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RehabMeasures Instrument

Scoliosis Research Society 22-Item/30-Item

Last Updated

Purpose

Demonstrates how spinal conditions impact quality of life and facilitate comparisons of the quality of life before and after surgical intervention.

Link to Instrument

Instrument Details

Acronym SRS-22/SRS-30

Area of Assessment

Activities of Daily Living
Life Participation
Mental Health
Pain
Patient Satisfaction
Positive Affect
Quality of Life
Social Relationships
Stress & Coping

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

Key Descriptions

  • SRS-22 has a minimum score of 22 and a maximum score of 110
  • SRS-30 has a minimum score of 23 without post surgery questions and 30 with post surgery questions. The maximum score is 115 without post surgery questions and 150 with post surgery questions.
  • Each question is scored on 1-5 scale. Questions are sorted into different domains and total and mean scores for each domain are calculated. A total score for the entire questionnaire is also calculated.
  • Patient completes the questionnaire independently with pencil and paper

Number of Items

SRS-22: 22

SRS-30: 31

Equipment Required

  • Pencil
  • Questionnaire

Time to Administer

10-20 minutes

Required Training

No Training

Age Ranges

Adolescents

13 - 17

years

Adults

18 - 64

years

Instrument Reviewers

Initially reviewed in 2018 by University of Illinois at Chicago Master of Science in Occupational Therapy students LaQueishia Cummins, Myeisha Hansbrough, and Laura Jennison.

Body Part

Back

ICF Domain

Activity
Body Function
Body Structure
Participation

Measurement Domain

Activities of Daily Living
Emotion
General Health
Motor
Sensory

Considerations

  • Consider the literacy level of the individual completing the questionnaire.

  • While the SRS 22/30 has been translated into many languages, the language of administration should also be considered.

Musculoskeletal Conditions

back to Populations

Standard Error of Measurement (SEM)

Adolescents with Idiopathic Scoliosis: (Carreon et al., 2010; n = 887; mean age = 14.3 (1.9); mean Cobb angle = 53 degrees (18 degrees); 1 year post-operation)

  • SEM for Appearance = 0.21

  • SEM for Activity = 0.17

  • SEM for Pain = 0.15

Adolescent Idiopathic Scoliosis: (Théroux et al., 2017; n = 352; mean age = 14.3 (1.8); French sample)

  • Pain: 0.034

  • Self-Image: 0.033

  • Function: 0.021

  • Mental Health: 0.035

  • Satisfaction with Management: 0.048

  • Total: 0.02

Adolescent Idiopathic Scoliosis: (Lonjon et al., 2014; n = 200, French-Canadian sample)

  • Pain: 0.50

  • Self-image: 0.53

  • Function: 0.47

  • Mental health: 0.53

  • Total: 0.31

Adult Spinal Deformity: (Kyr?l? et al., 2017; n = 274; Finnish sample)

Domains

Patients Self-Reported Change

First Measurement Mean (SD)

Change to Measurement 2, Mean (95% CI)

ICC (95% CI)

SEM (Range)

Function

All

2.75 (0.70)

-0.02 (-0.07-0.03)

0.829 (0.788-0.863)

0.28 (0.26-0.31)

 

Improved

2.93 (0.71)

0.12 (-0.02-0.26)

0.719 (0.555-0.829)

0.37 (0.31-0.46)

 

Stable

2.79 (0.72)

-0.04 (-0.09-0.02)

0.871 (0.827-0.904)

0.25 (0.22-0.28)

 

Worse

2.51 (0.59)

-0.08 (-0.18-0.02)

0.754 (0.627-0.843)

0.29 (0.24-0.35)

Pain

All

2.45 (0.75)

0.08 (0.01-0.14)

0.741 (0.681-0.790)

0.38 (0.35-0.42)

 

Improved

2.52 (0.66)

0.27 (0.12-0.41)

0.636 (0.384-0.789)

0.42 (0.32-0.61)

 

Stable

2.54 (0.78)

0.05 (-0.03-0.12)

0.759 (0.684-0.818)

0.38 (0.34-0.42)

 

Worse

2.19 (0.68)

-0.01 (-0.13-0.12)

0.708 (0.561-0.811)

0.36 (0.31-0.43)

Self-Image/Appearance

All

2.77 (0.65)

0.00 (-0.05-0.05)

0.795 (0.749-0.834)

0.30 (0.28-0.33)

 

Improved

2.90 (0.59)

0.19 (0.06-0.31)

0.722 (0.528-0.839)

0.34 (0.27-0.46)

 

Stable

2.82 (0.65)

-0.02 (-0.07-0.04)

0.856 (0.808-0.893)

0.24 (0.22-0.27)

 

Worse

2.54 (0.64)

-0.09 (-0.22-0.04)

0.653 (0.489-0.772)

0.38 (0.32-0.46)

Mental Health

All

3.41 (0.89)

-0.10 (-0.19--0.01)

0.703 (0.637-0.758)

0.53 (0.49-0.58)

 

Improved

3.61 (0.80)

0.18 (-0.20-0.56)

0.371 (0.110-0.585)

0.96 (0.80-1.19)

 

Stable

3.47 (0.89)

-0.12 (-0.19-0.04)

0.847 (0.790-0.888)

0.34 (0.30-0.39)

 

Worse

3.09 (0.89)

-0.27 (-0.41--0.14)

0.764 (0.573-0.866)

0.43 (0.33-0.62)

Subscore

All

2.85 (0.59)

-0.01 (-0.05-0.03)

0.843 (0.805-0.874)

0.24 (0.22-0.26)

 

Improved

2.99 (0.51)

0.19 (0.05-0.34)

0.611 (0.393-0.762)

0.38 (0.31-0.51)

 

Stable

2.91 (0.61)

-0.03 (-0.07-0.01)

0.904 (0.871-0.929)

0.18 (0.17-0.21)

 

Worse

2.59 (0.52)

-0.12 (-0.19--0.05)

0.832 (0.710-0.901)

0.21 (0.17-0.29)

Satisfaction with Management

All

3.10 (0.71)

0.25 (0.16-0.35)

0.463 (0.338-0.568)

0.56 (0.48-0.67)

 

Improved

3.23 (0.70)

