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Romano M, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Kotwicki T, Maier-Hennes A, Arienti C, Negrini S. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2024; 2:CD007837. [PMID: 38415871 PMCID: PMC10900302 DOI: 10.1002/14651858.cd007837.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a pathology that changes the three-dimensional shape of the spine and trunk. While AIS can progress during growth and cause cosmetic issues, it is usually asymptomatic. However, a final spinal curvature above the critical threshold of 30° increases the risk of health problems and curve progression in adulthood. The use of therapeutic exercises (TEs) to reduce the progression of AIS and delay or avoid other, more invasive treatments is still controversial. OBJECTIVES To evaluate the effectiveness of TE, including generic therapeutic exercises (GTE) and physiotherapeutic scoliosis-specific exercises (PSSE) in treating AIS, compared to no treatment, other non-surgical treatments, or between treatments. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, four other databases, and two clinical trials registers to 17 November 2022. We also screened reference lists of articles. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing TE with no treatment, other non-surgical treatments (braces, electrical stimulation, manual therapy), and different types of exercises. In the previous version of the review, we also included observational studies. We did not include observational studies in this update since we found sufficient RCTs to address our study aims. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology. Our major outcomes were progression of scoliosis (measured by Cobb angle, trunk rotation, progression, bracing, surgery), cosmetic issues (measured by surface measurements and perception), and quality of life (QoL). Our minor outcomes were back pain, mental health, and adverse effects. MAIN RESULTS We included 13 RCTs (583 participants). The percentage of females ranged from 50% to 100%; mean age ranged from 12 to 15 years. Studies included participants with Cobb angles from low to severe. We judged 61% of the studies at low risk for random sequence generation and 46% at low risk for allocation concealment. None of the studies could blind participants and personnel. We judged the subjective outcomes at high risk of performance and detection bias, and the objective outcomes at high risk of detection bias in six studies and at low risk of bias in the other six studies. One study did not assess any objective outcomes. Comparing TE versus no treatment, we are very uncertain whether TE reduces the Cobb angle (mean difference (MD) -3.6°, 95% confidence interval (CI) -5.6 to -1.7; 2 studies, 52 participants). Low-certainty evidence indicates PSSE makes little or no difference in the angle of trunk rotation (ATR) (MD -0.8°, 95% CI -3.8 to 2.1; 1 study, 45 participants), may reduce the waist asymmetry slightly (MD -0.5 cm, 95% CI -0.8 to -0.3; 1 study, 45 participants), and may result in little to no difference in the score of cosmetic issues measured by the Spinal Appearance Questionnaire (SAQ) General (MD 0.7 points, 95% CI -0.1 to 1.4; 1 study, 16 participants). PSSE may result in little to no difference in self-image measured by the Scoliosis Research Society - 22 Patient Questionnaire (SRS-22) (MD 0.3 points, 95% CI -0.3 to 0.9; 1 study, 16 participants) and improve QoL slightly measured by SRS-22 Total score (MD 0.3 points, 95% CI 0.1 to 0.4; 2 studies, 61 participants). Only Cobb angle results were clinically meaningful. Comparing PSSE plus bracing versus bracing, low-certainty evidence indicates PSSE plus bracing may reduce Cobb angle (-2.2°, 95% CI -3.8 to -0.7; 2 studies, 84 participants). Comparing GTE plus other non-surgical interventions versus other non-surgical interventions, low-certainty evidence indicates GTE plus other non-surgical interventions may reduce Cobb angle (MD -8.0°, 95% CI -11.5 to -4.5; 1 study, 80 participants). We are uncertain whether PSSE plus other non-surgical interventions versus other non-surgical interventions reduces Cobb angle (MD -7.8°, 95% CI -12.5 to -3.1; 1 study, 18 participants) and ATR (MD -8.0°, 95% CI -12.7 to -3.3; 1 study, 18 participants). PSSE plus bracing versus bracing alone may make little to no difference in subjective measurement of cosmetic issues as measured by SAQ General (-0.2 points, 95% CI -0.9 to 0.5; 1 study, 34 participants), self-image score as measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -0.3 to 0.5; 1 study, 34 participants), and QoL measured by SRS-22 Total score (MD 0.2 points, 95% CI -0.1 to 0.5; 