DOI 10.
36803/indojpmr.
Indonesian Journal of Physical Medicine and Rehabilitation | Volume 14.
Issue 02, 2025
ORIGINAL ARTICLE
The Association of Severity of Scoliosis Curvature and Quality of Life in Adolescent Idiopathic Scoliosis Patients at Prof.
Dr.
Soeharso Orthopedic Hospital Surakarta: A Crosectional Study Feliciana Novita Soraya Setiawan1.
Retno Setianing1 Department of Physical and Rehabilitation Medicine Prof.
Dr.
Soeharso Orthopedic Hospital Surakarta.
Surakarta.
Indonesia
ABSTRACT
Introduction: In 2018 in Surakarta.
Central Java, a team from the Orthopedic Hospital Prof.
Dr.
Soeharso Surakarta examined a total of 1100 junior high school students throughout Surakarta city and found that 1% of students had Common symptoms include pain, leg length discrepancy, posture disturbance, and psychological problems, resulting in poor health-related quality of life.
Physical and Rehabilitation Medicine section of the European Union of Medical Specialists (UEMS), which recommends regular monitoring of patients with scoliosis including quality of life measurements.
Objective: To determine the association between scoliosis curve severity and quality of life in adolescent idiopathic scoliosis patients.
Methods: This study employed an observational analytic approach with a cross-sectional design and utilized purposive sampling over a one-month period.
Secondary data were collected by assessing the severity of scoliosis curves based on patients' X-ray results, while primary data on the quality of life of adolescent scoliosis patients were gathered through questionnaires developed by the researcher.
Results: Spearman test was used to analyze the association of scoliosis curve severity and quality of life.
Significant results were obtained with p=0.
Conclusion: The results of this study support the theory and previous research which state that there is an association between the degree of scoliosis curve and the quality of life in patients.
Keywords: Adolescent idiopathic scoliosis.
Quality of life.
The SJ-27 Questionnaire Correspondence Detail:
Feliciana Novita Soraya Setiawan Department of Physical and Rehabilitation Medicine.
Prof.
Dr.
Soeharso Orthopedic Hospital Surakarta.
Surakarta Indonesia Email: Felicianasetiawan@gmail.
A Indonesian Journal of Physical Medicine and Rehabilitation Ai Published by PP PERDOSRI This is an open access article under the CC - BY .
ttp://creativecommons.
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0/).
190 The Association of Severity of Scoliosis Curvature and Quality.
INTRODUCTION
Scoliosis is a musculoskeletal disorder characterized by lateral spinal curvature of more than 100 accompanied by spinal rotation and deformation of the ribs in the direction of the convex curve.
1 The deformities in scoliosis were always in three dimensions, because it involved rotation of the axial spine, not only movement or rotation on the frontal Its prevalence is approximately 10.
4% globally.
Scoliosis was the third highest health problem for children and adolescents.
The etiology of scoliosis was still debatable.
In most cases the confirmed etiology is still unknown.
therefore, these cases are classified as idiopathic scoliosis.
Idiopathic scoliosis can be classified based on the age of disease onset: infantile .
irth to 2-year-ol.
, children .
-year-old to 9-yearol.
, and adolescent (Ou10-year-ol.
3 Adolescent idiopathic scoliosis (AIS) had the highest prevalence among idiopathic scoliosis, especially in female teenagers, with estimated prevalence of 0.
47 - 5.
and female to male ratio 2-4:1.
A study in 2018 concluded that 1% of students had scoliosis.
Patients hypokyphosis of the thorax.
Moreover, they often complain about pain, differing leg lengths, postural disorders, gait imperfection, and psychological Patients with progressive scoliosis may even have pulmonary impairments.
These symptoms often impacted their quality of life and regular follow up was recommended including life quality 5-7 Information on quality of life in AIS patients can help physicians in providing better health care quality which in turn may increase the effectiveness of medical intervention.
Surgery and non-surgery measures are used to treat scoliosis.
Untreated scoliosis resulted in higher morbidity and hospitalization.
Non-surgery modalities include physical therapy, brace fitting, and regular The use of braces is highly efficient to prevent disease progression.
However, long-term bracing may lead to physical complaints, psychological problems, and low quality of life.
Surgery was indicated in patients with severe degree of spinal curvature.
Approximately half of scoliosis patients were treated with surgery, such as spinal fusion surgery.
However, their quality of life was reportedly lower compared to brace.
6,9,10
Patients with spinal disorders, including AIS patients, have a high risk of a low quality of life which may be due to their psychosocial and physical Assessment of the quality of life is crucial Setiawan et.
, 2025
as it may reflect the effectiveness of medical 5 For this reason, a study on the quality of life in AIS patients is important.
This study aimed to determine the association between scoliosis curve severity and quality of life in adolescent idiopathic scoliosis patients.
METHODS
Study Population and Research Methods This study is an observational cross-sectional study performed on scoliosis patients presented to Medic Rehabilitation Clinic Dr.
Soeharso Orthopedic Hospital between 30th September and 30th October This study had received the ethical approval from Dr.
