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Protocol - Scoliosis - Quality of Life

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Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Description:

The Pediatric Outcomes Data Collection Instrument (PODCI) was developed by the American Academy of Orthopaedic Surgeons®, Pediatric Orthopaedic Society of North America, American Academy of Pediatrics, and Shriners Hospitals. The protocol here is based on Version 2.0 of the PODCI which was revised, renumbered, and reformatted in August 2005.

The PODCI consists of 86 items and is designed to collect data regarding an individual’s general health and problems related to bone and muscle conditions. This instrument is completed by parents (or caregivers) of children aged 2-10 years old.

Note: this protocol applies to the three major types of scoliosis; however, only congenital and syndromic scoliosis apply to rare genetic conditions.

Protocol:

Some kind of problems can make it hard to do many activities, such as eating, bathing, school work, and playing with friends. We would like to find out how your child is doing. (Circle one response on each line.)

During the last week was it easy or hard for your child to:

1.

Lift heavy books?

Easy

1

A little hard

2

Very hard

3

Can’t do at all

4

Too young for this activity

5

2.

Pour a half gallon of milk?

1

2

3

4

5

3.

Open a jar that has been opened before?

1

2

3

4

5

4.

Use a fork and spoon?

1

2

3

4

5

5.

Comb his/her hair?

1

2

3

4

5

6.

Button buttons?

1

2

3

4

5

7.

Put on his/her coat?

1

2

3

4

5

8.

Write with a pencil?

1

2

3

4

5

9. On average, over the last 12 months, how often did your child miss school (preschool, day care, camp, etc.) because of his/her health?

[ ] 1. Rarely

[ ] 2. Once a month

[ ] 3. Two or three times a month

[ ] 4. Once a week

[ ] 5. More than once a week

[ ] 6. Does not attend school, etc.

During the last week how happy has your child been with: (Circle one response on each line.)

Very happy

Somewhat happy

Not sure

Somewhat unhappy

Very unhappy

Child is too young

10.

How he/she looks?

1

2

3

4

5

6

11.

His/her body?

1

2

3

4

5

6

12.

What clothes or shoes he/she can wear?

1

2

3

4

5

6

13.

His/her ability to do the same things his/her friends do?

1

2

3

4

5

6

14.

His/her health in general?

1

2

3

4

5

6

During the last week, how much of the time:

(Circle one response on each line.)

Most of the time

Some of the time

A little of the time

None of the time

15.

Did your child feel sick and tired?

1

2

3

4

16.

Were your child full of pep and energy?

1

2

3

4

17.

Did pain or discomfort interfere with your child’s activities?

1

2

3

4

During the last week, has it been easy or hard for your child to:

(Circle one response on each line.)

Easy

A little hard

Very hard

Can’t do at all

Too young for this activity

18.

Run short distances?

1

2

3

4

5

19.

Bicycle or tricycle?

1

2

3

4

5

20.

Climb three flights of stairs?

1

2

3

4

5

21.

Climb one flight of stairs?

1

2

3

4

5

22.

Walk more than a mile?

1

2

3

4

5

23.

Walk three blocks?

1

2

3

4

5

24.

Walk one block?

1

2

3

4

5

25.

Get on and off a bus?

1

2

3

4

5

26. How often does your child need help from another person for walking and climbing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

27. How often does your child use assistive devices (such as braces, crutches, or wheelchair) for walking and climbing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

During the last week, has it been easy or hard for your child to:

(Circle one response on each line.)

Easy

A little hard

Very hard

Can’t do at all

Too young for this activity

28.

Stand while washing his/her hands and face at a sink?

1

2

3

4

5

29.

Sit in a regular chair without holding on?

1

2

3

4

5

30.

Get on and off a toilet or chair?

1

2

3

4

5

31.

Get in and out of bed?

1

2

3

4

5

32.

Turn door knobs?

1

2

3

4

5

33.

Bend over from a standing position and pick up something off the floor?

1

2

3

4

5

34. How often does your child need help from another person for sitting and standing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

35. How often does your child use assistive devices (such as braces, crutches, or wheelchair) for sitting and standing? (Circle one response.)

[ ] 1 Never

[ ] 2 Sometimes

[ ] 3 About half the time

[ ] 4 Often

[ ] 5 All the time

36. Can your child participate in recreational outdoor activities with other children the same age? (For example: bicycling, tricycling, skating, hiking, jogging) (Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 36 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

37.

