Objective:

To examine associations between physical activity (PA) parameters and scoliosis screening positive (SSP) in children and adolescents, and to explore optimal thresholds for PA.

Key Findings:

• Low physical activity (LPA) and vigorous physical activity (VPA) are associated with higher risks for SSP compared to moderate physical activity (MPA).
• A U-shaped dose-response relationship exists, with the lowest SSP odds at PAQ-C scores around 2.7.
• Exercise frequency of less than 3 sessions/week and session durations outside the range of approximately 54 to 90 minutes are positively associated with SSP.
• Aquatic sports are inversely associated with SSP.
• Children aged 6-11 years show heightened vulnerability to LPA.

Interpretation:

Moderate physical activity (approximately 54 min/day, 3-4 days/week) is associated with the lowest odds of SSP, while both low and vigorous levels of activity increase risk. Participation in water and team sports appears protective against SSP.

Limitations:

• Cross-sectional design limits causal inferences.
• Self-reported PA may introduce bias.

Conclusion:

The study highlights a U-shaped association between physical activity levels and scoliosis screening outcomes, suggesting the need for further longitudinal research to confirm these findings.