Pediatric Outcomes Data Collection Instrument (PODCI) and Functional Assessment in Patients with Adolescent Idiopathic Scoliosis and Congenital Scoliosis or Kyphosis
E. Sullivan, PhD
R. J. Haynes, MD
Shriners Hospitals for Children, Houston, Texas, USA
PURPOSE: The PODCI questionnaire attempts to measure functional outcomes in pediatric orthopaedics. The questionnaire includes functional outcome measures of Upper extremity function, Transfers & basic mobility, Sports & physical function, Comfort/pain, and Happiness with physical condition. The questionnaire was used to assess overall function in patients with adolescent idiopathic scoliosis (AIS), congential scoliosis (CS), and congenital kyphosis (CK). The scores were compared with a previously reported group of "normal" control children.
METHODS: A cohort of 251 consecutive patients seen at the spinal disorders clinic at Shriners Hospital, Houston completed the PODCI questionnaire. Of these, 102 had AIS, 47 had CS, and 9 had CK, after exclusion of patients with neurologic findings. Responses to the questionnaire were compared with those from the previously reported "normal" control population of 84 children. Subgroup analyses were performed for patients treated operatively and non-operatively, and for those with AIS, by curve location and Cobb angle. A p value less than .05 was considered statistically significant.
RESULTS: Scores in Transfers, Sports, Comfort/Pain, and Happiness were significantly lower than normal in AIS. In CS, scores in all categories except Happiness were significantly lower than normal. All category scores were significantly lower than normal in CK. In AIS, age and curve location did not influence Comfort/Pain scores. Pain scores were significantly lower than normal for all curve locations and for all ranges of Cobb angle, including small curves. Happiness scores were significantly lower in AIS patients with Cobb angles ‹ 50° who had not received surgery compared with those who had received surgery, and significantly lower than in patients with Cobb angles ‹ 50°.
CONCLUSIONS: These findings provide some normative values for the PODCI questionnaire for three specific diagnoses. Patients with AIS and congenital scoliosis and kyphosis without neurologic findings gave responses significantly different from normal children, and should this instrument be used in outcome assessment, diagnosis specific responses need be considered. Pain appeared to be a common finding with these diagnoses judging from the responses to the questionnaire.