Factors influencing participation in sports, exercise, and physical activity in adolescents with idiopathic scoliosis: a protocol for a qualitative secondary data analysis
Authors: Tucker S. , Soundy A. , Alamrani S. , Gardner A. , Rushton A. , Falla D. , Heneghan N.R. 
Published: July 2023

AbstractIntroductionAdolescent idiopathic scoliosis (AIS) is one of the most common paediatric spinal complaints (2-3% of children < 16 years). Regular physical activity is recommended and has been associated with significant improvements in quality of life, reduced pain, and improved function in AIS. However, participation rates remain low amongst individuals with AIS with limited research examining why. This qualitative study aims to identify factors influencing participation in sports, exercise, and physical activities in AIS.Methods and analysisA qualitative interpretive hermeneutic phenomenology study will be conducted. This study will use a subtle-realist view to enable a focus on the most common experiences of individuals with AIS considering factors influencing participation in exercise, sports, and physical activity. This will be a secondary data analysis (SDA) of a single centre qualitative study completed at a tertiary scoliosis centre during 2022. Participant data drawn from semi structured interviews of individuals <18 years old with a diagnosis of AIS will be included in a six-phase thematic analysis. Rigor will be enhanced through a qualitative checklist, reflexivity, researchers with expertise in the phenomena of interest, and additional researchers from the parent study to critique. Patient and public involvement has been utilised since conceptualisation to improve transparency of reporting.Ethics and disseminationFull ethical approval was given for this SDA and the parent study by the Health Research Authority (IRAS 289888) and Health and Care Research Wales approval (REC reference: 21/WM/0076). Dissemination will be via peer reviewed publication and conference presentation with results being used to inform future research projects.Registration detailsNo prior registration has been used for this protocol due to the empirical nature of this secondary data analysis.Strengths and LimitationsThis project will be conducted with a multidisciplinary research team with expertise in qualitative research, spinal conditions and AIS, and patient and public involvement.This study has ethical strengths in its efficiency of data capture from a single parent study. This is significantly cheaper with standardised procedures, less requirement on children suffering from AIS, and relieves the burden of further participant recruitment.The nature of SDA requires researcher reflexivity and involvement of the primary researcher from parent study to ensure that there is no loss of contextual information or a lack of immersion in the data.The sample will be limited to a single centre study with sampling limited to specialist scoliosis clinics giving opportunity for inferential generaslisation, but lacking opportunity for broad basis generalisations or subgroup analysis.The primary aim of parent study was to assess the content validity of the SRS-22r rather than assessment of factors influencing exercise. However, the interview topic guide was reviewed by the secondary data analyst as well as the wider research team to ensure the capture of appropriate and relevant data for this study.