INTRODUCTION:Non-traumatic spinal cord injury (NTSCI) is an increasingly common clinical condition, particularly among patients with cancer and multiple comorbidities. However, most established care pathways have been developed for acute traumatic spinal cord injury. OBJECTIVE:To describe the clinical and functional characteristics of patients with non-traumatic spinal cord injury assessed by a Rehabilitation Department in a tertiary care hospital and to characterize their rehabilitation care pathways. MATERIALS AND METHODS:A retrospective observational study was conducted. All inpatient rehabilitation consultations performed between January 2020 and August 2021 were reviewed. Adult patients with a confirmed diagnosis of non-traumatic spinal cord injury were included. Sociodemographic characteristics, etiology, American Spinal Injury Association (ASIA) Impairment Scale classification, functional status, complications, and discharge destination were collected. RESULTS:Among 2,156 inpatient rehabilitation consultations, 34 patients (1.6%) were diagnosed with non-traumatic spinal cord injury. The mean age was 57.8 ± 15.2 years, and 29.4% were women. The etiology was oncological in 82.4% of cases, mainly related to metastatic spinal disease. Most injuries were incomplete (91.2%), and ASIA grade D was the most frequent neurological impairment (67.6%). In 79.4% of patients, spinal cord injury was not explicitly documented as the reason for referral at the time of consultation. The mean Barthel Index score was 37.4 ± 32.8. Only 8.8% of patients were referred to specialized rehabilitation units. CONCLUSIONS:Non-traumatic spinal cord injury, predominantly of oncological origin and usually incomplete, represents a frequent clinical condition in the hospital setting. Our findings suggest opportunities to improve its early recognition and facilitate timely access to specialized rehabilitation services.
Introducción: La lesión medular (LM) no traumática representa una realidad clínica creciente, especialmente en pacientes con enfermedades oncológicas y elevada comorbilidad, sin embargo, la mayoría de los circuitos asistenciales hacen referencia a la lesión aguda traumática.Objetivo: Describir las características clínico-funcionales de los pacientes con lesión medular valorados en un Servicio de Rehabilitación en un hospital terciario y determinar las trayectorias asistenciales.Material y métodos: Estudio observacional retrospectivo. Se revisaron todas las interconsultas hospitalarias atendidas por el Servicio de Rehabilitación entre enero de 2020 y agosto de 2021. Se incluyeron pacientes adultos con diagnóstico de lesión medular no traumática. Se recogieron variables sociodemográficas, etiología, clasificación ASIA, nivel funcional, complicaciones y destino al alta.Resultados: De 2.156 interconsultas hospitalarias, 34 pacientes (1,6%) presentaban lesión medular. La edad media fue de 57,8 ± 15,2 años y el 29,4% eran mujeres. La etiología fue oncológica en el 82,4% de los casos, principalmente secundaria a enfermedad metastásica vertebral. El 91,2% de las lesiones fueron incompletas y el nivel ASIA D fue el más frecuente (67,6%). En el 79,4% de los pacientes no constaba un diagnóstico explícito de lesión medular en el momento de la derivación. El índice de Barthel medio fue de 37,4 ± 32,8. Solo el 8,8% fueron derivados a centros especializados de rehabilitación.Conclusiones: La lesión medular no traumática, predominantemente de origen oncológico e incompleta, constituye una realidad clínica frecuente en el entorno hospitalario. Nuestros resultados sugieren oportunidades de mejora en su identificación precoz y en el acceso a recursos de rehabilitación especializada.
Introducción y objetivo La parálisis facial periférica es una afección neurológica periférica que provoca debilidad o parálisis de los músculos faciales. La recuperación funcional es variable y pueden intervenir múltiples factores. El objetivo fue determinar la asociación entre factores clínicos y neurofisiológicos y la recuperación funcional en pacientes con parálisis facial periférica que acuden a un centro militar de referencia. Material y métodos Se realizó un estudio transversal, descriptivo y analítico mediante la revisión de expedientes clínicos. Se extrajeron variables clínicas y demográficas, así como parámetros neurofisiológicos (electroneurografía y reflejo de parpadeo). Los pacientes se estratificaron en 2grupos según su estado funcional: recuperación favorable (House-Brackmann I-III) y recuperación desfavorable (House-Brackmann IV-VI). Se empleó una regresión logística binaria para identificar factores asociados al desenlace funcional. Se consideró significativa una p<0,05. Resultados Se incluyeron 31 pacientes. El análisis multivariado identificó que la ausencia de la respuesta R2 ipsilateral en el reflejo de parpadeo se asoció con una recuperación funcional desfavorable (B=2,24; p=0,03; OR 9,46; IC95%: 1,23-72,66). Conclusión La ausencia de la respuesta R2 ipsilateral se asoció con una recuperación funcional desfavorable, tras ajustar por el tiempo de evolución al momento del estudio. Este estudio exploratorio podría orientar la investigación sobre el papel pronóstico de la respuesta R2 ipsilateral en la recuperación funcional tardía de las personas con parálisis facial.
