樱花视频

Skip to main content
Download PDF
  • Research
  • Published:

Association between meeting 24-hour movement behavior guidelines and quality of life in adolescents with idiopathic scoliosis

樱花视频 volume听24, Article听number:听2455 (2024) Cite this article

Abstract

Background

Meeting the 24-hour movement behavior (24-HMB) guideline helps enhance quality of life (QOL) of adolescents. This study aimed to assess the associations between the 24-HMB (physical activity, screen time, sleep) and QOL among adolescents with idiopathic scoliosis.

Methods

A cross-sectional study was conducted between September 2021 and September 2023. 24-HMB, QOL and demographic variables were collected through a self-reported questionnaire. Linear regression models and stratified analyses were used to explore statistical associations between the 24-HMB and QOL.

Results

A total of 1073 participants aged 10鈥�18 years with a spinal Cobb angle between 10掳 and 40掳 were included. Overall, 20 participants (1.9%) met all three behavioral guidelines, and 272 participants (25.3%) met none. Compared to those who did not meet any of the guidelines, adolescents meeting both screen time and sleep duration (尾鈥�=鈥�4.10, 95% CI: 2.02鈥�6.18, P鈥�<鈥�0.001) and all 3 guidelines (尾鈥�=鈥�4.39, 95% CI: 0.27鈥�8.51, P鈥�=鈥�0.037) had higher QOL scores. Stratified analyses showed that the above associations were more pronounced in adolescents without back pain or with good self-image.

Conclusions

These findings highlight the importance of adopting and maintaining healthy behavioral habits in order to improve QOL among adolescents with idiopathic scoliosis, especially in those without back pain or with good self-image.

Peer Review reports

Introduction

Adolescent idiopathic scoliosis (AIS) is characterized by a lateral curvature of the spine of 10掳 or more and typically presents as a three-dimensional deformity in adolescents aged from 10 to 18 years old [1, 2]. AIS, as the most common form of scoliosis, accounts for 84鈥�89% of all types of scoliosis [1]. The global prevalence rate of AIS ranges from approximately 0.47鈥�5.20% [3]. According to a meta-analysis comprising 72 studies, the estimated prevalence rate of AIS in China was found to be approximately 1.16%, suggesting that there could be millions of adolescents with AIS [4]. An adolescent scoliosis screening program carried out in Shenzhen, China, between 2018 and 2019 revealed an estimated prevalence of 3.2% [5]. AIS can result in a range of adverse consequences such as back pain [6], poor self-image [7], increased psychological stress [8], and even cardiopulmonary damage in severe cases [9], which significantly impacting the quality of life (QOL).

QOL refers to the perceived physical and mental health of an individual or group over time, including health-related functioning [10]. QOL serves as a valuable measure for assessing individual functional perceptions, as well as psychological and social well-being [11]. Compared to healthy peers, the QOL of adolescents with AIS declines [12], necessitating attention and appropriate intervention. Currently, there are different clinical measures for patients with varying degrees of spinal curvature. Patients with a curvature angle below 40 degrees are often observed or treated conservatively, with bracing therapy considered the most effective conservative treatment method, while patients with a curvature greater than 40 degrees may require surgery depending on the situation [13]. Bracing therapy typically lasts for several years, imposing huge pressure on patients and showing low compliance [14]. Ragborg et al. found that bracing therapy may not be beneficial for the long-term QOL of patients [15]. In contrast, Meng et al. discovered in their study that bracing therapy could potentially improve patients鈥� QOL [16], indicating that further research is needed. Therefore, it is necessary to explore methods that can both delay disease progression and improve QOL.

A healthy lifestyle has an important impact on the improvement of QOL in adolescents. In recent years, with the introduction of the 24-hour movement behavior (24-HMB) guidelines, more researchers have advocated that the effects of physical activity, sedentary behavior, and sleep on adolescent physical and mental health should be viewed in an integrated way [17, 18]. The 24-HMB guidelines recommend that children and adolescents aged 5鈥�17 years should maintain an average of at least 60听min of moderate to vigorous physical activity (MVPA), less than 2听h of screen time (ST), and adequate sleep duration (SD) per day, with 9鈥�11听h for those aged 6鈥�13 years and 8鈥�10听h for those aged 14鈥�17 years [17, 19]. There is substantial evidence shown that meeting the recommendations outlined in these guidelines has a positive influence on QOL-related outcomes among children and adolescents [20, 21].

Similar findings were observed in adolescents with idiopathic scoliosis. Newman et al. [22] and YAKUT et al. [23] found that individuals with AIS with a low level of physical activity (PA) or short SD reported a lower QOL score. However, other studies have not shown the beneficial effects of PA on QOL [24]. To our knowledge, few studies have examined the relationship between the 24-HMB guideline met and QOL in adolescents with AIS, and the factors that influence this relationship are also unclear. AIS has become one of the important risk factors affecting the physical and mental health of Chinese children and adolescents, and its incidence remains high [25]. Moreover, given the inconspicuous symptoms of AIS and potential adverse effects of brace treatment, it is crucial to further pay attention to the QOL of this population and identify effective ways to improve it. Therefore, we aimed to assess the compliance with the 24-HMB guidelines, explore its impact on QOL in adolescents with idiopathic scoliosis, and provide scientific advice for better improvement of QOL.

