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Comparison of Objective and Subjective Indicators in Patients with Idiopathic Scoliosis Undergoing PSSE
Marianna Białek1, Sylwia Piorun2, Ewelina Białek-Kucharska1
1Functional Individual Therapy of Scoliosis (FITS Method), 59-411 Paszowice, Poland.
Abstract:
Background and Objectives: Physiotherapeutic Scoliosis-Specific Exercises (PSSE) are recognized treatment methods for idiopathic scoliosis, focused on correcting three-dimensional postural abnormalities. Objective indices such as Angle of Trunk Rotation (ATR), Anterior Trunk Symmetry Index (ATSI), and Posterior Trunk Symmetry Index (POTSI) enable precise assessment of clinical changes, while the Trunk Appearance Perception Scale (TAPS) reflects the patient's subjective perception of their posture. Combining these data allows for a comprehensive assessment of the effects of therapy after intensive 5-day inpatient rehabilitation. We aimed to assess the improvement in the patients' clinical appearance and compare objective and subjective trunk assessment indicators after intensive 5-day inpatient rehabilitation, treated by PSSE, according to the Functional Individual Therapy of Scoliosis (FITS) Method. Materials and Methods: This retrospective study included 75 patients with idiopathic scoliosis who participated in a 5-day inpatient rehabilitation, treated by FITS Method. The average age was 13.5 years, and 63% of the girls were after menarche. The mean Cobb angle was 27.41° in single-curve scoliosis and 31.03° in double-curve scoliosis (31.24° in the thoracic spine, 30.82° in the lumbar spine), Risser test 2, and ATR was 7.1° in the thoracic spine and 4.6° in the lumbar spine. Forty-nine patients wore a brace. At the beginning and end of inpatient care, objective assessments were performed, including ATR at the peak of the scoliosis using the Adams test and photoregistration of the trunk in the front and back standing positions-ATSI and POTSI. A subjective assessment was also performed using the TAPS. Results: A statistically significant difference was demonstrated after therapy in the ATSI (p < 0.001) and POTSI (p = 0.008) values. A reduction in the ATR in the thoracic spine was observed (p < 0.001). The TAPS questionnaire demonstrated a statistically significant difference in the values of all indicators measured before and after therapy: in the frontal plane SET 1 (p = 0.002), in the transverse plane SET 2 (p = 0.042), and in the frontal plane SET 3 (p = 0.028). A statistically significant negative correlation was demonstrated between objective and subjective indicators after therapy: ATR Th vs. TAPS-SET 2 (-0.45) (p < 0.001) and ATSI vs. SET 3 (-0.29) (p = 0.011). Conclusions: The subjective assessment of trunk appearance correlates with the objective assessment, except for SET 1 vs. POTSI. Patients who noticed a change in their posture can expect confirmation in objective clinical tests. FITS Method positively influences the improvement of subjective and objective assessments of idiopathic scoliosis patients during the short term of intensive care.
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