S. Alamrani1,2, A. B Rushton1,3, E. Bini1, A. Gardner4, D. Falla1, N. R Heneghan1
1University of Birmingham, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, Birmingham, United Kingdom, 2University of Tabuk, Physical Therapy department, Tabuk, Saudi Arabia, 3Western University, London,Ontario, Canada, 4The Royal Orthopaedic Hospital, Spine Unit, Birmingham, United Kingdom

Background: Adolescents with Idiopathic Scoliosis (AIS) is the most common spine deformity in those aged 10 to 18 years old. Associated health problems (e.g., back pain and respiratory dysfunction) significantly impact the quality of life (QoL). One important domain in QoL is physical functioning, which can be measured with different measures (patient-reported, performance-based or body structure and function). Adequate measurement properties of outcome measures (OM) are important for precision in research and practice.

Purpose: To summarise evidence on the measurement properties of OM used to assess physical functioning in AIS.

Methods: Based on registered and published protocols, a two-search strategy was performed on MEDLINE, PsycINFO, EMBASE, CINAHL, SPORTdiscus, Web of Science, and PubMed databases, from inception until December 2019. Search one identified all types of OM used for assessment of physical functioning in individuals with AIS. A list of OM generated from this search was used to identify studies on the measurement properties of OM in search two. Studies not in the English language were excluded. Two reviewers independently performed study screening, study selection, risk of bias assessment (COnsensus-based Standards for the selection of health Measurement INstruments tool), and data extraction. The level of evidence was established using a modified GRADE approach.

Results: A list of OM was generated from search one, resulting in 28 Patient-Reported Outcome Measures (PROM), 20 Performance-Based Outcome Measures (PBOM), and 16 measures of body structure and function. Search two revealed 16 studies of measurement properties for PROM, 1 for PBOM and 3 for body structure and function. High to moderate-quality evidence supported the construct validity of PROMs. Very low to low quality of evidence showed that the Scoliosis Research Society (SRS)-22 questionnaire was responsive and SRS-22revised was not responsive to change. Very low evidence indicated that the Timed up and Go test has sufficient construct validity. Body structure and function measures have sufficient construct validity, supported with very low to low quality of evidence.  

Conclusion(s): Physical functioning was evaluated with a variety of measures among individuals with AIS. The majority of measurement properties studies were evaluating PROM with a paucity of information on the measurement properties of PBOM and body structure and function measures. Based on the COSMIN methodology, none of the OM identified in this review can be recommended for use in individuals with AIS.

Implications: The current evidence highlights a gap in the measurement properties of OM used for physical functioning assessment in AIS. Future studies should evaluate the measurement properties of these OM to be recommended for assessment of physical functioning in individuals with AIS.

Funding, acknowledgements: No funds received in support of this work. Samia Alamrani has a scholarship from University of Tabuk, Tabuk, Saudi Arabia

Keywords: Scoliosis, outcome assessment, Systematic review

Topic: Paediatrics

Did this work require ethics approval? No
Institution: University of Birmingham
Committee: None
Reason: Systematic review

All authors, affiliations and abstracts have been published as submitted.

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