Methods

Study design and participants

The current cross-sectional study was conducted at the Shenzhen Youth Spine Health Center (SYSHC) of the Shenzhen Second People鈥檚 Hospital between September 2021 and September 2023 [26]. Trained rehabilitation therapists from SYSHC approached patients and their guardians attending the clinic for recruitment. When the adolescents visited the SYSHC, after obtaining the consent of their parents, they were asked to fill out a self-reported questionnaire independently. Younger patients who were unable to complete the questionnaire themselves completed it with the assistance of their parents. The study was conducted in accordance with the Declaration of Helsinki, and received ethical approval from the institutional review board of the Shenzhen Second People鈥檚 Hospital (Ethics Number: 20211013002-fs01).

The diagnosis of AIS was confirmed by standard whole-standing posteroanterior full-spine radiographs and clinical assessment [27]. Adolescents aged between 10 and 18 years old with Cobb angle ranging from 10掳 to 40掳 were eligible for the study. Individuals with one of the following conditions were excluded: the presence of non-idiopathic scoliosis or other orthopedic malformations; a history of spinal injury, such as a fracture or spinal surgery; or current or previous scoliosis treatment, such as exercise therapy or brace therapy. The non-idiopathic scoliosis or other orthopedic deformities were excluded by clinical doctors based on examination results.

A total of 1302 participants were enrolled in this study, and 1073 (82.4%) met the inclusion criteria (Fig.听1). Individuals were excluded for inappropriate age (n鈥�=鈥�62), prior brace therapy (n鈥�=鈥�81), prior other therapy (n鈥�=鈥�46), Cobb angle鈥�>鈥�40掳 (n鈥�=鈥�10), or invalid questionnaires (n鈥�=鈥�30).

Fig. 1
figure 1

This diagram showing recruitment process of study participants

Full size image

Measures

Demographic variables

Demographic variables were collected by a self-reported questionnaire, including age, gender, height, weight, grade, Cobb angle, family economic situation (1鈥�=鈥塯ood, 2鈥�=鈥塮air, 3鈥�=鈥塸oor, 4鈥�=鈥塽nclear), education level of parents (1鈥�=鈥塽niversity or above, 2鈥�=鈥塻enior high school, 3鈥�=鈥塲unior high school, 4鈥�=鈥塽nclear), back pain (1鈥�=鈥塶o, 2鈥�=鈥墆es) and self-image (1鈥�=鈥塯ood, 2鈥�=鈥塮air, 3鈥�=鈥塸oor). Body mass index (BMI) was calculated by dividing weight in kilograms by the square of height in meters. We divided BMI into three categories (1鈥�=鈥塽nderweight, 2鈥�=鈥塶ormal, 3鈥�=鈥塷verweight) based on the criteria of different age groups [28, 29].

Physical activity

International physical activity questionnaire short form (IPAQ-SF), one of the most widely used self-report questionnaires, was used to assess the status of PA [30]. The Chinese version of IPAQ-SF has excellent validity, and it can be used to measure PA in Chinese population [31]. The questionnaire consists of seven questions to capture average daily time spent in vigorous (e.g., weight lifting, aerobics), moderate (e.g., light lifting, biking, double tennis) intensity physical activity, walking and sitting over the last seven days. The data from the moderate and vigorous activity domains were aggregated to generate a single MVPA variable. The specific calculation process was as follows: [(the days of moderate activity per week 脳 the hours of moderate activity per day) + (the days of vigorous activity per week 脳 the hours of vigorous activity per day)]/7 [32]. During the calculation process, if the duration of moderate/vigorous activity was greater than 180听min per day, it was calculated as 180听min, and if the duration was less than 10听min, it was recoded as 0听min [33]. In this study, an MVPA of 60听min or more was considered to meet the guideline of PA [19].

Screen time

Screen time (ST) was measured by asking the number of hours spent engaged in screen-based activities (watching TV/Video, using smartphones and computers). Daily ST was calculated by taking the average of the time spent using the above electronic devices on weekdays and weekends [34]. The calculation process was as follows: [(sum of weekday ST in decimal hours 脳 5) + (sum of weekend ST in decimal hours 脳 2)]/7. In this study, a daily ST of 2听h or less was considered to meet the guideline of ST [19].

Sleep duration

Sleep duration (SD) was assessed by the question, 鈥淒uring the past month, how many hours of sleep did you actually get each day on average?鈥�. According to the 24-HMB guidelines, responses of 9听h or more for children aged 10鈥�13 years and 8听h or more for those aged 14鈥�18 years were considered to meet the guideline of SD [17].