Soeharso Ethical Committee with the ethical approval number: IR.
01/D.
XXV.
3/8746/2024.
Patients were included using the non-probability purposive sampling technique where all patients fulfilling the inclusion and exclusion criteria were recruited into the study until the sample size target was Sample size was calculated using the alpha () of 0.
05 and beta () of 0.
1 and minimal correlation coefficient of 0.
The minimal sample size calculated is 32 subjects.
Inclusion criteria for the study include female patients, aged between 10-year-old to 18-year-old, diagnosed as AIS by a specialist, and had Cobb angle >100 through radiologic imaging.
Patients that had a history of surgery or presented with other congenital diseases were excluded.
Data was collected on the day of enrollment, including name, age, history of brace use, physical therapy, and scoliosis curvature.
All participants underwent radiologic imaging to measure their Cobb Quality of life assessments were performed by giving SJ-27 questionnaires to all subjects included in the study.
Case Definition Age was categorized into nine groups: 10year-old, 11-year-old, 12-year-old, 13-year-old, 14year-old, 15-year-old, 16-year-old, 17-year-old, and 18-year-old.
Radiologic imaging was performed on all Cobb angle was measured using the The severity of the spinal curvature was divided into three categories based on the curvature degree: mild (<.
, moderate .
- .
, and severe (>.
Indonesian Journal of Physical Medicine and Rehabilitation | Volume 14.
Issue 02, 2025 Quality of life was analyzed using the SJ-27 questionnaire which was translated into Indonesian.
This questionnaire consists of 27 items where each question was given points ranging from 0 point .
o impairmen.
to 4 points .
evere impairmen.
The total score was between 0 to 108 points where higher SJ-27 scores had poor quality of life.
The SJ-27 questionnaire measured several domains including back pain, discomfort on clothing, physical activities, self-awareness of the disorder, and psychological problems occurring, such as depression.
Data Analysis Descriptive statistics were used to assess demographic and clinical characteristics of the Categorical data, such as age categorization, history of brace use, and physical therapy, was described in frequency and percentage.
Mean and standard deviation were used to represent numerical data (SJ-27 score.
An analysis of the association between scoliosis curve severity and quality of life was performed using SpearmanAos rho test.
Significant association was concluded if p<0.
Data was analyzed using software SPSS version 25.
RESULTS
Forty-seven respondents were included in this study.
Based on age, most patients were 15-year-old .
subjects, 23.
4%), followed by 14-year-old and 16year-old .
subjects, 19.
1% eac.
One respondent .
1%) aged 11-year-old and none were aged 10-yearold.
The complete age distribution on subjects included in this study is displayed in Table 1.
Radiologic imaging was used to analyze the spinal curvature in all patients.
The results showed that most patients had a spinal curve 250 - 450 .
6%) as written in Table 1.
Patients with mild and severe degrees of spinal curvature were almost similar with 27.
7% and 8%, respectively.
Scoliosis can be managed through surgery and non-surgery modalities.
Non-surgery therapy included physical therapy and brace-fitting.
All our study participants had physical therapy.
Brace was fitted in 16 participants .
0%) and 31 participants .
0%) did not have a history of brace fitting as displayed in Table 1.
Our study uses the SJ-27 questionnaire to analyze the quality of life.
The questionnaire was given to all subject resulted in median 38 .
Ae .
The minimum score was 6 while the highest score was 78 (Figure .
Table 1.
Research Characteristics Characteristics Frequency N = 47 Age .
ear-ol.
Spinal Curvature .
<25 25 - 45
>45
Brace usage Yes Percentage (%) Figure 1.
Dot Plot of the SJ-27 scores A Indonesian Journal of Physical Medicine and Rehabilitation Ai Published by PP PERDOSRI This is an open access article under the CC -BY.
ttp://creativecommons.
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0/).
192 The Association of Severity of Scoliosis Curvature and Quality.
Setiawan et.
, 2025
Table 2.
The SJ-27 Questionnaire Results Based on The Degree of Spinal Curve SJ-27 Results Median (Q1 Ae Q.
Spinal curvature <250 250 Ae 450
>450
Ae .
8 Ae .
5 Ae .
Notes: Q1 : Quartile 1.
Q3 : Quartile 3 In the three groups of severity degree of spinal curvature, a difference of median SJ-27 results was detected.
The worst SJ-27 curvature was detected in the severe degree of spinal curvature .
ore than .
where the median was 42 .
5 Ae .
Patients with a moderate degree of spinal curvature presented a slightly lower SJ-27 results with a median of 38 .
8 Ae .
, while the lowest score was shown in mild degree of spinal curvature with a median of 31 .
Ae .
Median results for each spinal curve severity were displayed in Table 2.
SpearmanAos rho test was used to analyze the association between scoliosis curve severity and quality of life in patients with AIS.
The analysis showed p=0.
008 and authors concluded that there is a significant relationship between scoliosis curve severity and quality of life in patients with adolescent idiopathic scoliosis.
DISCUSSION