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Negrini A1, Donzelli S1, Vanossi M1, Poggio M1, Zaina F1, Romano M1, Negrini S1
1ISICO (Italian Scientific Spine Institute), Milan, Italy
Background: Despite the recommendations that are usually given to adolescents with idiopathic scoliosis (IS), little objective information is available to determine if their participation in sports activity should be recommended or avoided.
Purpose: To assess the effect of sports activity and their frequency in a large population of adolescents with IS.
Methods:
Design: Retrospective observational multicentric cohort study embedded in a prospective clinical database.
Participants: All the consecutive patients in a multicenter clinical database of a tertiary referral institute age ≥ 10, with juvenile or adolescent IS diagnosis, Cobb 11-25°, Risser 0-2, no brace prescription, follow-up X-ray at 12 ± 3 months.
Outcome measure: At 12-month follow-up X -ray, an increase of scoliosis curve ≥ 5° Cobb was considered as progression and an increase to ≥ 25° Cobb - need of a brace - was considered as failure.
Statistics: Relative risk (RR) was calculated to compare the outcome of subjects performing sport (SPORT) and those not performing sport (NO-SPORT). A logistic regression with co-variate adjustment was run to assess if frequency had an effect on the outcome measures.
Results: 511 subjects (mean age 11.9 ± 1.2, 415 females) were included (SPORT = 318). Subjects in NO-SPORT showed a higher risk of progression (RR = 1.57, 95%CI = 1.16-2.12, P=0.004) and of failure (RR = 1.85, 95%CI = 1.19-2.86, P = 0.007) than subjects in SPORT. Logistic regression confirmed that the more frequent the sports activity, the less probable progression (P = 0.0004) and failure (P = 0.004) were. As the sport's frequency increased from one to four times per week, the risk of progression decreased of 0.1 (95%CI = 0.05-0.15, P = 0.000) whereas the risk of failure decreased of 0.06 (95%CI = 0.02-0.09, P = 0.001) per day.
Conclusion(s): This study shows that sports activity has a protective role against progression at 12-month follow-up in adolescents with milder forms of IS. Excluding high-level sports activity, the risks of progression and failure decrease with the increase of sport frequency per week. Future studies with different designs should look at single sports, and at the combined effects of sport added to exercise therapy and bracing.
Implications: Sports activity has a protective role against progression at 12-month follow-up in adolescents with milder forms of IS.
Keywords: Sport, adolescent idiopathic scoliosis, juvenile idiopathic scoliosis
Funding acknowledgements: The study had no funding.
Purpose: To assess the effect of sports activity and their frequency in a large population of adolescents with IS.
Methods:
Design: Retrospective observational multicentric cohort study embedded in a prospective clinical database.
Participants: All the consecutive patients in a multicenter clinical database of a tertiary referral institute age ≥ 10, with juvenile or adolescent IS diagnosis, Cobb 11-25°, Risser 0-2, no brace prescription, follow-up X-ray at 12 ± 3 months.
Outcome measure: At 12-month follow-up X -ray, an increase of scoliosis curve ≥ 5° Cobb was considered as progression and an increase to ≥ 25° Cobb - need of a brace - was considered as failure.
Statistics: Relative risk (RR) was calculated to compare the outcome of subjects performing sport (SPORT) and those not performing sport (NO-SPORT). A logistic regression with co-variate adjustment was run to assess if frequency had an effect on the outcome measures.
Results: 511 subjects (mean age 11.9 ± 1.2, 415 females) were included (SPORT = 318). Subjects in NO-SPORT showed a higher risk of progression (RR = 1.57, 95%CI = 1.16-2.12, P=0.004) and of failure (RR = 1.85, 95%CI = 1.19-2.86, P = 0.007) than subjects in SPORT. Logistic regression confirmed that the more frequent the sports activity, the less probable progression (P = 0.0004) and failure (P = 0.004) were. As the sport's frequency increased from one to four times per week, the risk of progression decreased of 0.1 (95%CI = 0.05-0.15, P = 0.000) whereas the risk of failure decreased of 0.06 (95%CI = 0.02-0.09, P = 0.001) per day.
Conclusion(s): This study shows that sports activity has a protective role against progression at 12-month follow-up in adolescents with milder forms of IS. Excluding high-level sports activity, the risks of progression and failure decrease with the increase of sport frequency per week. Future studies with different designs should look at single sports, and at the combined effects of sport added to exercise therapy and bracing.
Implications: Sports activity has a protective role against progression at 12-month follow-up in adolescents with milder forms of IS.
Keywords: Sport, adolescent idiopathic scoliosis, juvenile idiopathic scoliosis
Funding acknowledgements: The study had no funding.
Topic: Musculoskeletal: spine; Sport & sports injuries
Ethics approval required: Yes
Institution: FONDAZIONE IRCCSCA'GRANDA OSPEDALE MAGGIORE POLICLINICO
Ethics committee: Milan Area B Ethical Committee
Ethics number: 801_2015bis del 12.2015
All authors, affiliations and abstracts have been published as submitted.
