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Does a four-week intensive scoliosis-specific exercises programme improve body-image in subjects with idiopathic scoliosis and is the effect rated equally by patients, physiotherapists and an external rater with scoliosis?

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Improving trunk appearance is important for scoliotic patients. Selecting an appropriate rater is vital for effectively measuring this outcome. This study investigates whether a four-week intensive scoliosis-specific exercise programme results in improved patient body image and how this varies between patients, physiotherapists and an external scoliotic rater.

Materials and methods

82 patients (70 females 12 males) with IS and mean age 30.79 years (Range 10-81) were treated with a four-week intensive scoliosis-specific physiotherapy course (ScolioGold). Patients, 2 blinded physiotherapists and a blinded scoliotic rater rated patients’ body-image before and after treatment. Body-image was assessed using a 0-10 scale, for 5 elements (Head, Shoulders, Ribs, Waist and Hips).


Mean total scores before treatment were; patients 28.51 (SD8.76), physiotherapists 22.94 (SD6.01) and external rater 20.55 (SD7.27) and after treatment were; patients 15.46 (SD7.40), physiotherapists 13.73 (SD5.88) and external rater 6.61 (SD4.10). Differences in patients (P), physiotherapists (T) and external rater(E) body-image scores were found to have statistically significantly improved after treatment using Wilcoxon-signed rank (p =<0.001, p=<0.001, p=<0.001). ICC scores between P&T, P&E and T&E were; fair (0.28), slight (0.19) and moderate (0.58) before treatment and fair (0.34), fair (0.28), moderate (0.59) after treatment.


Statistically significant improvements between pre-post treatment scores substantiate intensive exercise methods (ScolioGold), in the treatment of IS-related negative body image. Significant variation between patients’, physiotherapists’ and external rater’s scoring highlight the need for patients to rate body-image due to the subjectivity of this outcome measure, to ensure we adopt a client-centred care approach in our treatment goals to improve patient body-image.

Author information

Correspondence to J Head.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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About this article


  • Public Health
  • Significant Variation
  • Body Image
  • Idiopathic Scoliosis
  • Treatment Goal