This series describes 3 cases of persistent chronic Achilles tendinopathy treated with an ultrasound-guided injection of autologous cytokine-rich serum obtained using Qrem Cytokine. The patients, who were unresponsive to conservative treatments such as eccentric exercise, physiotherapy, and shockwave therapy, were tracked using the VAS, VISA-A, Roles-Maudsley, and ultrasound up to 12 months. All patients showed clear clinical improvement: pain decreased significantly (2 cases achieving a VAS score of 0 one year after treatment), and the VISA-A score increased by more than 16 points in all cases, one case achieving a score of 97/100. Ultrasound imaging revealed a moderate reduction in tendon thickness, which was more pronounced in one patient. The final Roles-Maudsley score was good or excellent, and no significant adverse effects were recorded, only transient discomfort. These results show that autologous cytokine-rich serum is a safe and promising alternative, although controlled studies are required to confirm its efficacy.
OBJECTIVE:To analyze the measurement properties of the Brazilian version of the Pain Catastrophizing Scale (PCS) in patients with chronic cancer pain. METHODS:The study was conducted in two hospitals in northeastern Brazil. In addition to the PCS, the following instruments were used: Barthel Index, Hospital Anxiety and Depression Scale (HADS), and Edmonton Symptom Assessment System (ESAS). The measurement properties tested were reliability, internal consistency, and structural and construct validity. RESULTS:The sample consisted of 120 cancer patients. The majority of the sample was female (65.8%) and had a basic education (60%). Thirty-three different types of cancer were identified; the most prevalent were uterine cancer (22.5%) and leukemia (10%). We identified the presence of a domain in the PCS in the exploratory factor analysis according to the fit indices: Kaiser-Meyer-Olkin test=0.80 and p value <0.001 in Bartlett's sphericity test. Adequate test-retest reliability (intraclass correlation coefficient=0.80) and internal consistency (Cronbach's alpha=0.89) were observed. Correlations between the PCS and HADS subscales fell within the 0.30-0.50 range, as hypothesized. We identified no floor or ceiling effects (<15%). CONCLUSION:The PCS presented adequate measurement properties to assess catastrophizing in patients with chronic cancer pain, becoming a useful tool to evaluate these patients.
La radiofrecuencia (RF), en sus modalidades pulsada y térmica, es una técnica mínimamente invasiva para el manejo del dolor neuropático crónico refractario. Se presenta el caso de una mujer de 60años con dolor persistente en tobillo izquierdo tras necrosis avascular del astrágalo tratada mediante artroplastia total de tobillo. Intervención quirúrgica que puede conllevar complicaciones como el dolor neuropático postoperatorio, con una incidencia que puede variar entre el 10% y el 20%. Pese a fisioterapia y electroterapia, la paciente mantenía EVA de 8 y DN4 de 7. Un bloqueo diagnóstico de los nervios peroneo superficial y sural proporcionó alivio temporal, por lo que se realizó RF pulsada (65V, 4min) en el peroneo superficial y RF térmica (80°C, 90 s) en el sural, ambas bajo guía ecográfica. Posteriormente se infiltraron ambos nervios con 1cc de betametasona, 2cc de mepivacaína y 2cc de suero para evitar el dolor tras el procedimiento. A las dos semanas, la paciente presentaba un EVA en reposo de0, EVA con actividad de3 y DN4 de2, mejoría mantenida al mes y a los 6meses, con incremento de la funcionalidad. Este caso sugiere el valor de la RF como alternativa segura y eficaz en dolor neuropático posquirúrgico resistente a terapias convencionales. El objetivo es presentar un caso representativo del manejo intervencionista del dolor neuropático mediante radiofrecuencia, con énfasis en la selección de pacientes, técnica de realización, destacando consideraciones de seguridad y revisar la evidencia disponible.