0.49 (0.26-0.73)

0.314 (0.028-0.552)

0.66 (0.47-1.11)

 

Stable

3.11 (0.65)

0.24 (0.13-0.35)

0.475 (0.322-0.601)

0.50 (0.43-0.62)

 

Worse

2.98 (0.82)

0.11 (-0.11-0.33)

0.504 (0.289-0.670)

0.59 (0.50-0.72)

Total

All

2.87 (0.55)

0.00 (-0.03-0.04)

0.874 (0.842-0.901)

0.20 (0.18-0.22)

 

Improved

3.01 (0.48)

0.19 (0.09-0.29)

0.726 (0.458-0.857)

0.27 (0.19-0.43)

 

Stable

2.94 (0.57)

-0.02 (-0.06-0.02)

0.905 (0.870-0.930)

0.17 (0.15-0.19)

 

Worse

2.60 (0.50)

-0.09 (-0.16--0.02)

0.840 (0.737-0.904)

0.20 (0.17-0.26)

Minimal Detectable Change (MDC)

Adolescents with Idiopathic Scoliosis: (Carreon et al., 2010)

  • MDC for Appearance = 0.47

  • MDC for Activity = 0.41

  • MDC for Pain = 0.33

Minimally Clinically Important Difference (MCID)

Mild Adolescent Idiopathic Scoliosis: (Monticone, Ambrosini, Rocca, Foti, & Ferrante, 2017; n = 149; mean age = 12.4 (1.1))

  • Function

    • Effect size: 1.45

    • Effect size (Guyatt): 1.57

    • MIC: 0.70

  • Pain

    • Effect size: 1.47

    • Effect size (Guyatt): 1.43

    • MIC: 0.70

  • Mental Health

    • Effect size: 1.23

    • Effect size (Guyatt): 1.08

    • MIC: 0.50

  • Self-perceived image

    • Effect size: 1.50

    • Effect size (Guyatt): 1.58

    • MIC: 0.40

Moderate Adult Idiopathic Scoliosis: (Monticone et al., 2017)

  • Function

    • Effect size: 1.37

    • Effect size (Guyatt): 1.42

    • MIC: 0.60

  • Pain

    • Effect size: 1.13

    • Effect size (Guyatt): 1.17

    • MIC: 0.40

  • Mental Health

    • Effect size: 1.02

    • Effect size (Guyatt): 0.99

    • MIC: 0.55

  • Self-perceived image

    • Effect size: 1.14

    • Effect size (Guyatt): 1.04

    • MIC: 0.60

Adolescents with Idiopathic Scoliosis: (Carreon et al., 2010)

  • Used ROC–curve derived MCID

  • For appearance, the change score distinguished between unchanged and better patients, MCID = 0.98

  • For activity, the change score distinguished between same and increased for patients MCID = 0.08

  • For pain, the change score distinguished between same and decreased for patients MCID = 0.20

Adult Spinal Deformity: (Crawford, Glassman, Bridwell, Berven, & Carreon, 2015; n = 1321; mean age = 53)

  • MCID estimate = 0.4. This corresponds to a change of 1 interval in 2 of the 5 questions for a single domain

Normative Data

Adult Spinal Deformity: (Kyr?l? et al., 2017)

  • Compared with the SRS-30 domain means of the age-sex normative non-scoliotic population data published by Baldus et al. our cohort had significantly lower means in all domains, i.e., 4.1-4.6 versus 2.46-3.11

Test/Retest Reliability

Adolescents with Idiopathic Scoliosis: (Lee, Choi, Hwang, & Park, 2017; n = 122; mean age = 14 (2.27); Korean sample)

  • Acceptable for Function (ICC = 0.80)

  • Acceptable for Pain (ICC = 0.84)

  • Acceptable for Mental health (ICC = 0.80)

  • Acceptable for Self-image (ICC = 0.75)

  • Poor for Satisfaction with management (ICC = 0.69)

Idiopathic Scoliosis: (Antonarakos et al., 2009; n = 51; Dutch sample)

  • Excellent for Function (ICC = 0.93)

  • Acceptable for Pain (ICC = 0.82)

  • Acceptable for Mental Health (ICC = 0.79)

  • Acceptable for Self-Image (ICC = 0.83)

  • Acceptable for Satisfaction with Management (ICC = 0.72)

Adolescent Idiopathic Scoliosis: (Haidar, Kassak, Masrouha, Ibrahim, & Mhaidli, 2015; n = 81; mean age = Group 1: 16.78 (4.41), Group 2: 17.35 (4.45); Arabic sample)

  • Acceptable for Function (ICC = 0.87)

  • Excellent for Pain (ICC = 0.90)

  • Acceptable for Mental Health (ICC = 0.88)

  • Acceptable for Self-Image (ICC = 0.84)

  • Acceptable for Satisfaction with Management (ICC = 0.82)

Adolescent Idiopathic Scoliosis: (Sathira-Angkura, Pithankuakul, Sakulpipatana, Piyaskulkaew, & Kunakornsawat, 2012; n = 58; mean age = 14.6 (2.8); Thai sample)

  • Acceptable for Function (ICC = 0.79)

  • Acceptable for Pain (ICC = 0.84)

  • Excellent for Mental Health (ICC = 0.90)

  • Acceptable for Self-Image (ICC = 0.89)

  • Acceptable for Satisfaction with Management (ICC = 0.84)

Idiopathic Scoliosis: (Niemeyer et al., 2009)

  • Acceptable for Function (ICC = 0.80)

  • Acceptable for Pain (ICC = 0.76)

  • Acceptable for Mental Health (ICC = 0.85)

  • Acceptable for Self-Image (ICC = 0.87)

  • Acceptable for Satisfaction with Management (ICC = 0.75)

  • Acceptable for main score without “only surgically treated patients” (ICC = 0.89)

  • Acceptable for main score including only surgically treated patients (ICC = 0.88)

Adolescent Idiopathic Scoliosis (Adobor, Rimesl?tten, Keller, & Brox, 2010; n = 57; median age = 21; Norwegian sample)

  • Acceptable for Pain (ICC = 0.87)

  • Acceptable for Self-image (ICC = 0.87)

  • Acceptable for Function (ICC = 0.76)

