Development of a Three-Dimensional Spinal Proprioception Assessment for Patients with Adolescent Idiopathic Scoliosis

Abstract

Objectives: Although it is evident that some patients with adolescent idiopathic scoliosis (AIS) have proprioceptive deficits in peripheral joints, knowledge of the proprioceptive function of the deformed spine is limited. Nonetheless, spinal proprioception in AIS may be affected threedimensionally, prior studies only focused on evaluating peripheral proprioception in a single plane. Therefore, this study aimed to develop a novel spinal proprioception assessment using three-dimensional motion analysis in patients with AIS. Methods: Participants were included if they had a primary diagnosis of AIS who did not receive or failed conservative treatments. Three trunk repositioning tests involving flexion-extension, lateral-flexion, and axial-rotation were conducted. Three-dimensional kinematics of the trunk were used as the outcome measures. The proprioceptive acuity was quantified by the repositioning error. The intra-examiner and test-retest reliability were analyzed by the intraclass correlation coefficient (ICC). Results: Fifty-nine patients with AIS were recruited. Regarding the trunk flexion-extension test, the single measure ICC showed moderate reliability (0.46) and the average measures ICC demonstrated good reliability (0.72). As for the trunk lateral-flexion test, the reliability of single measure and average measures ICC were moderate (0.44) and good (0.70) reliability, respectively. For the trunk axial-rotation test, the single measure ICC indicated fair reliability (0.32), while the average measures ICC showed moderate reliability (0.59). Conclusions: This is the first study to evaluate the reliability of novel three-dimensional spinal proprioception assessments in patients with AIS. The trunk flexionextension repositioning test may be a preferable clinical test given its highest reliability.