Finding normo: reporting values for the SRS22r score in healthy sport-active children.

introductionScoliosis Research Society-22 revised (SRS-22r) is a disease-specific measure of quality of life in patients diagnosed with idiopathic scoliosis (AIS). When answering the SRS-22r, patients answer 22 questions with scores 1–5, 1 corresponding to the worst possible option, and 5 to the best. It is validated in children with scoliosis > 10 years. Low SRS-22r scores have been suggested to serve as an indicator for considering surgical intervention along with a progression in Cobb angle. However, there are only few studies on SRS-22r scores among children without spine conditions, making the impact of a spine condition on the health-related quality of life scores in adolescents and teenagers difficult to assess. Since surgical treatment of progressive curves is often performed before age 16, normative data for this age group are essential. The aim therefore was to estimate normative data on children under 16 years of age and to assess what influenced the scores in otherwise healthy children without AIS.

methodIn total, 264 children, attending a sports-focused public school, were invited to answer the SRS-22r questionnaire and self-reported Tanner stage. 110 children (70 girls) answered the questionnaire, all but one reporting tanner stage as well. All students who received the questionnaire underwent a spine examination performed by a physiotherapist student.

resultsThe participants had a median age of 12 years [Interquartile range (IQR): 11;14]; most were reporting Tanner stages 3 or 4, although 27.5% of the boys reported stage 5. The median scores of mental health and self-image were 4.0 [IQR: 3.6; 4.4] and 4.2 [IQR: 3.8; 4.4], with boys reporting higher scores in both domains compared to girls. Among all children, the median pain reported was 4.2 [IQR: 3.8;4.6] with no sex difference. The differences between the genders were assessed using the Mann-Whitney U test. Ordinal logistic regression showed that lower pain levels and male sex predicted better mental health and self-image, while higher Tanner stages correlated with poorer outcomes. Interestingly, three boys aged 11 reported Tanner Stage 5, highlighting potential inaccuracies in self-reported data and the need for assisted reporting in body composition questionnaires.

conclusionThis study highlights the importance of normative data, revealing that active children without scoliosis report pain and issues with mental health and self-image, when addressed with the SRS-22r. In particular, the SRS-22r scores in this cohort were lower than those found in previous studies of children with scoliosis, highlighting the challenges of interpreting and potentially using the SRS-22r results in a clinical setting.