Evaluation of Methodological Quality in Chiropractic Guidelines for Adolescent Idiopathic Scoliosis

Adolescent Idiopathic Scoliosis (AIS) is a common spinal deformity that affects individuals between the ages of 10 and 16. It is characterised by an abnormal lateral curvature of the spine with no known cause, affecting approximately 5% of adolescents (Pagé et al., 2024).

The impact of AIS on a patient’s daily life can be significant, making appropriate management crucial.

This article evaluates the methodological quality of clinical guidelines related to AIS from a chiropractic standpoint, shedding light on how these guidelines can be effectively adapted for chiropractic practice to enhance patient care.

Chiropractic and AIS Management

Chiropractors are frequently consulted for the management of musculoskeletal conditions (Hestbaek & Stochkendahl, 2010), including scoliosis, making conservative treatment a widely preferred method for AIS management.

The goals of conservative treatment include halting curve progression, addressing respiratory issues, alleviating spinal pain, and improving aesthetic appearance and self-esteem (Pagé et al., 2024).

Techniques employed by chiropractors may encompass postural exercises, physical therapy, manual or soft tissue therapy, and the use of braces.

Methodological Evaluation of Clinical Guidelines

Clinical practice guidelines are pivotal for healthcare providers, offering a framework for informed decision-making in specific clinical scenarios. The 2016 SOSORT (Society on Scoliosis Orthopaedic and Rehabilitation Treatment) guidelines for AIS management were developed with contributions from various healthcare professionals, including chiropractors (Pagé et al., 2024). It is essential to assess the methodological quality and applicability of these guidelines to chiropractic practice.

According to Pagé et al. (2024), an international panel of experts, including 19 chiropractors from diverse backgrounds, evaluated the SOSORT guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. This tool assesses guidelines based on six domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence.

So, by involving a broader range of healthcare professionals in future guideline development, the recommendations can be better tailored to meet the specific needs of chiropractors and enhance patient care for those with Adolescent Idiopathic Scoliosis.

Conclusion

This evaluation underscores the importance of methodological quality in clinical practice guidelines and the need for ongoing refinement to ensure their applicability across diverse healthcare settings.

For chiropractors, high-quality, tailored guidelines are essential to providing optimal care for patients with AIS.

Future efforts should focus on increasing the involvement of various healthcare professionals in guideline development, ensuring that recommendations are both evidence-based and practicable for chiropractic practice.

References

1. Hestbaek, L., & Stochkendahl, M. J. (2010). The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor’s new suit? Chiropractic & Osteopathy, 18(1). https://doi.org/10.1186/1746-1340-18-15

2. Pagé, I., Doré, M., & Doucet, C. (2024). Critical Evaluation of the 2016 SOSORT Clinical Guidelines on the Detection and Clinical Management of Adolescent Idiopathic Scoliosis using the AGREE II Tool: A Chiropractic Perspective. Journal of Chiropractic Medicine, 23(4), 162–170. https://doi.org/10.1016/j.jcm.2024.08.001

3. https://scoliosisjournal.biomedcentral.com/articles/10.1186/s13013-017-0145-8