Quality of life

The 12-Item Short-Form Health Survey (SF-12) was used to measure QOL, which had been applicable to the adolescents of China [35]. The SF-12 comprises 12 questions across 8 dimensions, including physical functioning, role-physical, role-emotional and mental health scales, bodily pain, general health perceptions, vitality, and social functioning [36]. According to the SF-12 manual, we computed the physical component summary (PCS) and mental component summary (MCS) scores by standardizing the scores obtained from the 12 questions [37]. The PCS and MCS scores range from 0 to 100, with higher scores indicating better QOL.

Statistical analysis

First, descriptive analyses were performed to describe the demographic characteristics of the participants, and the results are expressed as numbers (%) or mean (standard deviation, SD). Second, univariable linear regression analyses were performed to test the associations of demographic variables, number of complying with 24-HMB guidelines and 8 possible movement behavior combinations (PA only, SD only, ST only, PA鈥�+鈥塖T, PA鈥�+鈥塖D, ST鈥�+鈥塖D, PA鈥�+鈥塖T鈥�+鈥塖D, and none) with PCS/MCS. Third, multivariable linear models were constructed for further analyses, with all the models adjusted for age, gender, BMI, grade, family economic condition, education of the father and mother, back pain and self-image; these variables have been widely reported to be associated with QOL previously or with P鈥�<鈥�0.10 in the univariable analyses [38]. Fourth, stratified analyses were conducted to explore whether the associations of the guidelines met with QOL varied according to sample characteristics. In all regression analyses, the guidelines met was analyzed as a continuous variable and categorical variable respectively. Missing data (<鈥�5%) were replaced by using multiple imputation. R 4.1.3 (the R Foundation for Statistical Computing, Vienna, Austria) and Statistical Package for the Social Sciences (SPSS) version 20.0 were used for the statistical analyses. All the statistical tests were two-sided, and a P-value less than 0.05 was considered statistically significant.

Results

Sample characteristics

As shown in Tables听1 and 1073 participants with AIS were included in this study, and the mean (SD) age was 13.56 (1.84) years (range 10鈥�18). There were 279 (26.0%) males and 794 (74.0%) females, with PCS mean (SD) score 53.17 (5.15) and MCS mean (SD) score 46.76 (9.49). The majority of participants had a normal BMI, and approximately 12.1% were underweight. About one-fifth of participants had a Cobb angle more than 20掳. Nearly half of the participants had parents with a university education or above. Over 70% of participants reported that their family鈥檚 economic condition is fair or good. More than 50% of participants reported back pain in the last three months, and 15.0% of them rated their trunk aesthetics as poor.

Table 1 Demographic characteristics of all participants (n鈥�=鈥�1073)
Full size table

Adherence to the 24-HMB guidelines

Only 1.9% of participants met all three behavioral guidelines, and 25.3% met none. The majority of participants did not have enough PA or sufficient SD. Approximately 67 (6.2%), 142 (13.2%), and 359 (33.5%) of participants only met PA guideline, SD guideline, and ST guideline, respectively. Nearly one-fifth of the participants met both guidelines (n鈥�=鈥�213 [19.9%]), in which the majority were SD and ST (n鈥�=鈥�100 [9.3%]) (Table听1).

Associations between meeting the 24-HMB guidelines and QOL

As presented in Table听2, the number of 24-HMB guidelines met was positively associated with MCS score, and participants meeting two or three guidelines had higher scores. After adjusting for previously widely reported factors related to QOL and those that were statistically significant according to univariate analyses, the MCS score was still 1.47 (95% CI鈥�=鈥�0.72 to 2.22) higher with each additional guideline. Compared to participants who did not meet any of the guidelines, participants who met all three guidelines had the highest score (尾鈥�=鈥�4.39, 95% CI鈥�=鈥�0.27 to 8.51). Participants met SD and ST had a greater positive association (尾鈥�=鈥�4.10, 95% CI鈥�=鈥�2.02 to 6.18) with MCS when comparing with meeting other two different combination guidelines. However, these associations were not found between the guidelines met and PCS score (Supplemental Table 1).

Table 2 Associations between meeting 24-HMB guidelines and MCS
Full size table

Associations between meeting the 24-HMB guidelines and MCS stratified by back pain and self-image

As shown in Supplemental Table 2, the associations between the interaction items (i.e., guidelines met and back pain, self-image) and MCS were statistically significant (P鈥�<鈥�0.05). No statistical differences were observed between the other sample characteristics. Therefore, further analyses were conducted stratified by back pain and self-image.

The results of stratified analyses presented in Table听3 show that the number of guidelines met was positively associated with the MCS score in both two groups. In the group with back pain, compared to those who did not meet any of the guidelines, there was a statistical difference in the MCS score when participants with AIS met two guidelines, specifically when they met SD and ST guidelines (尾鈥�=鈥�4.58, 95% CI鈥�=鈥�1.33鈥�7.83). Among participants without back pain, increasing numbers of guidelines met were associated with higher MCS scores compared to those meeting none of the guidelines, and the highest scores were achieved when all three guidelines were met (尾鈥�=鈥�5.28, 95% CI鈥�=鈥�0.91鈥�9.66).

