Physical functioning in adolescents with idiopathic scoliosis: a systematic review of outcome measures and their measurement properties

Research output: Contribution to journalArticlepeer-review


  • Samia Alamrani
  • Adrian Gardner
  • Elena Bini


Study Design: A systematic review.

Objective: To summarise evidence on measurement properties of outcome measures (OM) used to assess physical functioning in Adolescents with Idiopathic Scoliosis (AIS).

Summary of Background Data: The AIS is a common spine deformity in those aged 10 to 18 years old. Associated health problems (e.g., back pain) significantly impact the quality of life (QoL). One important domain in QoL is physical functioning, which can be measured with Patient-Reported Outcome Measures (PROM), Performance-Based Outcome Measures (PBOM), and body structure and function OM. Adequate measurement properties of outcome measures (OM) are important for precision in research and practice

Methods: A two-search strategy performed on electronic databases up to December 2019. Search one revealed list of OM were used for physical functioning assessment in AIS. Search two identified studies that evaluated measurement property in AIS; using list identified in search one. Two independent reviewers determined study eligibility, risk of bias assessment (COSMIN checklist), and data extraction. The level of evidence was established using modified GRADE approach.

Results: Search one yielded: 28 PROM, 20 PBOM, and 10 body structure and function OM. Search two revealed: 16 measurement properties studies of PROM, 1 for PBOM and 3 for body structure and function measure. Construct validity, reliability and responsiveness of most PROMs established in AIS, but not content validity or internal consistency (Moderate evidence). Construct validity was sufficient for the Timed up and Go test and, body structure and function measures (very low to low evidence).

Conclusion: Currently, physical functioning evaluated with variety of measures in AIS. Majority of measurement properties studies were evaluating PROM with paucity of information on measurement properties of PBOM and body structure and function OM. Based on COSMIN methodology, none of OM identified in this review can be recommended for use in individuals with AIS.

Level of Evidence: 2


Original languageEnglish
Early online date25 Jan 2021
Publication statusE-pub ahead of print - 25 Jan 2021