Pain?

1

38.

General Health?

1

39.

Doctor or parent instructions?

1

40.

Fear the other kids won’t like him/her?

1

41.

Dislike of recreational outdoor activities?

1

42.

Too young?

1

43.

Activity not in season?

1

44. Can your child participate in pickup games or sports with other children the same age? (For example: tag, dodge ball, basketball, soccer, catch, jump rope, touch football, hop scotch)

(Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 44 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

45.

Pain?

1

46.

General Health?

1

47.

Doctor or parent instructions?

1

48.

Fear the other kids won’t like him/her?

1

49.

Dislike of pickup games or sports?

1

50.

Too young?

1

51.

Activity not in season?

1

52. Can your child participate in competitive level sports with other children the same age? (For example: hockey, basketball, soccer, football, baseball, swimming, running [track or cross country], gymnastics, or dance) (Circle one response.)

[ ] 1 Yes, easily

[ ] 2 Yes, but a little hard

[ ] 3 Yes, but very hard

[ ] 4 No

If you answered "no" to Question 52 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

53.

Pain?

1

54.

General Health?

1

55.

Doctor or parent instructions?

1

56.

Fear the other kids won’t like him/her?

1

57.

Dislike of pickup games or sports?

1

58.

Too young?

1

59.

Activity not in season?

1

60. How often in the last week did your child get together and do things with friends? (Circle one response.)

[ ] 1 Often

[ ] 2 Sometimes

[ ] 3 Never or rarely

If you answered "sometimes" or "never or rarely" to Question 60 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

61.

Pain?

1

62.

General Health?

1

63.

Doctor or parent instructions?

1

64.

Fear the other kids won’t like him/her?

1

65.

Friends not around?

1

66. How often in the last week did your child participate in gym/recess? (Circle one response.)

[ ] 1 Often

[ ] 2 Sometimes

[ ] 3 Never or rarely

[ ] 4 No gym or recess

If you answered "sometimes" or "never or rarely" to Question 63 above, was your child’s activity limited by: (Circle yes to all that apply)

Yes

67.

Pain?

1

68.

General Health?

1

69.

Doctor or parent instructions?

1

70.

Fear the other kids won’t like him/her?

1

71.

Dislike of gym/recess?

1

72.

School not in session?

1

73.

Does not attend school?

1

74. Is it easy or hard for your child to make friends with children his/her own age? (Circle one response.)

[ ] 1 Usually easy

[ ] 2 Sometimes easy

[ ] 3 Sometimes hard

[ ] 4 Usually hard

75. How much pain has your child had during the last week? (Circle one response.)

[ ] 1 None

[ ] 2 Very mild

[ ] 3 Mild

[ ] 4 Moderate

[ ] 5 Severe

[ ] 6 Very severe

76. During the last week, how much did pain interfere with your child’s normal activities (including at home, outside of the home, and at school)? (Circle one response.)

[ ] 1 Not at all

[ ] 2 A little bit

[ ] 3 Moderately

[ ] 4 Quite a bit

[ ] 5 Extremely

What expectations do you have for your child’s treatment?
As a result of my child’s treatment, I expect my child:

(Circle one response on each line.)

Definitely yes

Probably yes

Not sure

Probably not

Definitely not

77.

To have pain relief.

1

2

3

4

5

78.

To look better.

1

2

3

4

5

79.

To feel better about himself/herself.

1

2

3

4

5

80.

To sleep more comfortably.

1

2

3

4

5

81.

To be able to do activities at home.

1

2

3

4

5

82.

To be able to do more at school.

1

2

3

4

5

83.

To be able to do more play or recreational activities (biking, walking, doing things with friends).

1

2

3

4

5

84.

To be able to do more sports.

1

2

3

4

5

85.

To be free from pain or disability as an adult.

1

2

3

4

5

86. If your child had to spend the rest of his/her life with his/her bone and muscle condition as it is right now, how would you feel about it? (Circle one response.)

[ ] 1 Very satisfied

[ ] 2 Somewhat satisfied

[ ] 3 Neutral

[ ] 4 Somewhat dissatisfied

[ ] 5 Very dissatisfied

Personnel and Training Required

None

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualYes
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Toddler, Child

Specific Instructions:

The physician should complete this form with diagnoses and procedures prior to administering the quality-of-life (QOL) questionnaire.