Table 3 Associations between meeting 24-HMB guidelines and MCS stratified by back pain
Full size table

As shown in Table听4, the number of guidelines met was positively associated with the MCS score in the groups with fair and good self-image, but no statistical difference was found in the poor self-image group. Specifically, in the group with good self-image, there were higher MCS scores as the number of guidelines met increased, and the highest scores were achieved when all three guidelines were met (尾鈥�=鈥�6.98, 95% CI鈥�=鈥�1.44鈥�12.52).

Table 4 Associations between meeting 24-HMB guidelines and MCS stratified by self-image
Full size table

Discussion

Our study analyzed the association between the 24-HMB guidelines met and QOL among adolescents with idiopathic scoliosis. The findings revealed a positive correlation between healthy lifestyles (including adequate PA, moderate amount of ST, and sufficient SD) and QOL. QOL improved incrementally with an increasing number of guidelines met. Additionally, it was observed that adolescents without back pain or with good self-image may experience greater enhancement in their QOL when adopting more healthy behaviors.

In the present study, we observed that only 1.9% of participants met all three guidelines, which was lower than that of healthy adolescents, while 25.3% met none. Chen et al. [38] reported that 5.12% of the participants met all three guidelines in a study including 114,072 Chinese adolescents, and Zhu et al. [39] found that the proportion was 9.4% among American adolescents. Of the three guidelines, the rate of meeting PA was the lowest, at 18.6%. Regina et al. [40] found that 81.6% of students did not meet physical activity requirements among 1.6听million people aged 11鈥�17 years in 146 countries around the world. Meanwhile, Swati et al. found that adolescents with idiopathic scoliosis spent 20-30% less time exercising on weekdays and weekends than did healthy people, and the proportion of patients meeting PA was lower than that of healthy people [41]. Our study revealed that only approximately one-quarter and half of participants met SD and ST guidelines, respectively. Compared with healthy peer, AIS patients had a higher proportion of more than two hours of ST per day and reported poorer sleep quality [26]. Differences in ratios could exist due to population characteristics as well as cultural and economic differences, and discrepancies in measuring these behavioral aspects might also have a significant influence on the outcomes. However, these results suggested a serious lack of adherence to the 24-HMB guidelines among adolescents with idiopathic scoliosis.

Moreover, our study observed that 54.8% of participants reported varying frequencies of back pain within three months, and 15.0% perceived their trunk aesthetics as poor. Similar to previous findings, AIS patients commonly exhibit back pain symptoms and low perceptions of trunk aesthetics [42]. Arnold et al. [43] reported that the 30-day prevalence of back pain was 25% in AIS patients, and the 12-month prevalence was 30%. Sato et al. [44] also reported that the prevalence of back pain was over 50% in adolescents with idiopathic scoliosis. Spinal deformities can cause pain by altering the biomechanics and muscle tissue function of the spine, thereby increasing the risk of developing back pain [45]. In addition, self-image is also of great concern for individuals with AIS, who may pay more attention to physiological changes in their bodies and compare themselves to adolescents without scoliosis [46]. Both back pain and poor self-image are important factors affecting patients鈥� health-related QOL [47]. Therefore, it is necessary to pay attention to the above factors and take corresponding measures in a timely manner.

In this study, we also found that meeting all the three guidelines (PA, ST and SD) exhibited the strongest positive association with MCS scores. Meeting both SD and ST had a positive association with MCS when two guidelines were met together. However, no statistical difference was observed when only one was met or when a combination of PA and any other behavioral guideline was met. To our knowledge, this is the first study to investigate 24-HMB and QOL among adolescents with idiopathic scoliosis, as previous studies have focused primarily on a single movement behavior. Cong et al. [48] found that physical fitness, exercise intensity and endurance were associated with QOL improvement in AIS patients. However, Marlene et al. [24] found that adequate daily PA could not improve the QOL of AIS patients within six months. This may need to be determined in a larger sample size of participants and over a longer period of time, taking into account other factors that affect QOL. Long-term sedentary behavior (e.g., watching TV or playing games), particularly when accompanied by an inappropriate sitting posture, may exacerbate paravertebral muscle fatigue and ligament pressure in adolescents with idiopathic scoliosis, possibly leading to back pain and decreased QOL [49]. Sleeping is an important way to promote muscle recovery, and when individuals with AIS sleep for a short time or have poor sleep quality, they are more likely to experience conditions such as back pain [50]. Moreover, as age increases, academic pressure rises resulting in decreased PA and SD, and increased sedentary behavior among adolescents, which hinders the development of healthy lifestyles [51, 52]. Therefore, taking targeted measures to improve and maintain patients鈥� healthy lifestyles and thus enhance their QOL requires the participation of the whole society.

In addition, this study revealed that the number of guidelines met and the different guideline combinations were not significantly associated with PCS. These results may be attributed to the fact that most of the participants included in the current study had mild curvature, whose clinical symptoms were not obvious, and the impact on daily exercise ability was small. Shen et al. [53] did not observe a correlation between exercise tolerance and chest curvature when measuring exercise ability in AIS patients, and Lin et al. [9] also found no correlation between exercise performance and thorax curvature size in a prospective study of AIS patients.