1 study, 34 participants). None of these results were clinically meaningful. Comparing TE versus bracing, we are very uncertain whether PSSE allows progression of Cobb angle (MD 2.7°, 95% CI 0.3 to 5.0; 1 study, 60 participants), changes self-image measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -1.0 to 1.1; 1 study, 60 participants), and QoL measured by SRS-22 Total score (MD 3.2 points, 95% CI 2.1 to 4.2; 1 study, 60 participants). None of these results were clinically meaningful. Comparing PSSE with GTE, we are uncertain whether PSSE makes little or no difference in Cobb angle (MD -3.0°, 95% CI -8.2 to 2.1; 4 studies, 192 participants; very low-certainty evidence). PSSE probably reduces ATR (clinically meaningful) (MD -3.0°, 95% CI -3.4 to -2.5; 2 studies, 138 participants). We are uncertain about the effect of PSSE on QoL measured by SRS-22 Total score (MD 0.26 points, 95% CI 0.11 to 0.62; 3 studies, 168 participants) and on self-image measured by SRS-22 Self-Image and Walter Reed Visual Assessment Scale (standardised mean difference (SMD) 0.77, 95% CI -0.61 to 2.14; 3 studies, 168 participants). Further, low-certainty evidence indicates that 38/100 people receiving GTE may progress more than 5° Cobb versus 7/100 receiving PSSE (risk ratio (RR) 0.19, 95% CI -0.67 to 0.52; 1 study, 110 participants). None of the included studies assessed adverse effects. AUTHORS' CONCLUSIONS The evidence on the efficacy of TE is currently sparse due to heterogeneity, small sample size, and many different comparisons. We found only one study following participants to the end of growth showing the efficacy of PSSE over TE. This result was weakened by adding studies with short-term results and unclear preparation of treating physiotherapists. More RCTs are needed to strengthen the current evidence and study other highly clinically relevant outcomes such as QoL, psychological and cosmetic issues, and back pain.
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Affiliation(s)
- Michele Romano
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | | | - Tomasz Kotwicki
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland
| | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Orellana KJ, Lee J, Yang D, Hauth L, Flynn JM. Impact of Social Determinants of Health on Adolescent Idiopathic Scoliosis Curve Severity. J Pediatr Orthop 2024; 44:e168-e173. [PMID: 37796167 DOI: 10.1097/bpo.0000000000002529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Social determinants of health have been shown to influence the health and outcomes of pediatric patients. Adolescent idiopathic scoliosis (AIS) may be particularly sensitive to such factors as early diagnosis and treatment can obviate the need for surgical intervention. The purpose of this study was to analyze the effect that social determinants of health have on the severity of AIS at presentation and at the time of surgery. METHODS A retrospective review was conducted for consecutive patients who underwent posterior spinal fusion for AIS from 2020 to 2022. Demographic data was collected, while insurance status (private vs. public) and childhood opportunity index (COI) categories (LOW vs. HIGH) were used as a proxy for socioeconomic status. Curve magnitude at the initial presentation and at the latest preoperative visit were recorded with a threshold of 25 to 40 degrees considered within the bracing range. Univariate and multivariate analysis was done to compare differences between subgroups as appropriate. RESULTS A total of 180 patients with mean initial and preoperative major curve angles of 48 and 60 degrees were included. Statistically significant differences in race and insurance types were appreciated, with the LOW COI group having a higher proportion of underrepresented minority and publicly insured patients than the HIGH COI group ( P <0.001). Patients within the LOW COI group presented with an initial curve that was, on average, 6 degrees more severe than those within the HIGH group ( P =0.009) and a preoperative curve that was 4 degrees larger than those within the HIGH group ( P =0.015). Similarly, only 13% of patients within the LOW COI group presented with curves within the bracing threshold, compared with 31% in the HIGH COI group ( P =0.009). CONCLUSION Socioeconomic status plays a significant role in the severity of AIS. Specifically, patients with lower COI tend to present with curve magnitudes beyond what is responsive to nonsurgical treatment, leading to larger curves at the time of surgery. Future work should focus on addressing social inequalities to optimize the treatment and outcomes of AIS patients. LEVEL OF EVIDENCE Level III- Retrospective Comparative Study.
