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Adolescent idiopathic scoliosis screening: could a school-based assessment protocol be useful for an early diagnosis?

Scaturro D, de Sire A, Terrana P, Costantino C, Lauricella L, Sannasardo CE, Vitale F, Mauro GL

Journal of Back and Musculoskeletal Rehabilitation 2021;34(2):301-306

primary study

BACKGROUND: Adolescent idiopathic scoliosis screening still needs a considerable implementation, particularly throughout a school-based assessment protocol. OBJECTIVE: This study aims to evaluate the effectiveness of clinical examinations currently in use for the diagnosis of adolescent idiopathic scoliosis, through a survey carried out in secondary schools to standardize a screening protocol that could be generalized. METHODS: In their classrooms, the adolescents underwent an idiopathic scoliosis screening through three examinations: Adam's Test, axial trunk rotation (ATR) and plumb line. In case of single positivity to one of the three examinations, a column x-ray examination was recommended. RESULTS: The sensitivity and diagnostic specificity of Adam's test or ATR were 56.3% and 92.7%, respectively. The positivity to at least one between ATR or plumb line showed that sensitivity was higher than specificity: 91.3% versus 80.8%; the positivity to at least one between Adams's Test or plumb line showed a sensitivity of 95.2% and a specificity of 81.5%. Finally, the positivity to all three examinations showed an increase in specificity (99.7%). CONCLUSIONS: Taken together, our findings show that this school-based screening protocol had a very high specificity in early diagnosis of adolescent idiopathic scoliosis.

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