Moreover, the study identified a significant association between interaction terms (i.e., guidelines met and back pain/self-image) and MCS score, as subsequent stratified analysis showed that participants without back pain or with good self-image may have a better enhancement of QOL through improving three movement behaviors. The following reasons may explain their associations: First, back pain is one of the most common symptoms in AIS patients, which is an important factor affecting their QOL [43]. The existence of back pain is not conducive to the mental health development of patients [42]. Second, patients with AIS are more concerned about their body appearance and lower evaluations than individuals without scoliosis are [54]. Ryan et al. found [55] that adolescents with idiopathic scoliosis would unwillingly adjust certain parts of their lives and avoid engaging in certain activities because they are overly concerned about their image, which could affect their mental health. Therefore, it is important to understand how these adolescents perceive their 鈥榙iagnosis, self-image, and how they compare themselves to peers鈥�. Among participants with back pain or fair self-image cognition, we found no statistical association between meeting all three guidelines and QOL, which may be due to the low proportion of individuals meeting three guidelines (only 1.9%). Meanwhile, the presence of back pain and poor self-image cognition prevent adolescents from contacting the outside world, which is not conducive to the formation of healthy behavioral habits [42, 55]. Therefore, interventions targeting the aforementioned three behaviors may yield greater benefits for adolescents with idiopathic scoliosis, especially those without back pain or with good self-image, which requires sufficient attention and targeted measures from parents and schools.

Our study expands the existing evidence on healthy behavioral habits and QOL in adolescents with idiopathic scoliosis, considering PA, ST and SD as a collective entity. This study also has several limitations. First, the information about three movement behaviors and QOL was obtained through self-reported questionnaires, which may lead to recall bias. Additionally, the scales used for physical activity and QOL were not be the most suitable for AIS patients, and we will make adjustments in future research. Second, our study primarily included participants who voluntarily sought treatment at hospitals, which could introduce selection bias, and we hope to expand the scope of investigation through joint community clinical centers in the future. Third, due to its cross-sectional design, establishing causal associations between adherence to guidelines and QOL among adolescents with idiopathic scoliosis is challenging. Fourth, the population in this study consists of Chinese adolescents, which limits the extrapolation of the results.

Conclusions

In conclusion, the prevalence of 24-HMB guidelines met was low among adolescents with idiopathic scoliosis, and there was a positive dose-response relationship between the number of guidelines met and the QOL score. Parents and schools should allocate more attention towards adolescents with idiopathic scoliosis, particularly those who have back pain and poor self-image, and encourage them to develop correct cognition and healthy behavioral habits. Our findings need to be explored and supported by further research in the future.

Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

AIS:

Adolescent idiopathic scoliosis

CI:

Confidence interval

QOL:

Quality of life

BMI:

Body mass index

PCS:

Physical component summary

MCS:

mental component summary

PA:

Physical activity

MVPA:

Moderate to vigorous physical activity

ST:

Screen time

SD:

Sleep duration

References

  1. Schlosser T, van der Heijden GJ, Versteeg A, Castelein RM. How idiopathic is adolescent idiopathic scoliosis? A systematic review on associated abnormalities. PLoS ONE. 2014;9(5):e97461.

    听 听 听 听

  2. Dunn J, Henrikson NB, Morrison C, Blasi PR, Nguyen M, Lin JS. Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(2):173鈥�87.

    听 听 听

  3. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013;7(1):3鈥�9.

    听 听 听

  4. Xu S, Su Y, Wang Z, Liu C, Jin L, Liu H. The prevalence and characteristics of primary and middle-school students in China: a Meta-analysis based on 72 epidemiological research. Chin J Spine Spinal Cord. 2021;31(10):901鈥�10.

    听

  5. Yan B, Lu X, Nie G, Huang Y. China urgently needs a nationwide scoliosis screening system. Acta Paediatr. 2020;109(11):2416鈥�7.

    听 听 听

  6. Clark EM, Tobias JH, Fairbank J. The impact of small spinal curves in adolescents who have not presented to secondary care: a Population-based Cohort Study. Spine (Phila Pa 1976). 2016;41(10):E611鈥�617.

    听 听 听

  7. Belli G, Toselli S, Latessa PM, Mauro M. Evaluation of self-perceived body image in adolescents with mild idiopathic scoliosis. Eur J Investig Health Psychol Educ. 2022;12(3):319鈥�33.

    听 听 听

  8. Sanders AE, Andras LM, Iantorno SE, Hamilton A, Choi PD, Skaggs DL. Clinically significant psychological and emotional distress in 32% of adolescent idiopathic scoliosis patients. Spine Deform. 2018;6(4):435鈥�40.

    听 听 听

  9. Lin Y, Feng E, Shen J, Tan H, Jiao Y, Rong T, et al. Influences of thoracic spinal deformity on Exercise Performance and pulmonary function: a prospective study of 168 patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2022;47(3):E107鈥�15.