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Affiliation(s)
- Kevin J Orellana
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Julianna Lee
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Daniel Yang
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Lucas Hauth
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - John M Flynn
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
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Raimondi L, De Luca A, Gallo A, Perna F, Cuscino N, Cordaro A, Costa V, Bellavia D, Faldini C, Scilabra SD, Giavaresi G, Toscano A. Investigating the Differential Circulating microRNA Expression in Adolescent Females with Severe Idiopathic Scoliosis: A Proof-of-Concept Observational Clinical Study. Int J Mol Sci 2024; 25:570. [PMID: 38203740 PMCID: PMC10779108 DOI: 10.3390/ijms25010570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Adolescent Idiopathic Scoliosis (AIS) is the most common form of three-dimensional spinal disorder in adolescents between the ages of 10 and 18 years of age, most commonly diagnosed in young women when severe disease occurs. Patients with AIS are characterized by abnormal skeletal growth and reduced bone mineral density. The etiology of AIS is thought to be multifactorial, involving both environmental and genetic factors, but to date, it is still unknown. Therefore, it is crucial to further investigate the molecular pathogenesis of AIS and to identify biomarkers useful for predicting curve progression. In this perspective, the relative abundance of a panel of microRNAs (miRNAs) was analyzed in the plasma of 20 AIS patients and 10 healthy controls (HC). The data revealed a significant group of circulating miRNAs dysregulated in AIS patients compared to HC. Further bioinformatic analyses evidenced a more restricted expression of some miRNAs exclusively in severe AIS females. These include some members of the miR-30 family, which are considered promising regulators for treating bone diseases. We demonstrated circulating extracellular vesicles (EVs) from severe AIS females contained miR-30 family members and decreased the osteogenic differentiation of mesenchymal stem cells. Proteomic analysis of EVs highlighted the expression of proteins associated with orthopedic disease. This study provides preliminary evidence of a miRNAs signature potentially associated with severe female AIS and suggests the corresponding vesicular component may affect cellular mechanisms crucial in AIS, opening the scenario for in-depth studies on prognostic differences related to gender and grade.
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Affiliation(s)
- Lavinia Raimondi
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Angela De Luca
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Alessia Gallo
- Dipartimento di Ricerca, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy
| | - Fabrizio Perna
- Ortopedia Generale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy (A.T.)
| | - Nicola Cuscino
- Dipartimento di Ricerca, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy
| | - Aurora Cordaro
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Viviana Costa
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Daniele Bellavia
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Cesare Faldini
- Clinica Ortopedica e Traumatologica I, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy
| | - Simone Dario Scilabra
- Fondazione Ri.MED, Dipartimento di Ricerca IRCCS ISMETT, Via Ernesto Tricomi 5, 90145 Palermo, Italy
| | - Gianluca Giavaresi
- Scienze e Tecnologie Chirurgiche, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy; (L.R.)
| | - Angelo Toscano
- Ortopedia Generale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy (A.T.)
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Peuchot C, Cassoudesalle H, David R, Jourdan L, Glize B, de Seze M. Could trochanteric pelvic stabilization be removed from the adolescent idiopathic scoliosis brace? A prospective pilot study. Prosthet Orthot Int 2024; 48:55-62. [PMID: 37708334 DOI: 10.1097/pxr.0000000000000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 06/09/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Idiopathic scoliosis is the most common musculoskeletal deformity in children. There is a dose-response relationship between compliance and improvement in scoliosis. The literature revealed that esthetic considerations have negative consequences on the quality of life (QOL) of patients and consequently on wearing time of the brace. To minimize esthetic problems and then increase QOL and wearing time, we proposed a new relay brace named "corset Collerette" without a pelvic-trochanteric base. METHODS A prospective cohort study was conducted in the rehabilitation department of Bordeaux University Hospital. Patients consulting for adolescent idiopathic scoliosis were registered in a prospective hospital database. The patients expressing unwillingness to wear the usual brace or who had decreased compliance were offered the corset Collerette and were included in a 3-month follow-up. Outcome measures assessed at baseline and at 3 months were Scoliosis Research Society Outcomes Questionnaire (SRS-22) and Brace Questionnaire scales and wearing time. Cobb's angle evolution since the start of bracing was also collected. The primary end point was the QOL assed by the SRS-22 scale at 3 months of follow-up. RESULTS The first 38 patients agreeing to wear the corset Collerette were included in the study. The QOL assessed by the SRS-22 was significantly improved with the corset Collerette ( p < 0.05). There was no significant increase in wearing time and thoracic Cobb's angles between baseline and follow-up ( p > 0.05). CONCLUSION The switch to the corset Collerette allowed an improvement in the QOL of the patients and avoid a decrease in compliance with wearing the brace and maintain the same in-brace Cobb's angles.
