For both brace treated and surgically treated AIS patients, spinal mobility and muscle endurance were reduced more than 20 years after completed treatment. The physical function was not severely restricted.

IntroductionThe consequences of low back pain (LBP) for an individual can be generally described and measured on three different levels [6,11,25] Abstract The General Function Score (GFS) is a disease-specific instrument consisting of nine items focusing on strict physical activities of daily living. It is intended as an alternative to the more complex scores of disability (such as the Oswestry Disability Index), serving as a complement to the quality of life instruments in the study of low back pain (LBP). It was developed from an original 17-item questionnaire, of which 11 of the items were tested for criterion validity in an observer-supervised performance test. Two items were excluded from further analysis because of too low a validity. The remaining nine-item GFS was tested for construct validity, reliability, feasibility and responsiveness in six different cohorts: 297 patients with chronic low back pain (cohort 1), an age-and sex-matched control group of 287 randomly allocated Swedish citizens (cohort 2), three separate groups of patients admitted for surgery due to low back disorders (cohorts 3-5) and outpatients with spinal disorders (cohort 6). Correlations were tested with the Spearman Rank correlation coefficient, differences between groups with the MannWhitney test and the internal consistency with the Cronbach's coefficient α. The GFS total scores showed correlations of 0.78, 0.81 and 0.88 in the three aspects of the performance test. The response rate was 98.3-100%. The mean time to complete the questionnaire was 1.2 min. The internal consistency was 0.69 and 0.86 in cohorts 1 and 2 respectively. The test-retest correlation was 0.88. The GFS showed a high responsiveness to difference and change. The effect size was 0.82-0.96 in surgically treated disc herniation and 0.55-0.85 in spondylolisthesis. The GFS is a highly valid and reliable instrument with good responsiveness and feasibility, useful for evaluation of physical disability.

The RMMI is a reliable instrument and usable in both clinical practice and research.

N/A.

Study design A group of adult patients with idiopathic scoliosis, diagnosed before the age of ten, at a mean of 26.5 years after treatment with either brace or surgery during childhood and adolescence attended a clinical follow-up. Objectives To evaluate the relation between thoracic mobility, rib-cage deformity, and pulmonary function. Summary of background data Long-term studies of pulmonary function in relation to thoracic mobility after treatment in this patient group have not been published. Methods A total of 106 patients, 57 braced and 49 operated patients, attended the follow-up. We examined thoracic mobility (range of motion of the thoracic spine, thorax expansion, and breathing movements) and rib-cage deformity (curve size and trunk deformity) as well as pulmonary function, especially total lung capacity (TLC). Respiratory muscle strength was evaluated in a subgroup. Results Thoracic range of motion was significantly less among the surgically treated patients compared with both the bracetreated and comparison group. Thorax expansion and breathing movements during maximal breathing were significantly reduced in the scoliotic patients compared with the reference values, with no significant differences between the treatment groups. The brace-treated group had better pulmonary function than the operated group, as measured by the TLC, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) (percentage of predicted values). The respiratory muscle strength was significantly lower only in the surgically treated patients when compared with reference values. The results of a multivariate analysis revealed that the strongest factors explaining TLC percentage of predicted were gender, brace model, and smoking habits. Conclusions Thoracic mobility was significantly reduced at mean 26.5 years after completed treatment in both brace-treated and surgically treated patients with early onset scoliosis, compared with the reference values, which did not influence TLC as strongly as gender, brace model, and smoking habits. Levels of evidence Level III.