    听 听 听

  10. Felce D, Perry J. Quality of life: its definition and measurement. Res Dev Disabil. 1995;16(1):51鈥�74.

    听 CAS听 听 听

  11. Chen M, Chua T, Shen Z, Tay LY, Wang X, Chia M. The associations between 24-Hour Movement behaviours and Quality of Life in preschoolers: a compositional analysis of cross-sectional data from 2018鈥�2021. Int J Environ Res Public Health. 2022;19(22):14969.

    听 听 听 听

  12. Diarbakerli E, Grauers A, Danielsson A, Abbott A, Gerdhem P. Quality of life in males and females with idiopathic scoliosis. Spine (Phila Pa 1976). 2019;44(6):404鈥�10.

    听 听 听

  13. Babaee T, Moradi V, Hashemi H, Shariat A, Anastasio AT, Khosravi M, et al. Does Bracing Control the Progression of adolescent idiopathic scoliosis in Curves Higher Than 40掳? A systematic review and Meta-analysis. Asian Spine J. 2023;17(1):203鈥�12.

    听 听 听

  14. Hawary RE, Zaaroor-Regev D, Floman Y, Lonner BS, Alkhalife YI, Betz RR. Brace treatment in adolescent idiopathic scoliosis: risk factors for failure-a literature review. Spine J. 2019;19(12):1917鈥�25.

    听 听 听

  15. Ragborg LC, Dragsted C, Ohrt-Nissen S, Andersen T, Gehrchen M, Dahl B. Health-related quality of life in patients 40 years after diagnosis of an idiopathic scoliosis. Bone Joint J. 2023;105鈥揃(2):166鈥�71.

    听 听 听

  16. Meng ZD, Li TP, Xie XH, Luo C, Lian XY, Wang ZY. Quality of life in adolescent patients with idiopathic scoliosis after brace treatment. Med (Baltim). 2017;96(19):e6828.

    听 听

  17. Tremblay MS, Carson V, Chaput JP, Connor Gorber S, Dinh T, Duggan M, et al. Canadian 24-Hour Movement Guidelines for Children and Youth: an integration of physical activity, sedentary Behaviour, and Sleep. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):S311鈥�327.

    听 听 听

  18. Rollo S, Antsygina O, Tremblay MS. The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. J Sport Health Sci. 2020;9(6):493鈥�510.

    听 听 听 听

  19. Chaput JP, Willumsen J, Bull F, Chou R, Ekelund U, Firth J, et al. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5鈥�17 years: summary of the evidence. Int J Behav Nutr Phys Act. 2020;17:141.

    听 听 听 听

  20. Xiong X, Dalziel K, Carvalho N, Xu R, Huang L. Association between 24-hour movement behaviors and health-related quality of life in children. Qual Life Res. 2022;31(1):231鈥�40.

    听 听 听

  21. Luo L, Zeng X, Cao Y, Hu Y, Wen S, Tang K, et al. The associations between Meeting 24-Hour Movement guidelines (24-HMG) and Mental Health in adolescents鈥擟ross Sectional evidence from China. Int J Environ Res Public Health. 2023;20(4):3167.

    听 听 听 听

  22. Newman M, Hannink E, Barker KL. Associations between physical activity and adolescent idiopathic scoliosis: a systematic review and Meta-analysis. Arch Phys Med Rehabil. 2023;S0003-9993(23)00095鈥夆�撯��3.

  23. Yakut Y, Pelin Z, Yagci G. An investigation of sleep profiles in individuals with idiopathic scoliosis. Sleep Sci. 2022;15(2):172鈥�8.

    听 听 听 听

  24. Dufvenberg M, Diarbakerli E, Charalampidis A, 脰berg B, Tropp H, Aspberg Ahl A, et al. Six-Month results on treatment adherence, physical activity, spinal appearance, spinal deformity, and quality of life in an Ongoing Randomised Trial on Conservative Treatment for adolescent idiopathic scoliosis (CONTRAIS). J Clin Med. 2021;10(21):4967.

    听 听 听 听

  25. Hengwei F, Zifang H, Qifei W, Weiqing T, Nali D, Ping Y, et al. Prevalence of idiopathic scoliosis in Chinese schoolchildren: a large, Population-based study. Spine (Phila Pa 1976). 2016;41(3):259鈥�64.

    听 听 听

  26. Dou Q, Zhu Z, Zhu L, Wang W, Guo L, Ru S, et al. Academic-related factors and daily lifestyle habits associated with adolescent idiopathic scoliosis: a case-control study. Environ Health Prev Med. 2023;28:23.

    听 听 听 听

  27. Zhu L, Ru S, Wang W, Dou Q, Li Y, Guo L, et al. Associations of physical activity and screen time with adolescent idiopathic scoliosis. Environ Health Prev Med. 2023;28(0):55鈥�55.

    听 听 听 听

  28. Zhu Z, Tang Y, Zhuang J, Liu Y, Wu X, Cai Y, et al. Physical activity, screen viewing time, and overweight/obesity among Chinese children and adolescents: an update from the 2017 physical activity and fitness in China-the youth study. 樱花视频. 2019;19(1):197.