Introducción Las áreas terapéuticas de los servicios de Medicina Física y Rehabilitación (MFyR) son espacios donde, por las características de los pacientes, existe un riesgo potencial de emergencias. La formación en primeros auxilios y reanimación cardiopulmonar (RCP) se considera esencial para una respuesta eficaz del personal. Este estudio evalúa el conocimiento y la percepción de preparación ante emergencias del equipo sanitario en estas áreas. Métodos Estudio transversal, mediante encuesta anónima dirigida a fisioterapeutas, terapeutas ocupacionales, logopedas y técnicos en cuidados auxiliares de enfermería de un hospital universitario. Resultados De los 86 profesionales contactados, 57 respondieron y, tras excluir dos cuestionarios incompletos, se incluyeron 55 respuestas válidas. El 87,2% (n=48) había realizado un curso de RCP y el 47,3% (n=26) uno de primeros auxilios. Solo el 14,5% (n=8) consideró suficiente su formación previa. La puntuación media fue superior en el grupo con formación combinada (7,05/10; p=0,03). No se observaron diferencias por años de experiencia. El 27,3% (n=15) se consideraba preparado para emergencias, observándose puntuaciones superiores en este grupo (p=0,011). El 100% (n=55) consideró necesaria la formación periódica en RCP y el 98,1% (n=54) en primeros auxilios, proponiendo actualización cada 2-3años. Conclusiones A pesar de la alta proporción de formación en RCP, la percepción de preparación es baja. La formación se asocia a un mayor rendimiento y una mayor percepción de preparación. Se requieren programas formativos estructurados, acreditados y específicos para el entorno rehabilitador.
Introducción La disnea u otros síntomas percibidos ante el ejercicio constituyen elementos fundamentales en la evaluación práctica clínica tanto para el proceso diagnóstico, estratificaciones de riesgos y gestión efectiva de la atención en enfermedades respiratorias. Objetivo Investigar la intensidad de disnea y molestias en las piernas ante el ejercicio físico y sus relaciones con variables funcionales multiorgánicas. Métodos Estudio multicéntrico de 948 pacientes adultos evaluados con prueba de ejercicio cardiopulmonar (PECP) integrada. Resultados La disnea en ejercicio pico mostró un valor medio de 6,1±3,1, y una mediana de 7 (Q1-Q3, 5). Las molestias en las piernas tuvieron un valor medio de 6,3±3,1 puntos, y mediana de 7 (Q1-Q3, 5). Los síntomas de disnea y molestias en las piernas fueron máximos (p. ej., 10 puntos) en 23% y 30% de los pacientes, respectivamente, mientras que los demás pacientes mostraron niveles submáximos de los síntomas. Se identificaron cuatro fenotipos ante el ejercicio pico: pacientes paucisintomáticos, síntomáticos periféricos, mixtos y disneicos. Estos fenotipos se asocian a deterioro progresivo secuencial de la carga (W) tolerada y consumo de O2, inicialmente y con tendencia bimodal en las molestias de piernas, y luego lineal e inverso con la disnea. Conclusiones Existen cuatro fenotipos basados por los síntomas predominantes ante el ejercicio: paucisintomático, síntomático periférico, mixto y disneico, que se asocian en su orden a grados más graves de deterioro funcional. Estos resultados justifican que estrategias como la rehabilitación se orienten hacia el sistema limitante y que justifica de forma predominante los síntomas con tal de ofrecer mayor valor al tratamiento.
Introducción La electroterapia se ha utilizado durante décadas en rehabilitación, pese a la limitada evidencia que respalda su eficacia en patologías musculoesqueléticas. El objetivo de este estudio fue analizar retrospectivamente las tendencias de prescripción de estas técnicas en un hospital terciario y describir la variabilidad entre profesionales. Métodos Estudio observacional retrospectivo basado en datos del sistema de información hospitalario. Se incluyeron todas las prescripciones de TENS, ultrasonidos, láser, microondas, diatermia por onda corta y magnetoterapia entre 2014 y 2024. Se empleó un modelo de regresión binomial negativa de efectos mixtos para evaluar tendencias temporales y variabilidad interprofesional. Resultados Se analizaron 17.361 prescripciones. El uso global de la electroterapia mostró un descenso progresivo, especialmente la terapia por microondas 0,847 (IC95%: 0,800-0,896; p<0,001), lo que corresponde a una reducción anual aproximada del 15,3%, y la diatermia por onda corta (IRR: 0,867; IC95%: 0,818-0,919; p<0,001), equivalente a una disminución anual del 13,3%. La variabilidad entre profesionales fue baja. El uso de TENS se mantuvo estable. Conclusiones El uso de la electroterapia ha disminuido de forma notable en la última década. Estos hallazgos sugieren una posible evolución en los patrones de uso, cuya interpretación requiere cautela dado el carácter descriptivo del estudio. Microondas y onda corta presentan los mayores descensos, mientras que TENS conserva niveles de prescripción constantes. Estos hallazgos subrayan la evolución del papel de la electroterapia en la rehabilitación actual y la necesidad de estudios multicéntricos que confirmen estas tendencias.
