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Noncontact sports participation in adolescent idiopathic scoliosis

effects on parent-reported and patient-reported outcomes

Segreto, Frank A.a; Messina, James C.b; Doran, James P.a; Walker, Sarah E.a; Aylyarov, Alexandra; Shah, Neil V.a; Mixa, Patrick J.a; Ahmed, Natashad; Paltoo, Karenb; Opare-Sem, Kwakub; Kaur, Harleena; Day, Louis M.a; Naziri, Qaisa; Paulino, Carl B.a; Scott, Claude B.c; Hesham, Khalida; Urban, William P.a; Diebo, Bassel G.a

Journal of Pediatric Orthopaedics B: July 2019 - Volume 28 - Issue 4 - p 356–361
doi: 10.1097/BPB.0000000000000574
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Comparing risks against benefits of adolescent idiopathic scoliosis (AIS) patients participating in sports represents a controversial topic in the literature. Previous studies have reported sports participation as a possible risk factor for AIS development, while others describe its functional benefits for AIS athletes. The objective of this study was to determine if sports participation had an impact on pain, function, mental status, and self-perception of deformity in patients and their parents. Patients had full spine radiographs and completed baseline surveys of demographics, socioeconomics, and patient-reported outcomes (PRO): Scoliosis Research Society (SRS)-30, Body Image Disturbance Questionnaire, and Spinal Appearance Questionnaire (SAQ: Children and Parent). Patients were grouped by their participation (sports) or nonparticipation (no-sports) in noncontact sports. Demographics, radiographic parameters, and PRO were compared using parametric/nonparametric tests with means/medians reported. Linear regression models identified significant predictors of PRO. Forty-nine patients were included (sports: n=29, no-sports: n=20). Both groups had comparable age, sex, BMI, bracing status, and history of physical therapy (all P>0.05). Sports and no-sports also had similar coronal deformity (major Cobb: 31.1° vs. 31.5°). Sagittal alignment profiles (pelvic incidence, pelvic incidence minus lumbar lordosis, thoracic kyphosis, and sagittal vertical axis) were similar between groups (all P>0.05). Sports had better SRS-30 (Function, Self-image, and Total) scores, SAQ-Child Expectations, and SAQ-Parent Total Scores (P<0.05). Regression models revealed major Cobb angle (β coefficient: −0.312) and sports participation (β coefficient: 0.422) as significant predictors of SRS-30 Function score (R=0.434, P<0.05). Our data show that for AIS patients with statistically similar bracing status and coronal and sagittal deformities, patients who participated in sports were more likely to have improved functionality, self-image, expectations, and parental perception of deformity. Further investigation is warranted to acquire a comprehensive understanding of the relationship between AIS and patient participation in sports. Maintaining moderate levels of physical activity and participating in safe sports may benefit treatment outcomes. Level of Evidence III – Retrospective Comparative Study.

aDepartment of Orthopaedic Surgery, State University of New York, Downstate Medical Center

bDownstate College of Medicine, State University of New York

cDepartment of Orthopaedic Surgery, Kings County Hospital Center, Brooklyn, New York, USA

dSchool of Medicine, Saba University, Saba, The Netherlands

Correspondence to Bassel G. Diebo, MD, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 30, Brooklyn, NY 11203, USA Tel: +1 718 221 5270; fax: +1 718 278 5270; e-mail: dr.basseldiebo@gmail.com

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