Abstract Paediatric scoliosis is frequently accompanied by measurable reductions in cardiopulmonary efficiency due to thoracic deformity, impaired chest wall dynamics, and altered ventilatory mechanics. Although spirometric indices are routinely used to assess respiratory function, these static measures often fail to capture the dynamic physiological limitations observed during exertion. Cardiopulmonary exercise testing (CPET) offers deeper insight into integrated respiratory, cardiovascular, and muscular performance. The measurement of maximal oxygen uptake (VO₂ max) through CPET provides an objective estimate of aerobic capacity and overall physiological reserve. However, its application in paediatric scoliosis care remains inconsistent. This systematic review protocol outlines the methodological framework to synthesise current evidence on cardiopulmonary function in paediatric scoliosis, with a focus on VO₂ max, in guiding clinical assessment and long-term outcomes. The review will be conducted in accordance with Assessing the Methodological Quality of Systematic Reviews and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Cochrane databases will be searched for studies evaluating cardiopulmonary function in paediatric scoliosis (0–18 years) in accordance with the eligibility criteria. Risk of bias will be assessed using the Joanna Briggs Institute criteria and ROBINS-I tool as appropriate. Data synthesis will be reported as per Synthesis Without Meta-analysis framework. This review will clarify the extent of functional limitation attributable to thoracic deformity and evaluate VO₂ max as a clinically meaningful biomarker for perioperative risk stratification and recovery. By consolidating heterogeneous methodologies, it aims to standardise cardiopulmonary assessment protocols and inform future research integrating CPET-based evaluation into routine scoliosis care.
Sharma et al. (Sun,) studied this question.