Is the SRS-22 able to detect Quality of Life (QoL) changes during conservative treatments ?

Background. The SRS-22 has been developed to monitor QoL in scoliosis. Only a few studies have evaluated its effects on therapies. Consequently, doubts exist on its utility in conservative treatment. Aim. To evaluate if SRS-22 is able to detect changes in patients treated conservatively. Material and Methods. Study design. Retrospective controlled cohort study nested in a prospective clinical database. Population. One hundred and thirty six consecutive adolescents at their first evaluation, age 12.8 ± 2.7, divided into 5 groups according to treatment: 30 brace for 18 hours/day, 7 for 21 h/d, 33 for 23 h/d, 48 exercises and 14 observed (controls). Methods. All patients completed SRS-22 before the first and at the 6 months follow-up evaluations. Statistical analysis. ANOVA and Kruskall-Wallis tests. Results. Controls did not show changes with time, while all treated patients had increase of satisfaction with treatment. Aesthetic improvement was perceived by patients treated with exercises, while brace treated patients showed a negative psychological impact: these statistical changes were not clinically significant (0.2-0.3 points out of 5), excluding satisfaction (1.15-1.8). Between the groups, the 23 h/d showed worst start but best results in functioning, aesthetics, pain and satisfaction. Conclusion. SRS-22 appears to detect changes in populations, but its clinical everyday use appears less reliable.