**4.6. Clinical implications**

This preliminary study showed that SBP exercises improved the Cobb angles, sagittal spinal balance, and some SRS-22 domain scores in adult patients with thoracolumbar and lumbar curves. In view of the fact that curves of ASD and DLS progress and that the present nonoperative treatments addressing adult scoliosis patients with low back pain are not effective, the authors believe it is worthwhile implementing SBP exercises in conjunction with standard medical or physiotherapeutic treatments on adult scoliosis patients with risk of progression, particularly when the patients have lumbar curves in excess of 30°, AVR ≥ 33%,, thoracolumbar kyphosis, and positive sagittal spinal imbalance [29, 40]. A low intercristal line is also a risk factor [6]. When the line joining both iliac crests lies below the L4/5 level, L4 is more mobile and prone to instability and translation.
