Abstract
BACKGROUND: Core stabilization exercises are a crucial intervention in Adolescent Idiopathic Scoliosis (AIS), as they are widely accessible and specifically address trunk muscle weakness and neuromuscular deficits that are considered potential contributors to curve progression. The aim of this study was to demonstrate the effects of core stabilization based exercise training on muscle strength, neuromuscular control, quality of life, and Cobb angle improvement in patients with AIS. METHODS: Thirty two patients with AIS were included in this prospective, randomized, and controlled study. Participants were randomly divided into two groups as training group (n = 16) and control group (n = 16). Two individuals were lost to follow-up, resulting in a final analytical sample of 30 participants, with 15 in the training group and 15 in the control group. Training group received core stabilization based exercise training. Control group received traditional exercises. These interventions were carried out in 16 sessions under the supervision of a physiotherapist 2 days a week to be applied daily for 8 weeks. Muscle strength (Biodex isokinetic dynamometer), neuromuscular control (sEMG), Cobb angle, quality of life (SRS-22 questionnaire), perception of cosmetic deformity (WRVAS), trunk rotation angle, and spinal flexibility were assessed at the beginning and end of the study. Between-group comparisons were performed using analysis of covariance (ANCOVA) with baseline values as covariates, and statistical significance was set at p < 0.05. RESULTS: Compared with the control group, the training group demonstrated significantly greater improvements in trunk muscle strength and neuromuscular control, with significant changes observed in the majority of parameters (p < 0.05). A clinically meaningful reduction in Cobb angle was observed in the training group (mean decrease: 5.7°, p < 0.001). Significant between-group improvements were also found in trunk rotation angle, spinal flexibility, quality of life, and perception of cosmetic deformity (p < 0.05). CONCLUSIONS: Based on comprehensive and objective assessments, and after adjusting for baseline differences, these findings indicate that core stabilization based exercise training may provide meaningful benefits for patients with AIS and support its consideration as a complementary component of conservative management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-026-09489-3.