Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 28, 2024
Date Accepted: Aug 13, 2025
Behavior Change Strategies in Digital Exercise Interventions for Adolescent Idiopathic Scoliosis: A Scoping Review
ABSTRACT
Background:
Adolescent Idiopathic Scoliosis (AIS) is a common spinal deformity typically treated with exercise therapy. Despite the increasing use of digital technologies in interventions, there remains a gap in understanding how to effectively integrate behavior change techniques (BCTs) and behavior theories within these digital solutions.
Objective:
This review aims to identify the digital characteristics of interventions and the BCTs used, and to analyze potential theoretical mechanisms with the Theoretical Domains Framework (TDF) and COM-B model.
Methods:
We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A total of 5 databases, including PubMed, Web of Science, Embase, Cochrane Library, and CINAHL were selected for screening eligible studies up to April 4, 2024. The inclusion criteria were studies involving AIS patients using digital interventions for exercise rehabilitation. Two researchers independently screened studies and extracted data into tables for descriptive analysis.
Results:
Out of the 3,267 identified papers, 21 studies (1%) were included. The most frequently used technologies were video conferencing (n = 7) and instructional videos (n = 5). The three most common BCT clusters were "Shaping Knowledge" (n = 19), "Social Support" (n = 16), and "Antecedents" (n = 16). "Knowledge" was the most utilized mechanism of action (n = 21), followed by "Skills” (n = 16), "Environmental Context and Resources” (n = 16), and "Social Influences” (n = 16). The studies primarily addressed "Capability" and "Opportunity", with less emphasis on "Motivation," particularly "Automatic Motivation."
Conclusions:
This review identified common digital technologies and their characteristics, analyzed potential mechanisms of behavior change in interventions, and provided recommendations for technology utilization. Future research should further evaluate the effectiveness of digital technologies, while enhancing patient motivation and user experience.
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