    听 听 听 听

  29. Dong Y, Zou Z, Yang Z, Wang Z, Yang Y, Ma J, et al. Prevalence of excess body weight and underweight among 26 Chinese ethnic minority children and adolescents in 2014: a cross-sectional observational study. 樱花视频. 2018;18(1):562.

    听 听 听 听

  30. Craig CL, Marshall AL, Sj枚str枚m M, Bauman AE, Booth ML, Ainsworth BE, et al. International Physical Activity Questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381.

    听 听 听

  31. Macfarlane D, Lee C, Ho E, Chan K. Reliability and validity of the Chinese version of IPAQ (short, last 7 days). J Sci Med Sport. 2007;10(1):45鈥�51.

    听 听 听

  32. X F, Zb C. Physical activity among Chinese school-aged children: National prevalence estimates from the 2016 physical activity and fitness in China-The Youth Study. J Sport Health Sci. 2017;6(4):404鈥�9.

    听 听

  33. Fan M, Lyu J, He P. Chinese guidelines for data processing and analysis concerning the International Physical Activity Questionnaire. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(8):961鈥�4.

    听 听

  34. Guerrero MD, Barnes JD, Walsh JJ, Chaput JP, Tremblay MS, Goldfield GS. 24-Hour Movement behaviors and Impulsivity. Pediatrics. 2019;144(3):e20190187.

    听 听 听

  35. Y L, Y Y, J Z, X Z, C W. Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study. Health and quality of life outcomes [Internet]. 2020 Sep 11 [cited 2024 Apr 5];18(1).

  36. Ware J, Kosinski M, Keller SD. A 12-Item short-form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220鈥�33.

    听 听 听

  37. Ge Y, Xin S, Luan D, Zou Z, Liu M, Bai X, et al. Association of physical activity, sedentary time, and sleep duration on the health-related quality of life of college students in Northeast China. Health Qual Life Outcomes. 2019;17(1):124.

    听 听 听 听

  38. Chen ST, Liu Y, Tremblay MS, Hong JT, Tang Y, Cao ZB, et al. Meeting 24-h movement guidelines: prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents. J Sport Health Sci. 2021;10(3):349鈥�59.

    听 听 听

  39. Zhu X, Healy S, Haegele JA, Patterson F. Twenty-four-Hour Movement guidelines and Body Weight in Youth. J Pediatr. 2020;218:204鈥�9.

    听 听 听 听

  40. Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1路6 million participants. Lancet Child Adolesc Health. 2020;4(1):23鈥�35.

    听 听 听 听

  41. Chopra S, Larson AN, Kaufman KR, Milbrandt TA. Accelerometer based assessment of daily physical activity and sedentary time in adolescents with idiopathic scoliosis. PLoS ONE. 2020;15(9):e0238181.

    听 CAS听 听 听 听

  42. Makino T, Kaito T, Sakai Y, Takenaka S, Yoshikawa H. Health-related quality of life and postural changes of spinal alignment in female adolescents Associated with Back Pain in adolescent idiopathic scoliosis: a prospective cross-sectional study. Spine. 2019;44(14):E833.

    听 听 听

  43. Wong AYL, Samartzis D, Cheung PWH, Cheung JPY. How common is back Pain and what Biopsychosocial factors are Associated with Back Pain in patients with adolescent idiopathic scoliosis? Clin Orthop Relat Res. 2019;477(4):676鈥�86.

    听 听 听

  44. Sato T, Hirano T, Ito T, Morita O, Kikuchi R, Endo N, et al. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. Eur Spine J. 2011;20(2):274鈥�9.

    听 听 听

  45. Eyvazov K, Samartzis D, Cheung JPY. The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study. 樱花视频 Musculoskelet Disord. 2017;18(1):51.

    听 听 听 听

  46. Savvides P, Gerdhem P, Grauers A, Danielsson A, Diarbakerli E. Self-experienced trunk appearance in individuals with and without idiopathic scoliosis. Spine. 2020;45(8):522.

    听 听 听

  47. Tones M, Moss N, Polly DW. A review of quality of life and psychosocial issues in scoliosis. Spine (Phila Pa 1976). 2006;31(26):3027鈥�38.

    听 听 听

  48. Cong H, Chen L, Shen J, Yuan W, Lin Y, Liu Z, et al. Is physical capacity correlated with health-related quality of life in patients with adolescent idiopathic scoliosis? Ann Palliat Med. 2021;10(6):6220鈥�7.

    听 听 听

  49. Minghelli B, Oliveira R, Nunes C. Postural habits and weight of backpacks of Portuguese adolescents: are they associated with scoliosis and low back pain? Work. 2016;54(1):197鈥�208.

    听 听 听

  50. Teles AR, Ocay DD, Bin Shebreen A, Tice A, Saran N, Ouellet JA, et al. Evidence of impaired pain modulation in adolescents with idiopathic scoliosis and chronic back pain. Spine J. 2019;19(4):677鈥�86.

