A Protocol of Accelerated Rehabilitation following surgery for adolescent Idiopathic Scoliosis (PARIS) : a feasibility study

Almost 50% of adolescents who undergo surgery for adolescent idiopathic scoliosis (AIS) do not return to their preoperative levels of physical activity. Considering the potential long-term impacts of surgery, testing postoperative physiotherapy interventions should be a priority in this group. This study aimed to evaluate the feasibility of a future randomized controlled trial (RCT), which compares the effectiveness of an accelerated physiotherapist-led rehabilitation protocol to standard care for patients following surgical correction of AIS.

A total of 23 participants with AIS were recruited from surgical waiting lists at a single elective orthopaedic hospital. Participants were randomly allocated postoperatively to either a physiotherapist-led intervention of 12 sessions or standard care. Patient-reported outcome measures (PROMs), including Scoliosis Research Society 22-point revised questionnaire, were collected at baseline, six months, and 12 months. Recruitment rate, retention rate, response rate to PROMs, treatment adherence, and safety of the intervention via adverse events were also measured.

Overall, 62% of eligible individuals were consented and there were three withdrawals (surgical delay, unable to travel to appointments). A total of 20 participants remained (intervention n = 9, standard care n = 11). The retention rate was 70% at six months and 65% at 12 months. Overall, treatment adherence was 76%. There were no adverse events related to the intervention.

This feasibility study has indicated that an accelerated physiotherapist-led rehabilitation protocol following surgery for AIS is safe and that patients can be successfully identified, recruited, and randomized to a future RCT. The next iteration of this intervention protocol needs to be developed with relevant stakeholders, including patients and the public, to improve retention rates and treatment adherence.