.214) and CPEI (F = 12.56, P < 0.001, η(2) = 0.287), surviving Bonferroni correction. CONCLUSION: This study is the first to report the short-term effects of balanced jar therapy combined with the FCAT for AIS. The combined therapy was associated with significant improvement in several scoliosis indices, plantar pressure, and mental health, suggesting potential clinical benefit. However, clinical translation of this treatment modality needs to be optimized and validated in long-term studies.