Introducción La debilidad de la musculatura respiratoria es frecuente tras la cirugía cardiaca y puede limitar la recuperación funcional. Aunque el entrenamiento de los músculos respiratorios ha demostrado beneficios, la evidencia en la fase II de la rehabilitación cardiaca es limitada, y muchos dispositivos disponibles son unidireccionales y de alto costo. TriBURTER® es un dispositivo que permite el entrenamiento bidireccional. Objetivo Evaluar la factibilidad, seguridad y explorar el posible efecto del dispositivo TriBURTER® en comparación con el incentivo respiratorio de flujo en pacientes sometidos a cirugía cardiaca en rehabilitación cardiaca fase II. Materiales y métodos Estudio piloto, aleatorizado, paralelo y abierto. Se incluyeron adultos sometidos a cirugía cardiaca por esternotomía. Los participantes fueron asignados a entrenamiento con TriBURTER® o incentivo respiratorio durante cuatro semanas. El desenlace primario fue la fuerza de los músculos respiratorios (presión inspiratoria máxima [PIM] y presión espiratoria máxima [PEM]). Como desenlaces secundarios se evaluaron la función pulmonar (volumen espiratorio forzado en el primer segundo [VEF1], capacidad vital forzada [CVF]), la capacidad funcional mediante la prueba de marcha de 6 minutos (PM6M) y la calidad de vida (SF-36). Resultados Se aleatorizaron 30 pacientes (61,7±9,4 años; 13,3% mujeres). En el análisis global no se observaron diferencias entre grupos en PIM ni PEM. En análisis exploratorios por subgrupos, los pacientes con debilidad de la musculatura respiratoria basal mostraron mayores incrementos en la PIM (-68 a -93cmH2O) y la PEM (93 a 116cmH2O) en el grupo TriBURTER®. En el análisis intragrupo, la distancia de la PM6M aumentó; sin embargo, no se observaron diferencias entre grupos tras el ajuste. No se reportaron eventos adversos. Conclusiones En este estudio piloto, el dispositivo TriBURTER® fue seguro y factible de implementar. Los hallazgos sugieren un posible efecto sobre la fuerza de la musculatura respiratoria en análisis exploratorios, particularmente en pacientes con debilidad basal, estos resultados deben confirmarse en estudios con mayor tamaño muestral.
INTRODUCTION:Sarcopenia represents a leading cause of functional decline in older adults. This randomized controlled trial examined whether the addition of ankle weights to a Nordic walking protocol yields superior outcomes compared with standard Nordic walking alone. METHODS:Thirty-six older adults were randomly allocated to either Nordic walking with ankle weights (n=18) or Nordic walking without additional loading (n=18), with twice-weekly sessions conducted over a 12-week period. The primary outcome was bilateral handgrip strength. Secondary outcomes comprised skeletal muscle mass percentage (%SMM), SARC-F score, the Chair Stand Test (CST), and gait speed. Between-group differences were assessed using analysis of covariance (ANCOVA), with adjustments for baseline values, age, and sex. RESULTS:The ankle-weight group demonstrated significantly greater improvements in right handgrip strength (β_adj=4.69kg; p=0.012) and left handgrip strength (β_adj=5.56kg; p=0.007), total body %SMM (β_adj=0.93%; p=0.017), lower-limb %SMM (β_adj=0.54%; p=0.011), and SARC-F score (β_adj=-1.17; p<0.001). No statistically significant between-group differences were identified for the CST (p=0.339) or gait speed (p=0.149), although changes over time were observed in both groups. CONCLUSIONS:The incorporation of ankle weights into a Nordic walking program improved handgrip strength, skeletal muscle mass percentage, and SARC-F scores in older adults, without conferring statistically significant additional benefits in functional physical performance outcomes.