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Affiliation(s)
- Charline Peuchot
- Handicap Activity Cognition Health-HACS BPH Inserm U1219, University of Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, Trois Marres Tampon, Ile de La Réunion, France
| | - Hélène Cassoudesalle
- Handicap Activity Cognition Health-HACS BPH Inserm U1219, University of Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, Bordeaux, France
| | - Romain David
- Department of Physical Medicine and Rehabilitation, CHU de Poitiers, Poitiers, France
| | - Louca Jourdan
- Handicap Activity Cognition Health-HACS BPH Inserm U1219, University of Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, Bordeaux, France
| | - Bertrand Glize
- Handicap Activity Cognition Health-HACS BPH Inserm U1219, University of Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, Bordeaux, France
| | - Mathieu de Seze
- Handicap Activity Cognition Health-HACS BPH Inserm U1219, University of Bordeaux, Bordeaux, France
- Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, Bordeaux, France
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Lee KP, Yip J, Yick KL, Lu C, Lu L, Lei QWE. A Novel Force-Sensing Smart Textile: Inserting Silicone-Embedded FBG Sensors into a Knitted Undergarment. SENSORS (BASEL, SWITZERLAND) 2023; 23:5145. [PMID: 37299872 PMCID: PMC10255815 DOI: 10.3390/s23115145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
A number of textile-based fiber optic sensors have recently been proposed for the continuous monitoring of vital signs. However, some of these sensors are likely unsuitable for conducting direct measurements on the torso as they lack elasticity and are inconvenient. This project provides a novel method for creating a force-sensing smart textile by inlaying four silicone-embedded fiber Bragg grating sensors into a knitted undergarment. The applied force was determined within 3 N after transferring the Bragg wavelength. The results show that the sensors embedded in the silicone membranes achieved enhanced sensitivity to force, as well as flexibility and softness. Additionally, by assessing the degree of FBG response to a range of standardized forces, the linearity (R2) between the shift in the Bragg wavelength and force was found to be above 0.95, with an ICC of 0.97, when tested on a soft surface. Furthermore, the real-time data acquisition could facilitate the adjustment and monitoring of force during the fitting processes, such as in bracing treatment for adolescent idiopathic scoliosis patients. Nevertheless, the optimal bracing pressure has not yet been standardized. This proposed method could help orthotists to adjust the tightness of brace straps and the location of padding in a more scientific and straightforward way. The output of this project could be further extended to determine ideal bracing pressure levels.
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Affiliation(s)
- Ka-Po Lee
- School of Fashion and Textile, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-P.L.); (K.-L.Y.); (Q.-W.E.L.)
| | - Joanne Yip
- School of Fashion and Textile, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-P.L.); (K.-L.Y.); (Q.-W.E.L.)
- Photonics Research Institute, The Hong Kong Polytechnic University, Hong Kong 999077, China; (C.L.)
| | - Kit-Lun Yick
- School of Fashion and Textile, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-P.L.); (K.-L.Y.); (Q.-W.E.L.)
| | - Chao Lu
- Photonics Research Institute, The Hong Kong Polytechnic University, Hong Kong 999077, China; (C.L.)
- Department of Electronic and Information Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Linyue Lu
- Photonics Research Institute, The Hong Kong Polytechnic University, Hong Kong 999077, China; (C.L.)
- Department of Electrical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Qi-Wen Emma Lei
- School of Fashion and Textile, The Hong Kong Polytechnic University, Hong Kong 999077, China; (K.-P.L.); (K.-L.Y.); (Q.-W.E.L.)