  • Acceptable for Mental Health (ICC = 0.80)

  • Acceptable for Satisfaction (ICC = 0.82)

Adolescent Idiopathic Scoliosis: (Mousavi et al., 2010; n = 84, Persian sample)

  • Acceptable for Function (ICC = 0.87)

  • Acceptable for Pain (ICC = 0.82)

  • Acceptable for Self-image (ICC = 0.85)

  • Acceptable for Mental Health (ICC = 0.79)

  • Acceptable for Satisfaction (ICC = 0.81)

Adolescent Idiopathic Scoliosis: (Zhao, Zhang, Sun, Du, & Shang, 2007; n = 86; Chinese sample)

Test-retest reliability (ICCs) for Chinese, English, and Spanish versions

Domains

Chinese

English

Spanish

Function/Activity

0.85

0.86

0.82

Pain

0.96

0.92

0.93

Self-Image

0.96

0.90

0.94

Mental Health

0.95

0.75

0.94

Satisfaction

0.91

0.88

0.98

Total

0.98

NA

0.97

Excellent Test-Retest Reliability (ICC > 0.9); Acceptable Test-Retest Reliability (ICC > 0.7); NA = not applicable

Adolescent Idiopathic Scoliosis: (Potoupnis et al., 2012; n = 96, Greek sample)

Test-Retest Reproducibility as Determined by ICC (n = 87)

SRS-22r Domain

ICC

Function/Activity

0.78

Pain

0.81

Self-Image/Appearance

0.88

Mental Health

0.82

Satisfaction with Management

0.79

Excellent Test-Retest Reliability (ICC > 0.9); Acceptable Test-Retest Reliability (ICC > 0.7)

Adolescent Idiopathic Scoliosis: (Monticone, Baiardi, Calabro, Calabro, & Foti, 2010; n = 223; Italian sample)

SRS-22r-I Repeatability Results (n = 223)

SRS-22 Domains

ICC

95% CI

Function

0.995

0.994-0.997

Pain

0.985

0.981-0.989

Self-Image

0.965

0.954-0.973

Mental Health

0.976

0.969-0.982

Satisfaction with Management

0.977

0.970-0.982

Excellent Test-Retest Reliability (ICC > 0.9); Acceptable Test-Retest Reliability (ICC > 0.7)

Adolescent Idiopathic Scoliosis: (Lonjon et al., 2014)

  • Acceptable for Pain (ICC = 0.93)

  • Acceptable for Self-Image (ICC = 0.89)

  • Acceptable for Function (ICC = 0.86)

  • Acceptable for Mental Health (ICC = 0.85)

Idiopathic Scoliosis (Lee et al., 2011; n = 64; mean age = 18.3; Korean sample)

  • Acceptable for Function (ICC = 0.83)

  • Acceptable for Pain (ICC = 0.81)

  • Acceptable for Self-Image (ICC = 0.84)

  • Acceptable for Mental Health (ICC = 0.88)

  • Acceptable for Satisfaction with Management (ICC = 0.87)

Adolescent Idiopathic Scoliosis (Danielsson et al., 2013; n = 193; mean age = 23.3 (8.9); Swedish sample)

  • Excellent for Pain (ICC = 0.93)

  • Acceptable for Self-Image (ICC = 0.78)

  • Acceptable for Function (ICC = 0.87)

  • Acceptable for Mental Health (ICC = 0.80)

  • Acceptable for Satisfaction with Management (ICC = 0.84)

Idiopathic Scoliosis (Alanay et al., 2005; n = 47; mean age = 19.8; Turkish sample)

  • Acceptable for Pain (ICC = 0.80)

  • Acceptable for Self-Image (ICC = 0.82)

  • Acceptable for Mental Health (ICC = 0.78)

  • Acceptable for Satisfaction (ICC = 0.81)

  • Acceptable for Function (ICC = 0.76)

Adolescent Idiopathic Scoliosis: (Cheung et al., 2007; n = 48, Mean Age = 16.5; Chinese sample)

  • Acceptable for Function (ICC = 0.83)

  • Acceptable for Pain (ICC = 0.76)

  • Acceptable for Self-Image (ICC = 0.79)

  • Acceptable for Mental Health (ICC = 0.84)

  • Acceptable for Satisfaction with Management (ICC = 0.82)

Adolescent Spinal Deformity: (Glates, Burton, Lai, Fraiser, & Asher, 2007; n = 70; mean age = 14.1 (2.7); 48 unoperated idiopathic scoliosis, 3 operated idiopathic scoliosis, 5 congenital scoliosis, 5 neuromuscular scoliosis, 4 spondylolisthesis, 2 scheuermann’s hyper-kyphosis, 2 syndromic scoliosis, 1 scoliosis associated with extremity amelia)

  • Acceptable for Function (ICC = 0.76)

  • Acceptable for Pain (ICC = 0.80)

  • Acceptable for Self-Image (ICC = 0.78)

  • Acceptable for Mental Health (ICC = 0.74)

  • Not Acceptable for Satisfaction/Dissatisfaction (ICC = 0.56)

Internal Consistency

French Adolescent Idiopathic Scoliosis: (Théroux et al., 2017)

Internal Consistency Comparison

Factor

 

Current Study

 

Beausejour

SRS-22fv

SRS-18fv

Pain

0.79

0.76

0.80

Self-Image

0.67

0.66

0.74

Function

0.68

0.60

0.61

Mental Health

0.79

0.83

0.83

Satisfaction with Management

0.69

0.71

0.71

Excellent Internal Consistency: Cronbach’s alpha >.0.8; Adequate Internal Consistency: Cronbach’s alpha <0.8 and >0.7; Poor Internal Consistency: Cronbach’s alpha <0.7

Adolescent Idiopathic Scoliosis: (Schlosser et al., 2014; n = 135; mean age = 15.1 (2.0); Dutch sample)

  • Adequate for Function (Cronbach’s alpha = 0.75)

  • Excellent for Pain (Cronbach’s alpha = 0.85)

  • Adequate for Self-Image (Cronbach’s alpha = 0.72)

  • Adequate for Mental Health (Cronbach’s alpha =0.78)

  • Adequate for Satisfaction with Management (Cronbach’s alpha = 0.71)

