Investigation of the effect of spine biomechanics on health-related quality of life in individuals with idiopathic scoliosis

The aim of this study was to examine which biomechanical factors cause negative effects on health-related quality of life of individuals with idiopathic scoliosis (IS). 49 individuals with IS (41 females, 8 males) and mean age of 14.14 ± 4.03 years were included in the study. Within the scope of the study, after obtaining the demographic information of the individuals, the curve pattern (single curve or double curve), the spine region included in the curve (thoracic, lumbar, thoracolumbar), the curve intensity (Cobb angle) were noted. Axial trunk rotation (ATR) with scoliometer, trunk lateral flexibility with tape measure, frontal and sagittal balance on spine radiograph, apical vertebra / disc translation, body shape and deformity with Scoliosis Appearance Questionnaire (SAQ), health-related quality of life with Patient Generated Index (PGI) and the Scoliosis Research Society-22 (SRS-22) Questionnaire was evaluated. The relationship between biomechanical assessments and quality of life was analyzed using Spearman correlation analysis. Thoracic Cobb value of the individuals was 27.9 ± 11.1 lumbar Cobb value was 24.4 ± 9.8. Thoracic trunk rotation was 8.59 ± 4.52, while lumbar rotation was 6.4 ± 3.06. While there is no relationship between the thoracic Cobb angles (r=-0.2) and the thoracic rotations (r =-0.106) of the cases and their quality of life scores (p>0.05); there was a moderate correlation between lumbar Cobb angles and SRS-22 total scores (r=-0.333 and p=0.044), between lumbar Cobb angles and PGI (r=-0.375 and p=0.045) and between lumbar rotations and SRS-22 Image scores (r=-0.348 and p=0.019). There was a moderate correlation between SAQ and SRS-22 ''Pain'' (r=-0.396 and p=0.005), ''Function'' (r=-0.424 and p=0.002), ''Image'' (r=-0.417 and p=0.003) and total scores (r=-0.472 and p=0.001), but not with PGI (r=-0.096 and p>0.05). In this study, as the body asymmetry and deformity increased; it was found that pain, function, self-image and quality of life were negatively affected, especially the lumbar curve had a negative effect on quality of life. According to our study, when determining the treatment program in individuals with scoliosis, an improvement should be aimed for both their appearance and image perception. Our study also showed the importance of family training in rehabilitation success. Our study highlight future studies, as it involves the comparison of different curve types in relation to biomechanic and quality of life.