FOR OFFICE USE ONLY

Clinic ID ___________________ First six letter of patient’s last name _____________

Physician ID ________________ Office Chart # ______________________________

Diagnosis & ICD-9 Code*

Procedure & CPT Code

CPT Date

Side of body procedure was performed on:

Primary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

Secondary DX

DX

Tx

□ Right

□ Left

ICD-9

ICD-9

□ Both

□ N/A

The following instructions appear at the beginning of the questionnaire.

Today’s Date / /

Thank you for completing this questionnaire!

This questionnaire will help us to better understand your general health and any problems related to bone and muscle conditions.

Your completion of this questionnaire is completely voluntary and your responses will be held in the strictest confidence.

Please answer every question. Some questions may look like others, but each one is different.

There are no right or wrong answers. If you are not sure how to answer a question, just give the best answer you can. You can make comments in the margin. We do read all your comments, so feel free to make as many as you wish.

Your Child’s Birth Date / /

Your Child’s Social Security Number* ___________________

Your Social Security Number* ______________________

*Personal identifying information that may not need to be collected.

Research Domain Information

Release Date:

April 30, 2015

Definition

Scoliosis is a spine deformity that can be categorized into three major types: congenital, syndromic, and idiopathic. Individuals can have various medical and/or quality-of-life (QoL) implications, depending on the type and severity of their scoliosis.

Purpose

This measure can be used to evaluate the impact of scoliosis on an individual’s quality of life (QOL). This self-reported information is beneficial to evaluate the severity of scoliosis and how it influences a person’s QOL over time.

Selection Rationale

The Rare Genetic Conditions Working Group selected the Pediatric Outcomes Data Collection Instrument (PODCI) because of its relevance to scoliosis and validity for many orthopaedic conditions.

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Scoliosis Quality of Life Questionnaire Assessment Text4798281CDE Browser

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

American Academy of Orthopaedic Surgeons®, Pediatric Orthopaedic Society of North America, American Academy of Pediatrics, Shriners Hospitals. (2005). Version 2.0 Pediatrics-Parent/Child Outcomes Instrument. American Academy of Orthopaedic Surgeons (AAOS) website: http://www.aaos.org/research/outcomes/outcomes_peds.asp

General References

Allen, D. D., Gorton, G. E., Oeffinger, D. J., Tylkowski, C., Tucker, C. A., & Haley, S. M. (2008). Analysis of the Pediatric Outcomes Data Collection Instrument (PODCI) in ambulatory children with cerebral palsy using confirmatory factor analysis and item response theory methods. Journal of Pediatric Orthopedics, 28(2), 192-198.

Kunkel, S., Eismann, E., & Cornwall, R. (2011). Utility of the pediatric outcomes data collection instrument for assessing acute hand and wrist injuries in children. Journal of Pediatric Orthopaedics, 31(7), 767-772.

Protocol ID:

