Preliminary assessment of adolescent idiopathic scoliosis prevalence and physiotherapeutic scoliosis specific exercises workforce needs in accessible areas of conflict-affected Syria

Background Adolescent idiopathic scoliosis (AIS) constitutes a significant public health challenge that necessitates specialized conservative management. However, in conflict-afflicted regions such as Syria, a profound deficit of epidemiological data exists, obscuring the true prevalence of the condition and the corresponding need for a skilled workforce in Physiotherapeutic Scoliosis-Specific Exercises (PSSE). Objective Despite its severe limitations, this study provides the first local data snapshot of AIS in conflict-affected Syria. Rather than a foundation for direct policy, these findings should serve as a compelling rationale and baseline for urgently needed, methodologically rigorous, and nationally representative epidemiological research. Any planning based on these preliminary estimates must be undertaken with extreme caution and must prioritize robust data collection. Methods A cross-sectional field study was conducted, screening a convenience sample of 2,847 adolescents (mean age 14.0 ± 2.6 years; 59.7% female) across eight accessible governorates in Syria. Initial screening utilized the Adam's forward bend test and a scoliometer. Suspected cases were referred for radiographic confirmation, with a Cobb angle of ≥ 10° defining a positive diagnosis. A preliminary workforce estimation model was subsequently developed, integrating the observed prevalence, national demographic data, and established conservative treatment parameters. Results The point prevalence of scoliosis in this sample was determined to be 2.49% (95% CI: 1.92%–3.07%), with a female-to-male ratio of 3.73:1. Critically, 92.96% of confirmed cases presented with mild to moderate curves (Cobb angle 10–39°), representing the cohort for whom PSSE is the recommended intervention according to SOSORT guidelines. An exploratory workforce model, applied strictly to the demographic profile of the surveyed accessible areas, illustrated a range of hypothetical scenarios. The Base Case scenario (α = 0.55, β = 0.25), reflecting current severe constraints, projects a need for approximately 240 specialists. A Moderately Optimistic scenario (α = 0.70, β = 0.30) projects a need for approximately 350 specialists. This figure serves not as a definitive target, but as a conceptual tool to visualize the potential scale of need and to frame discussions on resource allocation priorities in similar accessible, conflict-affected settings. Conclusion This preliminary investigation, based on a non-representative sample from accessible Syrian regions, provides the first internally generated data on scoliosis prevalence in this context, which is consistent with global estimates. The substantial proportion of cases amenable to conservative care underscores the theoretical demand for PSSE services. While any workforce projection remains speculative, it establishes a crucial initial benchmark and highlights the urgent imperative for methodologically rigorous, population-based epidemiological studies and the development of context-adapted implementation frameworks.