Adolescents with Idiopathic Scoliosis: (Lee et al., 2017)

  • Poor for Function (Cronbach’s alpha = 0.64)

  • Adequate for Pain (Cronbach’s alpha = 0.76)

  • Poor for Self-Image (Cronbach’s alpha = 0.69)

  • Adequate for Mental Health (Cronbach’s alpha = 0.74)

  • Poor for Satisfaction with management (Cronbach’s alpha = 0.48)

Idiopathic Scoliosis: (Antonarakos et al., 2009)

  • Adequate for Function (Cronbach’s alpha = 0.75)

  • Excellent for Pain (Cronbach’s alpha = 0.85)

  • Excellent for Mental Health (Cronbach’s alpha = 0.87)

  • Excellent for Self-Image (Cronbach’s alpha = 0.83)

  • Poor for Satisfaction with Management (Cronbach’s alpha = 0.67)

Adolescent Idiopathic Scoliosis: (Haidar, Kassak, Masrouha, Ibrahim, & Mhaidli, 2015)

  • Poor for Function (Cronbach’s alpha = 0.58)

  • Excellent for Pain (Cronbach’s alpha = 0.82)

  • Adequate for Mental Health (Cronbach’s alpha = 0.71)

  • Excellent for Self-Image (Cronbach’s alpha = 0.85)

  • Poor for Satisfaction with Management (Cronbach’s alpha = 0.44)

Adolescent Idiopathic Scoliosis: (Sathira-Angkura, Pithankuakul, Sakulpipatana, Piyaskulkaew, & Kunakornsawat, 2012)

  • Adequate for Function (Cronbach’s alpha = 0.70)

  • Adequate for Pain (Cronbach’s alpha = 0.76)

  • Excellent for Mental Health (Cronbach’s alpha = 0.80)

  • Excellent for Self-Image (Cronbach’s alpha = 0.81)

  • Adequate for Satisfaction with Management (Cronbach’s alpha = 0.73)

Adolescent Idiopathic Scoliosis: (Glowacki et al., 2008; n = 60; mean age = 15.6 (3.8); Polish sample)

  • Excellent for Functionality (Cronbach’s alpha = 0.81)

  • Excellent for Pain (Cronbach’s alpha = 0.81)

  • Excellent for Mental health (Cronbach’s alpha = 0.80)

  • Adequate for Self-Image Perception (Cronbach’s alpha = 0.77)

  • Poor for Satisfaction with management (Cronbach’s alpha = 0.69)

Idiopathic Scoliosis: (Niemeyer et al., 2009; n = 78; German sample)

  • Poor for Function (Cronbach’s alpha = 0.67)

  • Adequate for Pain (Cronbach’s alpha = 0.75)

  • Excellent for Self-Image (Cronbach’s alpha = 0.84)

  • Excellent for Mental Health (Cronbach’s alpha = 0.88)

  • Poor for Satisfaction with Management (Cronbach’s alpha = 0.61)

Adolescent Idiopathic Scoliosis: (Adobor et al., 2010)

  • Excellent for Pain (Cronbach’s alpha = 0.93)

  • Excellent for Self-Image (Cronbach’s alpha = 0.93)

  • Excellent for Function (Cronbach’s alpha = 0.87)

  • Excellent for Mental Health (Cronbach’s alpha = 0.89)

  • Excellent for Satisfaction (Cronbach’s alpha = 0.90)

Adolescent Idiopathic Scoliosis: (Mousavi et al., 2010)

  • Adequate for Function (Cronbach’s alpha = 0.70)

  • Adequate for Pain (Cronbach’s alpha = 0.73)

  • Poor for Self-image (Cronbach’s alpha = 0.68)

  • Adequate for Mental Health (Cronbach’s alpha = 0.78)

  • Adequate for Satisfaction (Cronbach’s alpha = 0.76)

Adolescent Idiopathic Scoliosis: (Zhao et al., 2007)

Internal Consistency (Cronbach’s Alpha) for Chinese, English, and Spanish versions.

Domains

Chinese

English

Spanish

Function/Activity

0.70

0.86

0.67

Pain

0.80

0.92

0.81

Self-Image

0.80

0.73

0.73

Mental Health

0.88

0.90

0.83

Satisfaction

0.81

0.88

0.78

Total

0.88

NA

0.89

Excellent Internal Consistency: Cronbach’s alpha >.0.8; Adequate Internal Consistency: Cronbach’s alpha <0.8 and >0.7; Poor Internal Consistency: Cronbach’s alpha <0.7; NA = not applicable

Adolescent Idiopathic Scoliosis: (Potoupnis et al., 2012)

Internal Consistency Reliability (Cronbach’s Alpha, n = 87)

SRS-22 Domain

Alpha

SF-36 Domain

Alpha

Function/Activity

0.74

Physical Function

0.86

Pain

0.84

Role – Physical

0.73

Self-Image/Appearance

0.90

Bodily Pain

0.71

Mental Health

0.92

General Health Perception

0.76

Satisfaction with Management

0.66

Vitality

0.74

 

Social Functioning

0.74

Role – Emotional

0.70

Mental Health

0.81

Excellent Internal Consistency: Cronbach’s alpha > 0.8; Adequate Internal Consistency: Cronbach’s alpha < 0.8 and > 0.7; Poor Internal Consistency: Cronbach’s alpha < 0.7

Adolescent Idiopathic Scoliosis:(Monticone et al., 2010)

  • Adequate Internal Consistency (Cronbach’s alpha = 0.77)

Adolescent Idiopathic Scoliosis: (Carrico et al., 2012; n = 64, Brazilian Portuguese sample)

Internal Consistency

Subdomain

Number of Items

Cronbach Alpha

Function

7

0.58

Pain

6

0.68

Appearance

9

0.75

Mental Health

5

0.78

Satisfaction

3

0.29

Total SRS-30

30

0.85

SRS-30 = Scoliosis Research Society-30; Excellent Internal Consistency: Cronbach’s alpha > 0.8; Adequate Internal Consistency: Cronbach’s alpha < 0.8 and > 0.7; Poor Internal Consistency: Cronbach’s alpha < 0.7

Adolescent Idiopathic Scoliosis: (Lonjon et al., 2014)