221501

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX221501_Scoliosis_QOL_Clinic_IDPX221501020000Clinic ID of Patient4N/A
PX221501_Scoliosis_QOL_Physician_IDPX221501030000Physician ID4N/A
PX221501_Scoliosis_QOL_FirstSix_Last_NamePX221501040000First sitx letters of patient's last name4N/A
PX221501_Scoliosis_QOL_Office_Chart#PX221501050000Office Chart #4N/A
PX221501_Scoliosis_QOL_PrimaryDX_DXCodePX221501060000Primary DX - DX Code4N/A
PX221501_Scoliosis_QOL_PrimaryDX_ICD9PX221501070000Primary DX - ICD-9 Code4N/A
PX221501_Scoliosis_QOL_PrimaryDX_TXProcedureCPT_CodePX221501080000Primary DX - TX Procedure Code4N/A
PX221501_Scoliosis_QOL_PrimaryDX_TXProcedureICD9_CodePX221501090000Primary DX - CPT Code4N/A
PX221501_Scoliosis_QOL_PrimaryDX_CPT_DatePX221501100000Primary DX - CPT Date4N/A
PX221501_Scoliosis_QOL_PrimaryDX_Procedure_BodySitePX221501110000Primary DX - Side of body procedure was performed on: Right, Left, Both, N/A4N/A
PX221501_Scoliosis_QOL_SecondarDX1_DXCodePX221501120000Secondary DX 1 - DX Code4N/A
PX221501_Scoliosis_QOL_SecondarDX1_ICD9PX221501130000Secondary DX 1- ICD-9 Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX1_TXProcedureCPT_CodePX221501140000Secondary DX 1- TX Procedure Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX1_TXProcedureICD9_CodePX221501150000Secondary DX 1 - CPT Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX1_CPT_DatePX221501160000Secondary DX 1 - CPT Date4N/A
PX221501_Scoliosis_QOL_SecondarDX1_Procedure_BodySitePX221501170000Secondary DX1 - Side of body procedure was performed on: Right, Left, Both, N/A4N/A
PX221501_Scoliosis_QOL_SecondarDX2_DXCodePX221501180000Secondary DX 2 - DX Code4N/A
PX221501_Scoliosis_QOL_SecondarDX2_ICD9PX221501190000Secondary DX 2- ICD-9 Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX2_TXProcedureCPT_CodePX221501200000Secondary DX 2- TX Procedure Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX2_TXProcedureICD9_CodePX221501210000Secondary DX 2 - CPT Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX2_CPT_DatePX221501220000Secondary DX 2- CPT Date4N/A
PX221501_Scoliosis_QOL_SecondarDX2_Procedure_BodySitePX221501230000Secondary DX2 - Side of body procedure was performed on: Right, Left, Both, N/A4N/A
PX221501_Scoliosis_QOL_SecondarDX3_DXCodePX221501240000Secondary DX 3 - DX Code4N/A
PX221501_Scoliosis_QOL_SecondarDX3_ICD9PX221501250000Secondary DX 3- ICD-9 Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX3_TXProcedureCPT_CodePX221501260000Secondary DX 3- TX Procedure Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX3_TXProcedureICD9_CodePX221501270000Secondary DX 3 - CPT Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX3_CPT_DatePX221501280000Secondary DX 3 - CPT Date4N/A
PX221501_Scoliosis_QOL_SecondarDX3_Procedure_BodySitePX221501290000Secondary DX 3 - Side of body procedure was performed on: Right, Left, Both, N/A4N/A
PX221501_Scoliosis_QOL_SecondarDX4_DXCodePX221501300000Secondary DX 4- DX Code4N/A
PX221501_Scoliosis_QOL_SecondarDX4_ICD9PX221501310000Secondary DX 4- ICD-9 Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX4_TXProcedureCPT_CodePX221501320000Secondary DX 4- TX Procedure Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX4_TXProcedureICD9_CodePX221501330000Secondary DX 4- CPT Code4N/A
PX221501_Scoliosis_QOL_SecondaryDX4_CPT_DatePX221501340000Secondary DX 4 - CPT Date4N/A
PX221501_Scoliosis_QOL_SecondarDX4_Procedure_BodySitePX221501350000Secondary DX 4 - Side of body procedure was performed on: Right, Left, Both, N/A4N/A
PX221501_Scoliosis_QOL_Today's_DatePX221501360000Today's Date4N/A
PX221501_Scoliosis_QOL_Child's_DOBPX221501370000Your Child¿¿¿s Birth Date4Variable Mapping
PX221501_Scoliosis_QOL_Last_Week_LiftBooksPX221501400000During the last week was it easy or hard for your child to lift heavy books?4N/A
PX221501_Scoliosis_QOL_Last_Week_PourMilkPX221501410000During the last week was it easy or hard for your child to Pour a half gallon of milk?4N/A
PX221501_Scoliosis_QOL_Last_Week_OpenJarPX221501420000During the last week was it easy or hard for your child to Open a jar that has been opened before?4N/A
PX221501_Scoliosis_QOL_Last_Week_ForkSpoonPX221501430000During the last week was it easy or hard for your child to use a fork and spoon?4N/A
PX221501_Scoliosis_QOL_Last_Week_CombHairPX221501440000During the last week was it easy or hard for your child to comb his/her hair?4N/A
PX221501_Scoliosis_QOL_Last_Week_ButtonsPX221501450000During the last week was it easy or hard for your child to button buttons?4N/A
