Reliability of the original Lehnert-Schroth (LS) scoliosis classification in physiotherapy practice.
Maksym Borysov, Xiaofeng Nan, Hans-Rudolf Weiss and 2 others
PMID 33132524WHAT IT FOUND
Specialist clinicians classified adolescent idiopathic scoliosis into Schroth 3-curve or 4-curve patterns with fair to good agreement, especially from X-rays.
Clinical photos were less consistent, so confirm uncertain patterns with imaging.
Key findings
01The same specialist rated the images twice and reached Kappa agreement of 0.90 for clinical pictures and 1.00 for X-rays, with 0.60 treated as acceptable.
02Between clinicians, Kappa values ranged from 0.58 to 0.80 for clinical pictures, averaging 0.65, and from 0.58 to 0.80 for X-rays, averaging 0.71.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 40 adolescents were included, so the agreement estimates are based on a small sample. Fifteen patients were already wearing a brace, which may have changed trunk shape and made clinical classification less reliable. The study did not directly compare clinical versus radiological classification reliability. The raters were specialised physiotherapists or orthotists, so results may not apply to clinicians without this training. The authors say posterior trunk views alone were used and forward bending information might improve reliability.
Declared interests
One author, HRW, reported financial support for attending symposia and royalties from Koob GmbH & Co KG.
The easy way to misread this
Do not read this as proof that Schroth exercises improve scoliosis. It tested how consistently clinicians classify curve patterns, not whether treatment works. The paper reported fair reliability for clinical photos and sufficient reliability for X-rays, so classification from photos alone may be uncertain.