    听 听 听

  51. X Z, Ja H, Academic Stress HLFY. Physical activity, sleep, and Mental Health among Chinese adolescents. Int J Environ Res Public Health. 2021;18(14):7257.

    听 听

  52. Tobias JH, Fairbank J, Harding I, Taylor HJ, Clark EM. Association between physical activity and scoliosis: a prospective cohort study. Int J Epidemiol. 2019;48(4):1152鈥�60.

    听 听 听

  53. Shen J, Lin Y, Luo J, Xiao Y. Cardiopulmonary Exercise Testing in patients with idiopathic scoliosis. J Bone Joint Surg Am. 2016;98(19):1614鈥�22.

    听 听 听

  54. Rushton PRP, Grevitt MP. Comparison of untreated adolescent idiopathic scoliosis with normal controls: a review and statistical analysis of the literature. Spine (Phila Pa 1976). 2013;38(9):778鈥�85.

    听 听 听

  55. Essex R, Bruce G, Dibley M, Newton P, Thompson T, Swaine I, et al. A systematic scoping review and textual narrative synthesis of the qualitative evidence related to adolescent idiopathic scoliosis. Int J Orthop Trauma Nurs. 2022;45:100921.

    听 听 听

Acknowledgements

We thank all the patients who participated in the study and the rehabilitation therapists who participated in the scoliosis diagnosis and data collection.

Funding

This study was funded by Shenzhen Second People鈥檚 Hospital level Clinical Key Project (20243357003) and Shenzhen Key Medical Discipline Construction Fund (SZSM202211003). The funding body had no role in the study design, data collection, analysis, interpretation, or preparation of the manuscript.

Author information

Author notes

  1. Xinchang Sun, Lei Yang and Zhixiang Zhu contributed equally to this work.

  2. Ciyong Lu and Bin Yan contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China

    Xinchang Sun,听Wanxin Wang,听Liwan Zhu,听Shuwen Dong,听Lan Guo,听Liwen Yang听&听Ciyong Lu

  2. Department of Spine Surgery, the Fist Affiliated Hospital of Shenzhen University, Number 3002, Sungang west road, Futian district, Shenzhen, 518035, China

    Lei Yang,听Zhixiang Zhu,听Yi-Fan Lin,听Xiaosheng Chen,听Weijun Wang,听Xinhai Lu听&听Bin Yan

  3. Department of Spine Surgery, the Shenzhen Second People鈥檚 Hospital, Shenzhen, China

    Lei Yang,听Zhixiang Zhu,听Yi-Fan Lin,听Xiaosheng Chen,听Weijun Wang,听Xinhai Lu听&听Bin Yan

  4. Shenzhen Youth Spine Health Center, Shenzhen, China

    Lei Yang,听Zhixiang Zhu,听Yi-Fan Lin,听Xiaosheng Chen,听Weijun Wang,听Xinhai Lu听&听Bin Yan

  5. The Affiliated Hospital of Xizang Minzu University, Xianyang, China

    Xinchang Sun

Authors
  1. Xinchang Sun

    You can also search for this author in 听

  2. Lei Yang

    You can also search for this author in 听

  3. Zhixiang Zhu

    You can also search for this author in 听

  4. Wanxin Wang

    You can also search for this author in 听

  5. Liwan Zhu

    You can also search for this author in 听

  6. Shuwen Dong

    You can also search for this author in 听

  7. Lan Guo

    You can also search for this author in 听

  8. Liwen Yang

    You can also search for this author in 听

  9. Yi-Fan Lin

    You can also search for this author in 听

  10. Xiaosheng Chen

    You can also search for this author in 听

  11. Weijun Wang

    You can also search for this author in 听

  12. Xinhai Lu

    You can also search for this author in 听

  13. Ciyong Lu

    You can also search for this author in 听

  14. Bin Yan

    You can also search for this author in 听

Contributions

All authors have read and approved the final manuscript. C.L. and B.Y. conceptualized, designed and supervised the study. X.S., S.D., L.Y., Y.L., X.C., W.W. and X.L. contributed to coordination and screening data collection. X.S., Z.Z. and L.Z. analysed and interpretation the data. X.S. and L.Y. wrote the original draft. L.Z., W.W., L.G. and C.L. reviewed the manuscript and approved the final version.

Corresponding authors

Correspondence to Ciyong Lu or Bin Yan.

Ethics declarations

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

This study received ethical approval from the Institutional Review Board of the Shenzhen Second People鈥檚 Hospital (20211013002-fs01). Oral or written informed consent was obtained from the participants or their parents prior to the investigation.

Additional information

Publisher鈥檚 Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article鈥檚 Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article鈥檚 Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit .

About this article

Cite this article

Sun, X., Yang, L., Zhu, Z. et al. Association between meeting 24-hour movement behavior guidelines and quality of life in adolescents with idiopathic scoliosis. 樱花视频 24, 2455 (2024). https://doi.org/10.1186/s12889-024-19753-7

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-024-19753-7

Keywords

樱花视频

ISSN: 1471-2458

Contact us