Assessment of Spinal Deformity in Adolescents with Scoliosis and Its Association with Functional Limitation During Daily Activities: A Cross-Sectional Study

Abstract

Background: Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional spinal deformity that may influence physical function beyond radiographic curvature; however, the relationship between curve severity and objective task-specific functional performance remains insufficiently characterized. Objective: To examine the association between spinal deformity severity and functional limitation during daily activities in adolescents with AIS using patient-reported and performance-based measures. Methods: In this cross-sectional observational study, 100 adolescents aged 10–18 years with radiographically confirmed AIS (Cobb angle ≥10°) were evaluated. Radiographic parameters included Cobb angle, vertebral rotation, thoracic kyphosis, and lumbar lordosis. Functional outcomes comprised the SRS-22 function domain, Pediatric Outcomes Data Collection Instrument (PODCI) global function score, six-minute walk test (6MWT), stair-climbing time, and sit-to-stand time. Correlation analyses and multivariable linear regression adjusted for age, sex, and BMI were performed. Results: The mean Cobb angle was 27.6° ± 11.8°. Cobb angle demonstrated moderate negative correlations with SRS-22 (r = −0.46, p < 0.001), PODCI (r = −0.42, p < 0.001), and 6MWT distance (r = −0.39, p = 0.002), and positive correlations with stair-climbing (r = 0.34, p = 0.006) and sit-to-stand time (r = 0.29, p = 0.010). Each 10° increase in Cobb angle was independently associated with a 22.4-meter reduction in 6MWT distance and a 0.88-second increase in stair-climbing time. Functional performance declined progressively across mild, moderate, and severe categories (p < 0.001). Conclusion: Greater AIS severity is independently associated with measurable reductions in endurance and transitional mobility, supporting integration of standardized functional assessment alongside radiographic evaluation.