Risk of Scoliosis in Adolescent Female Rhythmic Gymnasts Compared with Healthy Peers: A Cross-Sectional Study Using the Scoliosis Tele-Screening Test.

BACKGROUND: Rhythmic gymnasts have a higher prevalence of scoliosis; however, the literature remains limited due to differences in methodologies, populations, and definitions. Considering the inadequacy and the inconsistency of screening methods and comparison groups in the literature, we aimed to screen rhythmic gymnasts for scoliosis risk, identify risk groups using the Scoliosis Tele-Screening Test (STS-Test), and compare them with healthy peers.

HYPOTHESIS: Rhythmic gymnasts will exhibit a different risk distribution pattern and a higher scoliosis risk score on the STS-Test compared with healthy controls.

METHODS: Adolescents (10-18 years old) who had practised rhythmic gymnastics at a competitive level for ≥5 years (Tier 3, Participant Classification Framework) were included. A total of 56 gymnasts and 302 age-matched healthy controls were enrolled. Sport-specific data, pubertal maturity, hypermobility, STS-Test for scoliosis risk, and angle of trunk rotation were assessed.

RESULTS: Rhythmic gymnasts have higher STS-Test scores than controls (P < 0.001). Fisher's exact test revealed a difference in the distribution of scoliosis risk between groups (P < 0.001). Post hoc analysis showed the difference was driven primarily by gymnasts having significantly more moderate-risk cases (adjusted residual [AR], 5.1; P < 0.001) and fewer low-risk cases (AR, -4.6; P < 0.001). The Healthy controls showed the opposite pattern, with significantly more low-risk cases (AR, 4.6; P < 0.001) and fewer moderate-risk cases (AR, -5.1; P < 0.001).

CONCLUSION: Rhythmic gymnasts exhibit a higher scoliosis risk score on the STS-Test compared with healthy controls. Gymnasts had more moderate-risk and fewer low-risk cases, whereas the healthy controls exhibited the opposite pattern. Considering generalized joint hypermobility, high training volume at an early age, and risk of scoliosis, it is essential to assess scoliosis risk and closely monitor rhythmic gymnasts during growth for early diagnosis, as scoliosis can impact sports careers significantly. Gymnasts can be screened periodically for scoliosis risk using the STS-Test.

CLINICAL RELEVANCE: It is crucial to assess rhythmic gymnasts throughout their growth to enable early diagnosis and management of scoliosis, thereby preventing career impact.

STUDY DESIGN: Cross-sectional study.

LEVEL OF EVIDENCE: Level 4.