  • Poor for Function (Cronbach’s alpha = 0.60)

  • Adequate for Pain (Cronbach’s alpha = 0.71)

  • Poor for Self-Image (Cronbach’s alpha = 0.61)

  • Adequate for Mental Health (Cronbach’s alpha = 0.73)

  • Poor for Satisfaction (Cronbach’s alpha = 0.60)

Idiopathic Scoliosis (Lee et al., 2011)

  • Excellent for Function (Cronbach’s alpha = 0.85)

  • Excellent for Pain (Cronbach’s alpha = 0.83)

  • Adequate for Self-Image (Cronbach’s alpha = 0.75)

  • Excellent for Mental Health (Cronbach’s alpha = 0.81)

  • Poor for Satisfaction (Cronbach’s alpha = 0.61)

Adolescent Idiopathic scoliosis (Danielsson & Romberg, 2013)

Test #1

  • Adequate for Pain (Cronbach’s alpha = 0.79)

  • Excellent for Self-image (Cronbach’s alpha = 0.80)

  • Poor for Function (Cronbach’s alpha = 0.59)

  • Excellent for Mental Health (Cronbach’s alpha = 0.89)

  • Adequate for Satisfaction (Cronbach’s alpha = 0.75)

Test #2

  • Adequate for Pain (Cronbach’s alpha = 0.78)

  • Excellent for Self-image (Cronbach’s alpha = 0.84)

  • Adequate for Function (Cronbach’s alpha = 0.72)

  • Excellent for Mental Health (Cronbach’s alpha = 0.87)

  • Excellent for Satisfaction (Cronbach’s alpha = 0.81)

Idiopathic Scoliosis: (Alanay et al., 2005)

  • Adequate for Pain (Cronbach’s alpha = 0.72)

  • Excellent for Self-image (Cronbach’s alpha = 0.80)

  • Adequate for Mental Health (Cronbach’s alpha = 0.72)

  • Excellent for Satisfaction with Management (Cronbach’s alpha = 0.83)

  • Poor for Function (Cronbach’s alpha = 0.48)

Adolescent Idiopathic Scoliosis: (Cheung et al., 2007)

  • Excellent for Function (Cronbach’s alpha = 0.86)

  • Excellent for Pain (Cronbach’s alpha = 0.87)

  • Adequate for Self-Image (Cronbach’s alpha = 0.78)

  • Excellent for Mental Health (Cronbach’s alpha = 0.87)

  • Poor for Satisfaction (Cronbach’s alpha = 0.53)

Adolescent Spinal Deformity: (Glates et al., 2007)

  • Excellent for Function (Cronbach’s alpha = 0.82)

  • Excellent for Pain (Cronbach’s alpha = 0.81)

  • Excellent for Satisfaction/Dissatisfaction (Cronbach’s alpha = 0.93)

  • Adequate for Self-Image (Cronbach’s alpha = 0.71)

  • Adequate for Mental Health (Cronbach’s alpha = 0.79)

Criterion Validity (Predictive/Concurrent)

Predictive Validity

Adolescent Idiopathic Scoliosis: (Parent et al., 2009; n = 227; mean age = 18.6 (9.2); curve severity: < 30 degrees, n = 58; 30-50 degrees n = 66; > 50 degrees n = 34; all others operated)

  • Poor to Adequate correlation of SRS-22 scores with the internal and external deformity measures was observed in subjects that had received corrective surgery (in the domains of pain, self-image, satisfaction, and total scores) and in those that had not (in the domains of self-image, mental health, satisfaction, and total scores).

Concurrent Validity

Adolescents Idiopathic Scoliosis: (Lee et al., 2017)

  • Adequate concurrent validity was found by comparing the SRS-22r domains with the relevant PedsQL 4.0 in both the function and the pain domain of the SRS-22r and the physical domain of the PedsQL 4.0.

  • Adequate concurrent validity was found between the self-image domain with both the physical and the psychological domains of the PedsQL 4.0.

Adolescent Idiopathic Scoliosis: (Haidar, Kassak, Masrouha, Ibrahim, & Mhaidli, 2015)

Concurrent Validity of the Arabic Version of SRS-22r Questionnaire Domains with those of SF-36 Questionnaire

SF-36 Subscales

SRS-22r Domains

Function/Activity

Pain

Self-Image/Appearance

Mental Health

Satisfaction with Management

Physical Functioning

0.51**

0.37**

 

 

 

Pain

0.49**

0.93*

0.33**

0.41**

0.38*

General Health Perception

0.44**

0.49*

0.53*

0.54**

0.58**

Mental Health

0.57**

0.43*

 

0.81**

0.36*

Role-Physical

0.45**

0.56*

 

 

 

Role-Emotional

 

0.46*

 

0.36*

 

Social Functioning

0.39*

 

 

0.35*

 

Vitality

0.36*

0.56*

0.56*

0.69**

0.32*

**correlation significant at < 0.01 level; *correlation significant at < 0.05 level; Excellent concurrent validity: Correlation coefficient > 0.60; Adequate concurrent validity: Correlation coefficient 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30

Adolescent idiopathic Scoliosis: (Potoupnis et al., 2012)

Concurrent Validity of SRS-22 Domains with Relevant Subscales of SF-36 as Determined by Spearman’s Rho Correlation Coefficient (n = 87)

SRS-22r Domain

SF-36 Domain

Spearman’s Rho

p

Function

Physical Function

0.39

0.001

 

Role Physical

0.51

0.001

 

Bodily Pain

0.52

< 0.001

 

Social Function

0.41

0.001

Pain

Physical Function

0.19

0.074

 

Role Physical

0.30

0.019

 

Bodily Pain

0.37

0.005

Self-Image

Role Physical

0.43

< 0.001

 

General Health Perception

0.42

< 0.001

 

Vitality

0.55

< 0.001

 

Social Function

0.53

< 0.001

 

Mental Health

0.63

< 0.001

Mental Health

General Health Perception

0.56

< 0.001

 

Vitality

0.76

< 0.001

 

Social Function

0.51

< 0.001

 

Mental Health

0.65

< 0.001

Satisfaction with Management

General Health Perception

0.34

0.001

 

