Association of proprioceptive deficits with curve progression and treatment outcomes in subjects with adolescent idiopathic scoliosis: A prospective cohort study with 1 year of follow-up

Background context Proprioceptive deficits (PD) have been associated with adolescent idiopathic scoliosis (AIS). However, their long-term significance in curve progression and treatment outcomes remains uncertain. This study aimed to investigate whether spinal PD correlates with accelerated curve progression and to assess its influence on treatment outcomes.Methods Participants aged 10-25 years with AIS were recruited from a specialist outpatient clinic in Hong Kong and underwent baseline and 1-year follow-up assessments. Proprioception of the trunk, neck, elbow, and knee was measured using a 3-dimensional motion capture system, and spinal curvature was evaluated radiographically. Participants received observation, physiotherapy, bracing, or surgery according to clinical indications. Associations between PD and curve progression were examined using linear and logistic regression and chi-square tests, while changes in proprioception across treatment groups were assessed using 2-way analysis of variance.Results 166 participants were evaluated at baseline, and 115 completed follow-up. Trunk PD was significantly associated with greater surgical correction. Although no significant interaction effects between PD and treatment modality were detected, significant main effects of PD were observed across all trunk tests, as well as in left neck rotation, right elbow flexion, and bilateral knee extension proprioception.Conclusions The current findings indicated that PD may identify a distinct subgroup with different responsiveness to surgical intervention. Further longitudinal research with extended follow-up periods and comprehensive clinical outcomes is necessary to elucidate the prognostic significance and underlying mechanisms of proprioception in AIS.