INTRODUCTION:Calcaneal spurs are bony outgrowths typically originating from the medial calcaneal tuberosity and are commonly associated with chronic plantar heel pain. Radial pressure wave therapy (rPWT) is widely used when symptoms do not respond to conservative treatments; however, optimal treatment intervals and scheduling remain unclear. This study aimed to compare conventional and accelerated rPWT schedules to determine whether a shorter treatment duration could achieve similar clinical outcomes. MATERIALS AND METHODS:Sixty-eight participants with heel pain lasting at least six months and radiographically confirmed calcaneal spurs were randomly assigned to either a Conventional group (n=34), receiving three rPWT sessions at weekly intervals over 14 days, or an Accelerated group (n=34), receiving three sessions every other day over 5 days. Identical treatment parameters were applied in both groups (maximum tolerable pressure, 8Hz frequency, 2000 pulses per session). Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline, post-treatment, and 1-year follow-up. Functional outcomes (Foot Function Index [FFI], Roles-Maudsley [RM] score), calcaneal spur length, and plantar fascia thickness were evaluated at baseline and post-treatment. RESULTS:Both groups showed significant improvements in pain and functional outcomes, including VAS, RM, and FFI scores (p<0.001 for within-group comparisons). Calcaneal spur length decreased in both groups, while plantar fascia thickness did not demonstrate significant post-treatment changes. No statistically significant differences were observed between the Conventional and Accelerated groups for any clinical or structural outcome. At the 1-year follow-up, VAS scores remained comparable between groups, with no significant group×time interaction [F(2,36)=0.014, p=0.775]. CONCLUSION:Conventional and accelerated rPWT schedules resulted in similar short-term clinical improvements in patients with symptomatic calcaneal spurs. Under the conditions of this study, an accelerated protocol may allow completion of treatment within a shorter time frame without clear evidence of inferior clinical outcomes. These findings should be interpreted cautiously in light of methodological limitations, and further studies are needed to confirm long-term effects and optimal treatment scheduling.
Introduction: Telephone-based application of questionnaires may be valuable and cost-effective approaches for remote evaluation of patients. Objective: The aim of this study was to examine the concurrent validity of the telephone-based application of the Craig Hospital Inventory of Environmental Factors (CHIEF) in comparison with in-person application, and its measurement properties, in people with rheumatoid arthritis. Methods: A methodological study was conducted. Participants were requested to answer the questionnaire on four randomized occasions: three times by telephone, and once in-person. Concurrent validity, test-retest, and inter-rater reliability of the telephone-based application of the CHIEF were reported. Results: Sixty participants (52 women) chronically diagnosed with rheumatoid arthritis were included. There were no significant differences between the mean scores obtained by telephone-and in-person applications of the CHIEF (MD 3; 95% CI-4 to 9; p = 0.38). Overall, a high agreement was found (ICC = 0.83; 95% CI 0.72 to 0.90). A very high test-retest agreement (ICC = 0.99; 95% CI 0.98 to 0.99) and a high inter-rater agreement (ICC = 0.88; 95% CI 0.78 to 0.93) of the total scores obtained by telephone applications was found. Conclusion: In people with rheumatoid arthritis, the results suggested that there is no difference when the CHIEF is applied by telephone or during in-person interviews. This could help encourage new studies examining the influence of environmental factors on social participation in people with rheumatoid arthritis. In conclusion, the telephone-based application of the CHIEF showed to be a valid and reliable method for the assessment of barriers to participation in people with rheumatoid arthritis.
INTRODUCTION:Respiratory muscle weakness is common after cardiac surgery and may impair recovery. Although respiratory muscle training has demonstrated benefits, evidence during phase II cardiac rehabilitation remains limited, and many available devices are unidirectional and costly. TriBURTER® is a device that enables bidirectional respiratory muscle training. OBJECTIVE:To evaluate the feasibility, safety, and explore the potential effect of the TriBURTER® device compared with flow incentive spirometry in patients undergoing phase II cardiac rehabilitation after cardiac surgery. METHODS:This was a pilot, randomized, open-label, parallel study. Adults who had undergone cardiac surgery via sternotomy were included. Participants were assigned to training with TriBURTER® or flow incentive spirometry for 4 weeks. The primary outcome was respiratory muscle strength assessed by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Secondary outcomes included pulmonary function (FEV1, FVC), functional capacity assessed by the six-minute walk test (6MWT), and quality of life (SF-36). RESULTS:Thirty patients were randomized (mean age 61.7±9.4 years; 13.3% women). No between-group differences in MIP or MEP were observed in the overall analysis. In exploratory subgroup analyses, patients with baseline respiratory muscle weakness showed greater increases in MIP (-68 to -93cmH2O) and MEP (93 to 116cmH2O) in the TriBURTER® group. In intragroup analyses, 6MWT distance increased; however, no between-group differences were observed after adjustment. No adverse events were reported. CONCLUSIONS:In this pilot study, TriBURTER® was safe and feasible to implement. The findings suggest a potential effect on respiratory muscle strength in exploratory analyses, particularly in patients with baseline weakness; these results require confirmation in larger, adequately powered trials.