PX221501_Scoliosis_QOL_Last_Week_PutOn_CoatPX221501460000During the last week was it easy or hard for your child to put on his/her coat?4N/A
PX221501_Scoliosis_QOL_Last_Week_WritePencilPX221501470000During the last week was it easy or hard for your child to write with a pencil?4N/A
PX221501_Scoliosis_QOL_Last12Mo_MissSchoolPX221501480000On average, over the last 12 months, how often did your child miss school (preschool, day care, camp, etc.) because of his/her health?4N/A
PX221501_Scoliosis_QOL_Last_Week_HappYLooksPX221501490000During the last week how happy has your child been with how he/she looks?4N/A
PX221501_Scoliosis_QOL_Last_Week_HappyBodyPX221501500000During the last week how happy has your child been with his/her body?4N/A
PX221501_Scoliosis_QOL_Last_Week_HappyClothesPX221501510000During the last week how happy has your child been with what clothes or shoes he/she can wear?4N/A
PX221501_Scoliosis_QOL_Last_Week_HappyAbilityPX221501520000During the last week how happy has your child been with his/her ability to do the same things his/her friends do?4N/A
PX221501_Scoliosis_QOL_Last_Week_HappyHealthPX221501530000During the last week how happy has your child been with his/her health in general?4N/A
PX221501_Scoliosis_QOL_Last_Week_SickTIredPX221501540000During the last week, how much of the time did your child feel sick and tired?4N/A
PX221501_Scoliosis_QOL_LastWeek_FullEnergyPX221501550000During the last week, how much of the time were your child full of pep and energy?4N/A
PX221501_Scoliosis_QOL_Last_Week_PainInterferePX221501560000During the last week, how much of the time did pain or discomfort interfere with your child's activities?4N/A
PX221501_Scoliosis_QOL_Last_Week_RunPX221501570000During the last week, has it been easy or hard for your child to run short distances?4N/A
PX221501_Scoliosis_QOL_Last_Week_BicycleTricyclePX221501580000During the last week, has it been easy or hard for your child to bicycle or tricycle?4N/A
PX221501_Scoliosis_QOL_Last_Week_3FlightsStairsPX221501590000During the last week, has it been easy or hard for your child to climb three flights of stairs?4N/A
PX221501_Scoliosis_QOL_Last_Week_1FlightStairsPX221501600000During the last week, has it been easy or hard for your child to climb one flight of stairs?4N/A
PX221501_Scoliosis_QOL_Last_Week_WalkMilePX221501610000During the last week, has it been easy or hard for your child to walk more than a mile?4N/A
PX221501_Scoliosis_QOL_Last_Week_WalkThreeBlocksPX221501620000During the last week, has it been easy or hard for your child to walk three blocks?4N/A
PX221501_Scoliosis_QOL_Last_Week_WalkOneBlockPX221501630000During the last week, has it been easy or hard for your child to walk one block?4N/A
PX221501_Scoliosis_QOL_Last_Week_GetOnOffBusPX221501640000During the last week, has it been easy or hard for your child to get on and off a bus?4N/A
PX221501_Scoliosis_QOL_Child's_SSNPX221501380000Your Child's Social Security Number4N/A
PX221501_Scoliosis_QOL_Parent_SSNPX221501390000Your Social Security Number4N/A
PX221501_Scoliosis_QOL_Child_Need_HelpPX221501650000How often does your child need help from another person for walking and climbing? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Child_Use_AssistiveDevicesPX221501660000How often does your child use assistive devices (such as braces, crutches, or wheelchair) for walking and climbing? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Last_Week_StandSinkPX221501670000During the last week, has it been easy or hard for your child to stand while washing his/her hands and face at a sink?4N/A
PX221501_Scoliosis_QOL_Last_Week_SitChairPX221501680000During the last week, has it been easy or hard for your child to sit in a regular chair without holding on?4N/A
PX221501_Scoliosis_QOL_Last_Week_OnOffToiletPX221501690000During the last week, has it been easy or hard for your child to get on and off a toilet or chair?4N/A
PX221501_Scoliosis_QOL_Last_Week_InOutBedPX221501700000During the last week, has it been easy or hard for your child to get in and out of bed?4N/A
PX221501_Scoliosis_QOL_Last_Week_TurnDoorKnobsPX221501710000During the last week, has it been easy or hard for your child to turn door knobs?4N/A
PX221501_Scoliosis_QOL_Last_Week_BendOverPX221501720000During the last week, has it been easy or hard for your child to bend over from a standing position and pick up something off the floor?4N/A
PX221501_Scoliosis_QOL_Help_SittingStandingPX221501730000How often does your child need help from another person for sitting and standing?4N/A