Vitality

0.23

0.031

 

Mental Health

0.20

0.064

Excellent concurrent validity: Correlation coefficient > 0.6; Adequate concurrent validity: Correlation coefficient: 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30

Adolescent Idiopathic Scoliosis: (Monticone et al., 2010)

Concurrent Validity of SRS-22r Domains with Relevant SF-36 subscales (n = 223)

SRS-22 Domains

SF-36 Domains

Pearson r

Function

Physical Role

0.34*

 

Physical Functioning

0.32*

 

Pain

0.33*

 

Social Activities

0.32*

Pain

Pain

0.65*

 

Physical Role

0.40*

 

Physical Functioning

0.40*

Self-Image

General Health

0.32*

 

Social Functioning

0.42*

 

Physical Functioning

0.35*

Mental Health

Mental Health

0.79*

 

Social Functioning

0.64*

 

Vitality

0.54*

Satisfaction with Management

Physical Functioning

0.25*

 

Physical Role

0.14

*p < 0.001; SRS = Scoliosis Research Society; SF = Short-Form; Excellent concurrent validity: Correlation coefficient > 0.60; Adequate concurrent validity: Correlation coefficient 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30

Adolescent Idiopathic Scoliosis: (Lonjon et al., 2014)

  • Excellent concurrent validity in patients with scoliosis

Idiopathic Scoliosis (Alanay et. al, 2005)

Concurrent Validity of SRS-22 Domains with Relevant SF-36 Domains as Determined by Pearson Correlation Coefficients (n = 47)

SRS-22 Domain

SF-36 Domain

Pearson r

p

Function/Activity

Role-Physical

0.37

0.012

 

Physical Functioning

0.63

< 0.001

 

Pain Index

0.37

0.011

 

General Health Perceptions

0.50

< 0.001

Pain

Pain Index

0.75

< 0.001

 

Role-Physical

0.49

0.001

 

Physical Functioning

0.53

< 0.001

Self-Image/Appearance

General Health Perceptions

0.65

< 0.001

 

Social Functioning

0.49

< 0.001

 

Physical Functioning

0.34

0.021

Mental Health

Mental Health Index

0.81

< 0.001

 

Social Functioning

0.68

< 0.001

 

Vitality

0.70

< 0.001

Satisfaction with Management

Physical Functioning

0.27

0.074

 

Role-Physical

0.42

0.004

 

Pain Index

0.38

0.009

 

General Health Perceptions

0.50

< 0.001

Excellent concurrent validity: Correlation coefficient > 0.60; Adequate concurrent validity: Correlation coefficient 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30

Adolescent Idiopathic Scoliosis: (Danielsson & Romberg, 2013)

SRS-22 Domain

n

SF-36 Domain

Pearson r

p

Pain

141

Bodily Pain

0.74

< 0.0001

 

Role Physical

0.45

< 0.0001

 

Physical Functioning

0.50

< 0.0001

Function

141

Role Physical

0.56

< 0.0001

 

Physical Functioning

0.53

< 0.0001

 

Bodily Pain

0.41

< 0.0001

 

General Health

0.36

< 0.0001

Self-Image

141

General Health

0.47

< 0.0001

 

Social Functioning

0.41

< 0.0001

 

Physical Functioning

0.36

< 0.0001

Mental Health

141

Mental Health

0.88

< 0.0001

 

Social Functioning

0.61

< 0.0001

 

Vitality

0.74

< 0.0001

 

Role Emotional

0.58

< 0.0001

Management Satisfaction

132

Physical Functioning

0.20

0.0200

 

Role Physical

0.08

0.3355

 

Bodily Pain

0.27

0.0016

 

General Health

0.27

0.0019

SRS-22 = Scoliosis Research Society-22 Questionnaire; Excellent concurrent validity: Correlation coefficient > 0.60; Adequate concurrent validity: Correlation coefficient 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30

Adolescent Idiopathic Scoliosis: (Cheung et al., 2007)

Concurrent Validity of SRS-22 Domains with Relevant SF-36 Domains as Determined by Pearson Correlation Coefficients (n = 50)

SRS-22 Domain

SF-36 Domain

Pearson r

Function/Activity

Role-Physical

0.77

 

Physical Functioning

0.73

 

Pain Index

0.62

 

General Health Perceptions

0.59

Pain

Pain Index

0.72

 

Role-Physical

0.54

 

Physical Functioning

0.68

Self-Image/Appearance

General Health Perceptions

0.62

 

Social Functioning

0.59

 

Physical Functioning

0.50

Mental Health

Mental Health Index

0.67

 

Social Functioning

0.57

 

Vitality

0.66

Satisfaction with Management

Physical Functioning

0.25*

 

Role-Physical

0.24*

 

Pain Index

0.18*

 

General Health Perceptions

0.49

Excellent concurrent validity: Correlation coefficient > 0.60; Adequate concurrent validity: Correlation coefficient 0.31-0.59; Poor concurrent validity: Correlation coefficient < 0.30; *Not significant (p > 0.05)

Adolescent Spinal Deformity: (Glates, Burton, Lai, Frasier, & Asher, 2007)

Concurrent Validity with the CHQ-CF 87 Domains

SRS-22r Domain

Relevant CHQ-CF 87 Domains

Pearson r

Function

Physical Function

0.73*

 

Family Activity

0.71*

 

Role Physical

0.54*

 

General Health

0.52*

Pain

Bodily Pain

0.82*

 

Family Activity

0.45*

 

Physical Function

0.42(t)

 

General Health

0.41(t)

Self-Image

General Health

0.50*

 

Mental Health

0.48*

 

Family Cohesion

0.47*

 

Self-Esteen

0.50*

Mental Health

Mental Health

0.68*

 

Self-Esteem

0.59*

 

Behavior

0.63*

 

Family Cohesion

0.53*

Satisfaction/Dissatisfaction

Bodily Pain

0.29(T)

 

Self-Esteem

0.30(T)

 

Global Behavior (single item)

0.29(T)

*p < 0.0001; (t) p < 0.0005; (T) p < 0.05; Excellent Criterion Validity: correlation coefficient > 0.60; Adequate Criterion Validity: correlation coefficient 0.31-0.59; Poor Criterion Validity: correlation coefficient < 0.3

