title: Quality of life in normal and idiopathic scoliosis adolescents before diagnosis: reference values and discriminative validity of the SRS-22. A cross-sectional study of 1,205 pupils.
abstract: BACKGROUND
  The Scoliosis Research Society 22 Questionnaire (SRS-22) has shown to worsen with increasing deformity in adolescents with idiopathic scoliosis (AIS). However, all the studies have been performed on patients who have already been diagnosed and in relatively small samples.
  
  
  OBJECTIVE
  The purposes of this study were to evaluate a large sample of consecutive patients before diagnosis to develop reference values and check the discriminative validity and correlation with deformity of the SRS-22.
  
  
  METHODS
  This is a cross-sectional study, with patients referred to a specialized outpatient scoliosis rehabilitation institute.
  
  
  METHODS
  The recruited subjects were 1,205 consecutive adolescents, 75% females (13.7±1.9 years), before their first scoliosis evaluation. Five subgroups were 0°-10° Cobb (normal) and 11° to 20°, 21° to 30°, 31° to 40°, and greater than 40° (AIS).
  
  
  METHODS
  The outcome measure is based on the SRS-22.
  
  
  METHODS
  The SRS-22 was used to examine the differences between the domains of the five subgroups and total scores, and it was correlated with Cobb degrees and curve location. We used one-way analysis of variance and Spearman rho test.
  
  
  RESULTS
  Apart from the self-image domain in both genders and all subgroups, all other scores were greater than 4 points with small standard deviations. Females showed significant differences among groups for all domains and total score (p<.05). In males, function, pain, and mental health did not show statistically significant differences among groups (p>.1). All differences found were less than the minimally clinically significant change (0.5 points). The correlations with the severity of deformity measures were very low (rs<0.289).
  
  
  CONCLUSIONS
  According to our results, deformity is apparently not a real issue for AIS before diagnosis made, treatment planned, and/or specialists interfere with their everyday life. Scoliosis Research Society 22 Questionnaire demonstrated some discriminative validity between small and large curves, but the differences found were small.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Core in Care Association, Piazza Borromeo 14, 20123 Milan, Italy; Department of Physical and Rehabilitation Medicine, Faculty of Psychology, Vita-Saluta San Raffaele University, Via Olgettina 58, 20132 Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Rainoldi
authors.affiliation: Department of Physical and Rehabilitation Medicine, ISICO (Italian Scientific Spine Institute), Via Bellarmino 13/1, Milan 20141, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Zaina
authors.affiliation: Department of Physical and Rehabilitation Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Gnocchi, Via Capecelatro 66, Milan 20148, Italy.
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Villafañe
authors.affiliation: Department of Physical and Rehabilitation Medicine, ISICO (Italian Scientific Spine Institute), Via Bellarmino 13/1, Milan 20141, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Donzelli
authors.affiliation: Department of Physical and Rehabilitation Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Gnocchi, Via Capecelatro 66, Milan 20148, Italy; Department of Clnical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia 25123, Italy. Electronic address: stefano.negrini@unibs.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Negrini
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012016:Reference Values; D012600:Scoliosis / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Adolescent idiopathic scoliosis; Disability; Discriminative validity; Quality of Life; Reference sample; SRS-22