PX221501_Scoliosis_QOL_Use_AssistiveDevices_SitStandPX221501740000. How often does your child use assistive devices (such as braces, crutches, or wheelchair) for sitting and standing?4N/A
PX221501_Scoliosis_QOL_Recreational_OutdoorActivitiesPX221501750100Can your child participate in recreational outdoor activities with other children the same age? (For example: bicycling, tricycling, skating, hiking, jogging) (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Activity_Limited_ByOutdoorPX221501750200If you answered ¿¿¿no¿¿¿ to Question 36 above, was your child's activity limited by: (Circle yes to all that apply)4N/A
PX221501_Scoliosis_QOL_PIckupGames_SportsPX221501760100Can your child participate in pickup games or sports with other children the same age? (For example: tag, dodge ball, basketball, soccer, catch, jump rope, touch football, hop scotch) (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Activity_Limited_BySportsPX221501760200If you answered ¿¿¿no¿¿¿ to Question 44 above, was your child's activity limited by: (Circle yes to all that apply)4N/A
PX221501_Scoliosis_QOL_CompetitiveLevel_SportsPX221501770100Can your child participate in competitive level sports with other children the same age? (For example: hockey, basketball, soccer, football, baseball, swimming, running [track or cross country], gymnastics, or dance) (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Activity_Limited_ByCompetiviteSportsPX221501770200If you answered ¿¿¿no¿¿¿ to Question 52 above, was your child's activity limited by: (Circle yes to all that apply)4N/A
PX221501_Scoliosis_QOL_GetTogether_FriendsPX221501780100How often in the last week did your child get together and do things with friends? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_Frequency_GetTogether_LimitedByPX221501780200If you answered ¿¿¿sometimes¿¿¿ or ¿¿¿never or rarely¿¿¿ to Question 60 above, was your child's activity limited by: (Circle yes to all that apply)4N/A
PX221501_Scoliosis_QOL_LastWeek_GymRecessPX221501790100How often in the last week did your child participate in gym/recess? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_LimitedBY_GymRecessPX221501790200If you answered ¿¿¿sometimes¿¿¿ or ¿¿¿never or rarely¿¿¿ to Question 63 above, was your child's activity limited by: (Circle yes to all that apply)4N/A
PX221501_Scoliosis_QOL_Easy_MakeFriendsPX221501800000Is it easy or hard for your child to make friends with children his/her own age? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_LastWeek_PainPX221501810000How much pain has your child had during the last week? (Circle one response.)4N/A
PX221501_Scoliosis_QOL_TXExpectations_PainReliefPX221501830000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to have pain relief.4N/A
PX221501_Scoliosis_QOL_TXExpectations_LookBetterPX221501840000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to look better.4N/A
PX221501_Scoliosis_QOL_TXExpectations_FeelBetterSelfPX221501850000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to feel better about himself/herself.4N/A
PX221501_Scoliosis_QOL_TXExpectations_SleepPX221501860000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to sleep more comfrotably.4N/A
PX221501_Scoliosis_QOL_TXExpectations_ActivitiesHomePX221501870000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do activities at home.4N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_SchoolPX221501880000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do more at school.4N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_PlayPX221501890000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child To be able to do more play or recreational activities (biking, walking, doing things with friends).4N/A
PX221501_Scoliosis_QOL_TXExpectations_DoMore_SportsPX221501900000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be able to do more sports.4N/A
PX221501_Scoliosis_QOL_TXExpectations_FreeofPain_NoDisabilityAdultPX221501910000What expectations do you have for your child's treatment? As a result of my child's treatment, I expect my child to be free from pain or disability as an adult.4N/A
PX221501_Scoliosis_QOL_NoChangeDX_HowYouFeelPX221501920000If your child had to spend the rest of his/her life with his/her bone and muscle condition as it is right now, how would you feel about it?4N/A
PX221501_Scoliosis_QOL_LastWeek_PainInterferePX221501820000During the last week, how much did pain interfere with your child's normal activities (including at home, outside of the home, and at school)? (Circle one response.)4N/A