Construct Validity

Adolescent Idiopathic Scoliosis: (Parent et al., 2009)

  • Adequate to Excellent correlation with pain scores for subjects treated with a brace than for those pre-surgery

  • Adequate to Excellent correlation with Self-Image for pre-surgery subjects than for subjects under observation or for those post-surgery

  • Adequate correlation to Satisfaction for patients treated with a brace than for those under observation or pre-surgery

  • Adequate correlation to Satisfaction for patients post-surgery patients than for those under observation or pre-surgery

  • Poor correlation for differences between management subgroups for the function scores

  • Poor correlation for differences between management subgroups for the mental health scores

  • Poor correlation for differences between management subgroups for total scores

  • Excellent correlations for subjects with curves > 50 degrees than for those with curves between 30 and 50 degrees in the domain of function score

  • Excellent correlations for subjects with curves > 50 degrees than for those with curves between 30 and 50 degrees in the domain of pain score

  • Excellent correlations for subjects with curves > 50 degrees than for those with curves between 30 and 50 degrees in the domain of self-image score

  • Excellent correlations for subjects with curves > 50 degrees than for those with curves between 30 and 50 degrees in the domain of mental health score

  • Excellent correlations for subjects with curves > 50 degrees than for those with curves between 30 and 50 degrees in total score

  • Adequate correlation for subjects with curves > 50 degrees than for those with curves < 30 degrees in the domain of pain score.

  • Adequate correlation for subjects with curves > 50 degrees than for those with curves < 30 degrees in the domain self-image score.

  • Adequate correlation for subjects with curves > 50 degrees than for those with curves < 30 degrees in the total score

  • Poor correlation with differences in satisfaction were found between the subgroups of different curve severity

Adolescent Idiopathic Scoliosis: (Monticone et al., 2010)

  • Adequate discriminant validity

Adolescent Idiopathic Scoliosis: (Danielsson et al., 2013)

SRS-22 Domain

n

Pearson r

p

Pain

175

-0.12

0.11

Function

175

-0.07

0.37

Self-Image

175

-0.21

< 0.01

Mental Health

175

0.04

0.60

Management Satisfaction

160

-0.24

< 0.01

Total without Satisfaction

175

-0.12

0.12

Total Score

160

-0.13

0.09

Excellent Construct Validity: correlation coefficient > 0.60; Adequate Construct Validity: correlation coefficient 0.31-0.59; Poor Construct Validity: correlation coefficient < 0.3

Idiopathic Scoliosis (Climent et al., 2005; n = 175; mean age = 18.9; Spanish sample)

  • Poor correlation between age and function/activity (r = -0.29)

  • Adequate correlation between age and pain (r = -0.41)

  • Poor correlation between age and self- image (r = -0.28)

  • Adequate correlation between age and mental health (r = -0.33)

  • Poor correlation between age and satisfaction (r = -0.30)

  • Adequate correlation between age and total score (r = -0.43; p < 0.01)

  • Adequate correlation between the age at which surgery and pain (r = -0.33, p < 0.01)

  • Poor correlation between the age at which surgery and mental health (r = -0.28; p < 0.01)

  • Adequate correlation between the age at which surgery and total score (r = -0.32; p < 0.01)

  • Excellent Convergent validity was found by comparing data from the SRS-22 and the QLPSD profile (r = 0.84; p < 0.001).

  • Excellent convergent validity between the SRS-22 and QLSDP (r = 0.84)

  • Adequate construct validity with the classic variables of the condition

  • Adequate discriminant validity with the classic variables of the condition

Floor/Ceiling Effects

Adolescent Idiopathic Scoliosis: (Théroux et al., 2017)

  • Floor

    • Excellent for Pain (0%)

    • Excellent for Self-Image (0%)

    • Excellent for Function (0%)

    • Excellent for Mental Health (0%)

    • Adequate for Satisfaction with Management (1.7%)

  • Ceiling

    • Poor for Pain (22.8%)

    • Adequate for Self-Image (5.4%)

    • Adequate for Function (0.9%)

    • Adequate for Mental Health (11.1%)

    • Adequate for Satisfaction with Management (17.1%)

Adolescent Idiopathic Scoliosis: (Schlosser et al., 2014)

  • Floor

    • Adequate for Pain (1%)

    • Excellent for Self-Image (0%)

    • Excellent for Function (0%)

    • Excellent for Mental Health (0%)

    • Excellent for Satisfaction with Management (0%)

  • Ceiling

    • Poor for Pain (20%)

    • Adequate for Self-Image (4%)

    • Poor for Function (33%)

    • Adequate for Mental Health (8%)

    • Poor for Satisfaction with Management (22%)

Adolescents Idiopathic Scoliosis: (Lee et al., 2017)

  • Floor

    • Adequate for Function (0.8%)

    • Adequate for Pain (1.6%)

    • Adequate for Self-image (0.8%)

    • Adequate for Mental health (0.8%)

    • Adequate for Satisfaction with management (0.8%)

  • Ceiling

    • Poor for Function (37.7%)

    • Poor for Pain (33.6%)

    • Adequate for Self-image (1.6%)

    • Adequate for Mental Health (5.7%)

    • Adequate for Satisfaction with management (8.2%)

Idiopathic Scoliosis: (Antonarakos et al., 2009)

  • Floor

    • Adequate for Pain (2%)

    • Adequate for Self-Image (2%)

    • Adequate for Function (2%)

    • Adequate for Mental Health (2%)

    • Adequate for Satisfaction with Management (2%)

  • Ceiling

    • Adequate for Pain (9.8%)

    • Adequate for Self-Image (13.7%)

    • Adequate for Function (7.8%)

    • Adequate for Mental Health (2%)

    • Poor for Satisfaction with Management (37.3%)

Adolescent Idiopathic Scoliosis: (Haidar, Kassak, Masrouha, Ibrahim, & Mhaidli, 2015)

  • Floor

    • Adequate for Pain (2.4%)

    • Adequate for Self-Image (2.4%)

    • Adequate for Function (2.4%)

    • Adequate for Mental Health (4.9%)

    • Adequate for Satisfaction with Management (4.9%)

  • Ceiling

    • Adequate for Pain (14.6%)

