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The relationship between physical activity, structural deformity, and spinal mobility in adolescent idiopathic scoliosis patients

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Abstract

Purpose

Adolescent idiopathic scoliosis (AIS) patients experience structural spinal deformity, but the impact of AIS on physical activity is not widely studied. Reports of physical activity levels between children with AIS and their peers are mixed. This study sought to characterize the relationship between spinal deformity, spinal range of motion, and self-reported physical activity in AIS patients.

Methods

Patients aged 11–21 completed self-reported measures of physical activity using the HSS Pedi-FABS and PROMIS Physical Activity questionnaires. Radiographic measures were obtained from standing biplanar radiographic imaging. Surface topographic (ST) imaging data was obtained using a whole-body ST scanning system. Hierarchical linear regression models analyzed the relationship between physical activity, ST, and radiographic deformity while controlling for age and BMI.

Results

149 patients with AIS (mean age 14.5 ± 2.0 years, mean Cobb angle 39.7° ± 18.9°) were included. In the hierarchical regression predicting physical activity from Cobb angle, no factors were significant predictors of physical activity. When predicting physical activity from ST ROM measurements, age and BMI served as covariates. No covariates or ST ROM measurements were significant predictors of physical activity levels for either activity measure.

Conclusions

Physical activity levels of patients with AIS were not predicted by levels of radiographic deformity or surface topographic range of motion. Although patients may experience severe structural deformity and range of motion limitations, these factors do not appear to be associated with decreased physical activity level utilizing validated patient activity questionnaires.

Level of evidence

Level II.

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Data availability

The data collected in this study is stored on the secure drive at Hospital for Special Surgery and can be made available on request.

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Funding

Funding support for this project was provided by the Leon Root Chair in Pediatric Orthopaedic Surgery at the Hospital for Special Surgery (HSS), the Hospital for Special Surgery Lerner’s Children’s Pavilion Research Fund, the Foundation Yves Cotrel Basic Science Research Grant, the Neumann Family Fund Foundation, and the Professor Rahamimoff Travel Grant for Young Scientists of the US-Israel Binational Science Foundation. Physical space was provided by the HSS Department of Radiology, and construction costs were supported by HSS.

Author information

Authors and Affiliations

  1. Hospital for Special Surgery (Pediatric Orthopedics), New York, NY, USA

    C. P. Zucker, P. M. Cirrincione, A. Thakur, J. L. Wisch, J. H. Heyer & R. F. Widmann

  2. Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA

    H. J. Hillstrom

  3. Technion-Israel Institute of Technology (Mechanical Engineering), Haifa, Israel

    B. N. Groisser

  4. Hospital for Special Surgery (Radiology), New York, NY, USA

    D. N. Mintz

  5. Hospital for Special Surgery (Spine Surgery), New York, NY, USA

    M. E. Cunningham

  6. Boston Children’s Hospital (Pediatric Orthopedics), Boston, MA, USA

    M. T. Hresko

  7. University of Rochester (Orthopedics), Rochester, NY, USA

    R. Haddas

Authors
  1. C. P. Zucker
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  2. P. M. Cirrincione
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  3. H. J. Hillstrom
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  4. A. Thakur
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  5. J. L. Wisch
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  6. B. N. Groisser
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  7. D. N. Mintz
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  8. M. E. Cunningham
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  9. M. T. Hresko
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  10. R. Haddas
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  11. J. H. Heyer
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  12. R. F. Widmann
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Contributions

CPZ: developed study, prepared material, collected data, carried out data analysis, wrote first draft.. PMC: assisted in study design and data analysis, commented on previous versions of manuscript. HJH: assisted in study design and data analysis, commented on previous versions of manuscript. AT: assisted in study design, data collection, material preparation, and data analysis, commented on previous versions of manuscript. JLW: assisted in study design and data collection, commented on previous versions of manuscript. BNG: assisted in study design, commented on previous versions of manuscript. DNM: assisted in study design, commented on previous versions of manuscript. MEC: assisted in study design, commented on previous versions of manuscript. MTH: assisted in study design, commented on previous versions of manuscript. RH: assisted in study design, commented on previous versions of manuscript. JHH: assisted in study design, commented on previous versions of manuscript. RFW: assisted in study design, commented on previous versions of manuscript. All authors made substantial contributions to study design. The first draft of the manuscript was written by CPZ, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to J. H. Heyer.

Ethics declarations

Conflict of interest

Dr. Roger Widmann is a member of the editorial board for Spine Deformity and Children’s Orthopedics. All other authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Approval was obtained from the Institutional Review Board of Hospital for Special Surgery. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Zucker, C.P., Cirrincione, P.M., Hillstrom, H.J. et al. The relationship between physical activity, structural deformity, and spinal mobility in adolescent idiopathic scoliosis patients. Spine Deform 11, 1093–1100 (2023). https://doi.org/10.1007/s43390-023-00702-0

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  • DOI: https://doi.org/10.1007/s43390-023-00702-0

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