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Jalloh H, Andras LM, Sanders A, Iantorno S, Hamilton A, Choi PD, Skaggs DL. Adolescent idiopathic scoliosis patients treated with bracing, surgery, or observation showed no difference in behavioral and emotional function over a 2-year period. Medicine (Baltimore) 2023; 102:e32610. [PMID: 36701729 PMCID: PMC9857555 DOI: 10.1097/md.0000000000032610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The purpose of this study was to assess if behavior and emotional function, as measured by the Pearson Behavioral Assessment Survey for Children, Second Edition (BASC-2) in patients and parents, changes with differing treatment protocols in patients with adolescent idiopathic scoliosis (AIS). One previous study showed abnormal BASC-2 scores in a substantial number of patients diagnosed with AIS; however, no study has assessed how these scores change over the course of treatment. AIS patients aged 12 to 21 years completed the BASC-2. The 176-item questionnaire was administered to subjects at enrollment, assessing behavioral and emotional problems across 16 subscales of 5 domains: school problems, internalizing problems, inattention/hyperactivity, emotional symptoms index, and personal adjustment. Parents were given an equivalent assessment survey. Surveys were administered again after 2 years. Subject treatment groups (bracing, surgery, and observation) were established at enrollment. Patients were excluded if they did not complete the BASC-2 at both time points. Forty-six patients met the inclusion criteria, with 13 patients in the surgical, 20 in the bracing, and 13 in the observation treatment groups. At enrollment, 26% (12/46) of subjects with AIS had a clinically significant score in 1 or more subscales, and after 2 years 24% (11/46) of subjects reported a clinically significant score in at least 1 subscale (P = .8). There were no significant differences in scores between enrollment and follow-up in any treatment group. Similar to what was reported in a previous study, only 36% (4/11) of patients had clinically significant scores reported by both patient and parent, conversely 64% (7/11) of parents were unaware of their child's clinically significant behavioral and emotional problems. Common patient-reported subscales for clinically significant and at-risk scores at enrollment included anxiety (24%; 11/46), hyperactivity (24%; 11/46), attention problems (17%; 8/46), and self-esteem (17%; 8/46). At 2-year follow-up, the most commonly reported subscales were anxiety (28%; 13/46), somatization (20%; 9/46), and self-esteem (30%; 14/46). Patients with AIS, whether observed, braced or treated surgically, showed no significant change in behavior and emotional distress over the course of their treatment, or compared with each other at 2-year follow-up.
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Affiliation(s)
- Hulaimatu Jalloh
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Lindsay M. Andras
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
- * Correspondence: Lindsay M. Andras, Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS #69, Los Angeles, CA 90027 (e-mail: )
| | - Austin Sanders
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Stephanie Iantorno
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Anita Hamilton
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Paul D. Choi
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
| | - David L. Skaggs
- Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA
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Gornitzky AL, England P, Kiani SN, Yellin JL, Flynn JM. Why Don't Adolescents Wear Their Brace? A Prospective Study Investigating Psychosocial Characteristics That Predict Scoliosis Brace Wear. J Pediatr Orthop 2023; 43:51-60. [PMID: 36194756 DOI: 10.1097/bpo.0000000000002272] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although bracing for adolescent idiopathic scoliosis can prevent curve progression and reduce the risk for future surgery, children frequently do not wear their braces as prescribed. The purpose of this study is to investigate how a broad array of psychosocial characteristics predict future compliance with scoliosis brace wear. METHODS This was a single institution, prospective cohort study. All adolescents prescribed a first-time brace for adolescent idiopathic scoliosis were eligible. Patients and their parents completed a separate series of questionnaires that assessed baseline psychosocial characteristics across 6 domains: (1) brace-specific attitudes; (2) body image and self-esteem; (3) school performance and social relationships; (4) psychological health; (5) family functioning; and (6) demographics and scoliosis-specific details (242 total questions across 12 validated questionnaires). Objective brace compliance was collected using temperature-sensitive monitors. Defining compliance as percentage of brace prescription completed, comparative analyses were performed to identify baseline psychosocial characteristics that were associated with future wear. A composite measure (Bracing Fidelity Follow-Up Scale [BFFS]) of the 12 most predictive individual questions across all domains (both parent and adolescent) was constructed to help assess which adolescents were at highest risk of failure to wear their brace. Total BFFS score for each parent-adolescent dyad who completed all the included surveys was then determined by awarding one point for each factor that positively influenced future brace wear (maximum 12 points), and a correlation was calculated between total score and percent adherence to prescribed brace wear. RESULTS A total of 41 patients were included. On average, patients with high self-esteem, above average peer relationships and poor brace-specific attitudes had lower brace compliance, although