    • Adequate for Self-Image (4.9%)

    • Adequate for Function (4.9%)

    • Adequate for Mental Health (2.4%)

    • Poor for Satisfaction with Management (26.8%)

Adolescent Idiopathic Scoliosis: (Glowacki et al., 2008)

  • Floor

    • Adequate for all domains (1.7%)

  • Ceiling

    • Poor for Pain (20.7%)

    • Adequate for Self-Image (8.6%)

    • Adequate for Function (5.2%)

    • Adequate for Mental health (15.5%)

Adolescent Idiopathic Scoliosis (Adobor et al., 2010)

  • Floor

    • Excellent for Pain (0%)

    • Adequate for Self-Image (1.8%)

    • Excellent for Function (0%)

    • Excellent for Mental Health (0%)

    • Adequate for Satisfaction (4.2%)

  • Ceiling

    • Adequate for Pain (10.5%)

    • Excellent for Self-Image (0%)

    • Excellent for Function (0%)

    • Adequate for Mental Health (10.0%)

    • Adequate for Satisfaction (7.3%)

Adolescent Idiopathic Scoliosis: (Mousavi et al., 2010)

  • Floor

    • Adequate for all domains (2.8%)

  • Ceiling:

    • Adequate for Function (2.8%)

    • Adequate for Pain (16.1%)

    • Adequate for Self-image (2.8%)

    • Adequate for Mental Health (5.8%)

    • Adequate for Satisfaction (19.4%)

Adolescent Idiopathic Scoliosis: (Monticone, Carabalona, Negrini, 2004; n = 55, Italian sample)

  • Floor

    • Adequate for Function (5.7%)

    • Poor for Pain (25.7%)

    • Adequate for Self-Image (2.9%)

    • Adequate for Mental Health (11.4%)

    • Adequate for Satisfaction (2.9%)

  • Ceiling

    • Poor for Function (48.6%)

    • Poor for Pain (74.3%)

    • Adequate for Self-Image (8.6%)

    • Poor for Mental Health (34.3%)

    • Poor for Satisfaction (20.0%)

Adolescent Idiopathic Scoliosis: (Zhao et al., 2007)

  • Floor

    • Adequate for Function (2.3%)

    • Adequate for Pain (7.0%)

    • Adequate for Self-Image (2.3%)

    • Adequate for Mental Health (4.7%)

    • Adequate for Satisfaction (2.3%)

  • Ceiling

    • Adequate for Function (2.3%)

    • Adequate for Pain (15.1%)

    • Adequate for Self-Image (4.7%)

    • Adequate for Mental Health (5.8%)

    • Adequate for Satisfaction (2.3%)

Adolescent Idiopathic Scoliosis: (Potoupnis et al., 2012)

  • Floor:

    • Adequate for all domains (1.1%)

  • Ceiling

    • Poor for Function (52.9%)

    • Adequate for Pain (18.4%)

    • Adequate for Self-Image (11.5%)

    • Adequate for Mental Health (8.0%)

    • Poor for Satisfaction (31.0%)

Adolescent Idiopathic Scoliosis: (Lonjon et al., 2014)

  • Floor

    • Excellent for Function (0%)

    • Excellent for Pain (0%)

    • Excellent for Self-Image (0%)

    • Excellent for Mental health (0%)

    • Adequate for Satisfaction (1.2%)

  • Ceiling

    • Excellent for Function (0%)

    • Adequate for Pain (19.4%)

    • Adequate for Self-Image (1.1%)

    • Adequate for Mental health (8.0%)

    • Adequate for Satisfaction (9.4%)

Idiopathic Scoliosis (Lee et al., 2011)

  • Floor Effects

    • Adequate for Function (1.2%)

    • Adequate for Pain (1.2%)

    • Adequate for Self-Image (2.4%)

    • Adequate for Mental Health (1.2%)

    • Adequate for Satisfaction (2.4%)

  • Ceiling effects

    • Poor for Function (31.3%)

    • Poor for Pain (24.1%)

    • Adequate for Self-Image (4.8%)

    • Adequate for Mental Health (12.0%)

    • Adequate for Satisfaction (8.4%)

Adolescent Idiopathic Scoliosis (Danielsson et al., 2013)

  • Floor

    • Adequate for Pain (0.5%)

    • Adequate for Self-image (0.5%)

    • Adequate for Function (0.5%)

    • Adequate for Mental Health (0.5%)

    • Adequate for Satisfaction (1.7%)

  • Ceiling

    • Poor for Pain (28%)

    • Adequate for Self-Image (5.7%)

    • Poor for Function (21.8%)

    • Adequate for Mental Health (11.9%)

    • Adequate for Satisfaction (17.4%)

Adolescent Idiopathic Scoliosis: (Cheung et al., 2007)

  • Floor

    • Adequate for Function (2.0%)

    • Adequate for Pain (2.0%)

    • Adequate for Satisfaction (2.0%)

    • Adequate for Self-Image (4.0%)

    • Adequate for Mental health (4.0%)

  • Ceiling

    • Poor for Function (44.0%)

    • Poor for Pain (30.0%)

    • Adequate for Satisfaction (10.0%)

    • Adequate for Self-Image (2.0%)

    • Adequate for Mental Health (18.0%)

Adolescent Spinal Deformity: (Glates et al., 2007)

  • Floor Effects

    • Adequate for Function (1.4%)

    • Adequate for Pain (1.4%)

    • Adequate for Self-Image (2.9%)

    • Adequate for Mental Health (1.4%)

    • Adequate for Satisfaction/Dissatisfaction (3.4%)

  • Ceiling Effects

    • Poor for Function (47.1%)

    • Poor for Pain (27.1%)

    • Adequate for Self-Image (12.9%)

    • Poor for Mental Health (21.4%)

    • Poor for Satisfaction/Dissatisfaction (24.1%)

Responsiveness

Mild Adolescent Idiopathic Scoliosis: (Monticone et al., 2017)

  • Large responsiveness for all domains

Moderate Adult Idiopathic Scoliosis: (Monticone et al., 2017)

  • Large to Moderate responsiveness

Adolescent Idiopathic Scoliosis(Monticone et al., 2010)

  • Large responsiveness

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