Stroke is a leading cause of long-term disability, significantly affecting physical, psychological and social well-being. Quality of life (QoL) and health-related quality of life (HRQoL) are essential outcomes reported by patients in stroke rehabilitation. This systematic review evaluated and compared psychometric properties of generic and stroke-specific instruments using the COSMIN guidelines. They were searched in PubMed, PEDro, and Cochrane Library (1992-December 2025). Eleven non-experimental studies were included. Stroke-specific tools such as SS-QOL-17 and HRQOLISP-40 demonstrated superior content validity, structural validity, and response compared to generic measures such as SF-36, WHOQOL-100, and EQ-5D. SS-QOL-17 showed excellent internal consistency, while HRQOLISP-40 demonstrated strong responsiveness to clinical change. Evidence of inter-test and replication reliability and cross-cultural validity remains limited across instruments. Stroke-specific measures appear to be more sensitive to multidimensional stroke outcomes. In addition to evaluating measurement characteristics, this review proposes a new model of psychometric maturity to classify instruments according to their degree of validation according to COSMIN standards. In addition, a screening algorithm is developed to help researchers and clinicians choose the right tools for quality of life based on study objectives, stroke stage, and domain priorities. More high-quality psychometric validation studies are needed to strengthen reliability and cultural applicability.
INTRODCTION:Dyspnea and other exertional symptoms are cornerstone elements in clinical practice, essential for diagnostic processes, risk stratification, and the effective management of respiratory diseases. OBJECTIVES:To investigate the intensity of dyspnea and leg discomfort during physical exercise and their relationships with multi-organ functional variables. METHODS:A multicenter study involving 948 adult patients evaluated via integrated cardiopulmonary exercise testing (CPET). RESULTS:Dyspnea at peak exercise showed a mean value of 6.1±3.1 and a median of 7 (IQR, 5). Leg discomfort presented a mean value of 6.3±3.1 and a median of 7 (IQR, 5). Symptoms of dyspnea and leg discomfort reached maximal intensity (i.e., 10 points) in 23% and 30% of patients, respectively, while the remaining participants exhibited submaximal symptom levels. Four phenotypes were identified at peak exercise: paucisymptomatic, peripheral, mixed, and dyspneic. These phenotypes were associated with a sequential and progressive impairment of peak work rate (Wpeak) and peak oxygen consumption (VO2peak), initially exhibiting a bimodal trend for leg discomfort and a subsequent linear inverse relationship with dyspnea. CONCLUSIONS:Four distinct phenotypes exist based on predominant exertional symptoms: paucisymptomatic, peripheral, mixed, and dyspneic. These are sequentially associated with increasingly severe grades of functional impairment. These findings warrant the orientation of rehabilitation strategies toward the specific limiting system predominantly responsible for the symptoms, thereby enhancing the therapeutic value of the intervention.
We evaluated whether lower-limb length discrepancy (LLLD) is a risk factor for curve progression in adolescent idiopathic scoliosis (AIS). A systematic review of observational studies was conducted. On April 18, 2025, two independent reviewers searched Medline (PubMed and Ovid), Embase, PsycINFO, BIREME, PEDro, and Google Scholar using a PECO framework: population (AIS), exposure (LLLD), comparator (AIS without LLLD), and outcome (Cobb angle progression). The search identified 730 records; after removing 75 duplicates, 655 titles and abstracts were screened. Of these, 644 were excluded, and 11 full-text articles were assessed for eligibility. Eight were excluded for not meeting inclusion criteria, leaving three studies that partially met eligibility requirements. Because of the small number of included studies and the absence of appropriate control groups, meta-analysis and formal assessment of publication bias were not feasible. Current evidence is insufficient to determine whether LLLD is a risk factor for curve progression in AIS.
