文献类型：期刊文献

英文题名：Comment on "Responsiveness and minimal clinically important changes of surface topography parameters in adolescents with idiopathic scoliosis: results from the schroth exercise trial"

作者：Zhu, Hai[1];Wang, Zhengping[1];Feng, Yiwen[1];Liu, Yongming[2]

第一作者：Zhu, Hai

通信作者：Liu, YM[1]

机构：[1]Gansu Univ Tradit Chinese Med, Grad Sch, Lanzhou, Gansu, Peoples R China;[2]Gansu Prov Hosp Tradit Chinese Med, Dept Spinal & Orthoped Surg 4, Lanzhou, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Hosp Tradit Chinese Med, Dept Spinal & Orthoped Surg 4, Lanzhou, Peoples R China.

年份：2026

外文期刊名：EUROPEAN SPINE JOURNAL

收录：;WOS:【SCI-EXPANDED(收录号:WOS:001804841900001)】；

语种：英文

外文关键词：Adolescent idiopathic scoliosis; Surface topography; Minimal clinically important change; Minimal detectable change; Schroth exercises; Clinical outcome assessment

摘要：ObjectiveTo offer constructive comments on the recent study by Mohamed et al. published in European Spine Journal, with a focus on the clinical detectability of the proposed minimal clinically important changes (MCICs) for surface topography (ST) parameters, the robustness of the anchoring method, and the differential responsiveness between thoracic and lumbar curve subgroups, aiming to provide reference for future research on ST application in conservative management of adolescent idiopathic scoliosis (AIS).MethodsThis commentary was developed through logical analysis of the original study data and cross-referencing with existing literature, addressing three key aspects: (1) a theoretical comparison between the reported MCIC values and the inherent measurement error (minimal detectable change, MDC) of ST systems to evaluate their clinical discriminability; (2) an examination of the limitations of using the Global Rating of Change (GRC) scale as a single anchoring tool, with suggestions for incorporating the SRS-22 self-image domain and region-specific parameters as complementary measures; and (3) an interpretation of the discordance between ST parameter changes and patient perception in the thoracic subgroup, supported by independent evidence from postoperative AIS studies on the correlation between radiographic parameters and self-imageResultsThe MCIC values proposed in the original study-0.27 mm for RMS and 0.49 mm for MaxDev-are substantially smaller than the known measurement errors of most ST systems. Without reporting the MDC, such "clinically important" changes may be indistinguishable from random noise. The correlation between GRC scores and ST parameter changes was only moderate (r approximate to -0.5), and the use of a single global parameter failed to capture shoulder and waist asymmetries, limiting its ability to reflect clinically meaningful improvement in thoracic curves. Independent postoperative evidence supports the authors' hypothesis that lumbar curve changes are more readily perceived by patients, as residual thoracolumbar/lumbar curve magnitude, but not the main thoracic curve, correlates with SRS-22 self-image scores.ConclusionThe original study provides pioneering data on ST parameters in AIS; however, the clinical application of its MCIC values warrants cautious interpretation. Future studies should systematically report MDC to establish measurement reliability, employ multi-dimensional anchoring tools (e.g., SRS-22), and develop region-specific or composite ST parameters, particularly optimized for patients with thoracic curves, to more accurately capture patient-perceived clinical improvement.