International Consensus on Sports, Exercise, and Physical Activity participation during post-operative interventions for Adolescent Idiopathic Scoliosis: an e-Delphi study
Bibliographic record
Abstract
Introduction: Physiotherapists and surgeons have a significant role in promoting participation and offering a graded return to sports, exercise, and physical activity following spinal fusion in adolescent idiopathic scoliosis (AIS). However, there is a lack of evidence to guide post-operative rehabilitation and variability worldwide. This study aims to obtain consensus on 1) when it is safe and 2) how an individual with AIS might return to sports, exercise, and physical activity. Methods and analysis: An international electronic 3 round Delphi study was conducted and reported. Eligible expert surgeons or physiotherapists had either specific clinical or research experience in AIS. Round 1 included a series of open-ended questions. Round 2 provided a summary of the existing literature for participants to review and rate items. Round 3 participants were asked to re-rate responses. Consensus was determined through content analysis of open statements >1 participant, round 2 statements achieving >75% on a 5-point Likert scale, and round 3 Kendall’s coefficient of concordance. Results: From 53 recruited participants (18 countries, 1 unknown), 41 responded to round 1, 32 to round 2, and 29 to Round 3 (14 surgeons, 15 physiotherapists). Round 1 generated 85 statements under 19 themes surrounding graded return to sports, rehabilitation milestones, philosophical approaches, and treatment modalities. Round 2 generated 63 statements with >75% agreement. Round 2 open comments generated 22 statements. The 66 statements agreed in round 3 generated 9 themes with corresponding statements regarding different phases of care. All round 3 statements demonstrated significant (p<0.001) moderate agreement (W=0.5). A Wilcoxon Sum-rank result (p<0.05) showed stability between rounds 2 and 3. An additional 5 statements (total 71 statements) were generated from round 3 open comments. Conclusion: This Delphi study provides the first international consensus of 71 statements on return to sports, exercise, and physical activity following spinal fusion in AIS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.092 | 0.091 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".