This study aims to evaluate the user experience of three distinct structural designs of wearable devices for adolescent scoliosis rehabilitation, focusing on their functionality and adaptability. According to the World Health Organization (WHO), the global prevalence of adolescent scoliosis is approximately 2–3%, with about 0.3–0.5% of cases being severe. In China, millions of adolescent’s face scoliosis annually, affecting not only their physical health but also their psychological well-being and quality of life. Traditional rehabilitation methods, such as corrective braces and physical therapy, often lack comfort and interactivity, leading to low adolescent engagement. To address this, the study proposes a prototype testing approach based on different structural designs, comparing their impact on user experience through experimentation. The core focus of the research is on the design of flexible fabric structures, analyzing their performance in terms of acceptability, comfort, and fit. The methodology involves a comprehensive literature review to understand advancements in wearable scoliosis rehabilitation devices, followed by identifying user needs through questionnaires and interviews to explore how structural design influences experience. Three flexible smart vest prototypes with distinct structural designs were developed to simulate sensor placement and functionality, allowing for the evaluation of structural impacts on usability and comfort. A Likert scale was used to record real-time and post-use user experiences, providing both quantitative and qualitative data for statistical analysis. These methods enabled a detailed comparison of functionality, adaptability, and comfort across the prototypes, offering insights into optimizing wearable designs for scoliosis rehabilitation. The collected data evaluated differences in functionality, usability, comfort, and adaptability among the three designs, analyzing operational efficiency and user perceptions during actual use. This study explores how structural design influences user experience, providing a scientific basis for optimizing the design of scoliosis rehabilitation devices for adolescents. The findings not only contribute to optimizing wearable devices in medical rehabilitation but also promote the development of personalized rehabilitation solutions, facilitating broader adoption of wearable technology in health management. Future research will expand the sample size and validate the applicability of different designs across diverse populations and scenarios to better meet the needs of adolescent scoliosis rehabilitation.