Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study

Abstract

ObjectiveThis observational cohort study aimed to evaluate ventilatory function (VF) and functional exercise capacity (FEC) in mild adolescent idiopathic scoliosis (AIS).MethodsSeventy-three adolescents with idiopathic scoliosis, aged approximately 10 to 17 years (mean age: 13.43 ± 1.27 years), with a Cobb angle less than 20° (mean: 16.44° ± 1.59°), met the inclusion criteria and were assigned to group A. Another 34 healthy adolescents with normal VF and FEC served as controls (group B). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV), and FEC (by the 6-minute walk test [6MWT]) were the main outcome measures.ResultsPost-study mean values of FVC, FEV1, FEV1/FVC, MVV, and the 6MWT were 2.42 ± 0.36 L and 3.26 ± 0.59 L, 2.14 ± 0.31 L and 3.03 ± 0.43 L, 88.13% ± 3.89% and 91.14% ± 4.67%, 76.96 ± 6.85 L/m and 107.61 ± 11.44 L/m, and 581.12 ± 12.25 m and 627.74 ± 15.27 m in groups A and B, respectively. Between-group comparisons showed significant differences in FVC, FEV1, FEV1/FVC, MVV, and the 6MWT.ConclusionMild pulmonary and functional restrictions start early in mild AIS. This issue requires immediate intervention to prevent further deterioration.

Biplanar stereoradiography predicts pulmonary function tests in adolescent idiopathic scoliosis: a cross-sectional study

“…Redding The choice of a Cobb angle > 50° was based on surgical cut-offs. Since it is a common belief that there is no respiratory impairment at this degree of scoliosis, we showed that PFTs are modified early in the natural history of scoliosis, in accordance with Abdelaal et al, who reported from an observational cohort study that even adolescents with mild idiopathic scoliosis had mild pulmonary and functional restriction (24).…”

Accelerometer based assessment of daily physical activity and sedentary time in adolescents with idiopathic scoliosis

“…In AIS patients, prolonged relaxed sitting led to an even greater trunk asymmetry due to the habitual leaning on one side depending on the curvature type [ 10 ]. Knowing the health complications related to scoliosis (musculoskeletal, psychological and respiratory conditions) which seem to progress with an increase in the scoliosis curvature [ 11 – 14 ] it is important to identify PA and ST as important factors in assessing health status of patients with AIS.…”

Adolescent Idiopathic Thoracic Scoliosis - Case Report of a Patient With Respiratory Symptom

“…(15) The present case suffered from right rib hump for two years associated with difficulty of breathing although his pulmonary function was normal thus supported by previous study that showed the spirometry and functional capacity restrictions are not correlated with the degree of spinal curvature in adolescents with mild AIS. (16) There are many studies showed that chest cage rigidityof thoracic scoliosis may contribute to pulmonary function deficits in scoliosis patients, increases with age, could in part account for the observation that respiratory failure can occur in adult IS patients even when there is no progression of the curvature. (15,16) Yet in recent years some spine surgeons have argued that, with the exception of cases diagnosed before the age of five years and with a Cobb angle of >100 degrees, IS patients suffer from 'no functional limitations' and that, moreover, the improvement of 'appearance and deformity with all its social and psychological deprivation is the only indication for treatment'.…”

“…(16) There are many studies showed that chest cage rigidityof thoracic scoliosis may contribute to pulmonary function deficits in scoliosis patients, increases with age, could in part account for the observation that respiratory failure can occur in adult IS patients even when there is no progression of the curvature. (15,16) Yet in recent years some spine surgeons have argued that, with the exception of cases diagnosed before the age of five years and with a Cobb angle of >100 degrees, IS patients suffer from 'no functional limitations' and that, moreover, the improvement of 'appearance and deformity with all its social and psychological deprivation is the only indication for treatment'. (15,17) In context of treatment,the goal of the treatment is a curve with a Cobb angle of <40° at skeletal maturity.…”