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Scoliosis and Spinal Disorders

Open Access

Body image in idiopathic scoliosis: a comparison study of psychometric properties between four patient-reported outcome instruments

  • Elisabetta DAgata1,
  • Antonia Matamalas2,
  • Joan Bago2 and
  • Ferran Pellise2
Scoliosis20149(Suppl 1):O74

Published: 4 December 2014


Body ImagePsychometric PropertyIdiopathic ScoliosisCobb AngleAssessment Instrument


Four patient-reported outcome (PRO) instruments are used to assess body image in idiopathic scoliosis (IS): Quality of Life Profile for Spinal Deformities (QLPSD), SRS-22 Self Image scale, Spinal Appearance Questionnaire (SAQ), and Trunk Appearance Perception Scale (TAPS).


To compare the psychometric properties of these four assessment instruments.

Design: This is a cross-sectional study. Inclusion criteria were patients with IS, 10 to 40 years old, Cobb angle ≥25°, without previous surgical treatment..


80 patients (mean age 20.3 years) were included. The four instruments in a Spanish version were administered. In addition, full-spine x-ray was obtained. Sample was stratified into two groups according to Cobb angle (less and more than 45º). Psychometric properties studied included internal consistency, convergent (correlation between self-image scales and Cobb angle) and divergent validity (correlations with Health Related Quality of Life domains: function, pain, mental health, measured through SRS-22).


All the PRO instruments presented high internal consistency (QLPSD Body Image, α=0.80; SRS-22 Image, α=0.78; SAQ, α=0.89; TAPS, α=0.87).Pictorial scales showed higher correlations with Cobb angle (SAQ Appearance r=0.61 and TAPS r=-0.62) than textual scales (QLPSD-bi (r=0.36; SRS-22 Self-Image r=-0.41).The four image scales showed significant correlations with other HRQL SRS22 dimensions (from r=-.2 to 0.7).


All four instruments have good psychometric properties. To evaluate patients with IS is advisable to add pictorial image perception scales to HRQL assessment instruments.

Authors’ Affiliations

Fundacion Hospital Vall Hebron, Barcelona, Spain
Hospital Vall Hebron, Barcelona, Spain


© DAgata et al; licensee BioMed Central Ltd. 2014

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. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.