Protective and risk physical activities for adolescent idiopathic scoliosis: a systematic review identifying one-hour daily activity threshold and Chinese school-based prevention framework
Bibliographic record
Abstract
Objective: To systematically review the association between different types and intensities of physical activity and adolescent idiopathic scoliosis (AIS) risk, synthesize evidence on dose-response relationships between physical activity and AIS prevention, and propose school intervention recommendations. Methods: Literature related to physical activity for preventing scoliosis and promoting spinal health in adolescents was retrieved from PubMed, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, and Google Scholar, published between January 2015 and January 2025. After screening, key information was extracted, and methodological quality was assessed using the Newcastle-Ottawa Scale for case-control and cohort studies, the AHRQ methodology checklist for cross-sectional studies, and the Cochrane Risk-of-Bias tool and Jadad scale for randomized controlled trials. The protocol was registered with PROSPERO (CRD420251065070). Results: Twenty-one studies were included after screening, of good methodological quality, involving 77,813 adolescents, including 5,259 AIS patients, published between 2015 and 2025. Physical activity was significantly associated with AIS. Most recreational sports and traditional Chinese sports may prevent AIS, while long-term participation in competitive sports, dance, and artistic gymnastics were risk factors for AIS. Adolescents need to achieve a minimum threshold of one hour of daily physical activity to effectively prevent spinal scoliosis. Conclusion: Appropriate physical activity may reduce AIS risk. Schools should enhance their focus on adolescent physical activity and establish an integrated "school-family", "school-medical", and "school-sports" approach to support scoliosis prevention and promote healthy adolescent development. Systematic Review Registration: https://www.crd.york.ac.uk/, PROSPERO (CRD420251065070).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.009 |
| Bibliometrics | 0.009 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".