patients with increased loneliness and parental religiousness had higher compliance. Body image, socioeconomic status, family dynamics, and school performance had no significant relationship with brace use. Total score on the Bracing Fidelity Follow-Up Scale (BFFS) was significantly associated with improved brace wear (r=0.687, P <0.001). Those with a score of 6 or above (n=15/33 [45%], median compliance 96%) were more reliable users (15/15 with compliance >75%), and those with a score of 5 or less (n=18/33 [55%], median compliance 50%) had less consistent brace wear (9/18 with compliance <50%). CONCLUSION This prospective study identifies numerous baseline psychosocial factors that are associated with future compliance with scoliosis brace wear. Although in need of further validation before widespread clinical application, the novel BFF scale offers a potential opportunity to partially discriminate between compliant and noncompliant scoliosis brace users such that supportive resources (eg, supportive counseling, peer-support groups, additional provider-based education, etc.) can be targeted to those patients most likely to benefit. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Alex L Gornitzky
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA
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Nonoperative management of adolescent idiopathic scoliosis (AIS) using braces. Prosthet Orthot Int 2022; 46:383-391. [PMID: 35320151 DOI: 10.1097/pxr.0000000000000117] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
This review presents the state of the art according to the current evidence on nonoperative treatment for adolescent idiopathic scoliosis, focusing on bracing. The definition of braces for the treatment of adolescent idiopathic scoliosis and a short history are provided. The analysis includes biomechanics, types, existing classifications, indications for treatment, time of brace wear and weaning, adherence, three-dimensional modeling, use of ultrasound imaging for bracing, management of treatment, issue of immediate in-brace correction, and documentation of the outcomes usually assessed for brace treatment, including the quality-of-life issues. According to the current evidence, there are two randomized control trials in favor of bracing. There are insufficient data on the superiority of one brace over another, although it is possible to classify and grade braces for efficacy from nonrigid to rigid and very rigid. Nevertheless, there is consensus on patients' management on the need for teamwork focusing on adherence to treatment, acceptability, and family and patient involvement.
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Li X, Huo Z, Hu Z, Lam TP, Cheng JCY, Chung VCH, Yip BHK. Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis. PLoS One 2022; 17:e0271612. [PMID: 35857763 PMCID: PMC9299303 DOI: 10.1371/journal.pone.0271612] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022] Open
Abstract
This review aimed to systematically review and meta-analyze the effects of interventions in improving bracing compliance among adolescent idiopathic scoliosis (AIS) patients. Eight databases were searched from their inception to April 2022. The eligibility criteria included controlled studies that used any type of intervention to enhance bracing compliance in braced AIS patients. Two researchers independently screened articles and extracted data based on the PICO (participant, intervention, comparator, and outcome) framework. Quality appraisal of included studies was performed using GRADE (overall assessment), and the risk of bias was assessed with Cochrane RoB Tool 2 for randomized controlled trials (RCT) and ROBINS-I for non-RCT studies. The primary outcome was bracing compliance and secondary outcomes included Cobb Angle and measurements for quality of life. Six eligible studies involving 523 participants were included. All studies were evaluated as low or very low quality with a high risk of bias. Four types of interventions were identified, including sensor monitoring (n = 2, RCTs), auto-adjusted brace (n = 1, RCT), more intensive or collaborated medical care (n = 2), and psychosocial intervention (n = 1). A meta-analysis of 215 patients from the three RCTs suggested that the compliance-enhancing intervention group had 2.92 more bracing hours per day than the usual care control (95%CI [1.12, 4.72], P = 0.001). In subgroup analysis, sensor monitoring significantly improved bracing wearing quantity compared to usual care (3.47 hours/day, 95%CI [1.48, 5.47], P = 0.001), while other aforementioned interventions did not show a significant superiority. Compliance-enhancing interventions may be favorable in preventing curve progression and promoting quality of life, but the improvements cannot be clarified according to limited evidence. In conclusion, although the results of this study suggested that sensor monitoring may be the most promising approach, limited high-quality evidence precludes reliable conclusions. Future well-designed RCTs are required to confirm the actual benefit of compliance-improving interventions in clinical practice.
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Affiliation(s)
- Xue Li
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhaohua Huo
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zongshan Hu
- Department of Spine Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Tsz Ping Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR, China
| | - Jack Chun Yiu Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong SAR, China
| | - Vincent Chi-ho Chung
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Hon Kei Yip
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- * E-mail:
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Mitsiaki I, Thirios A, Panagouli E, Bacopoulou F, Pasparakis D, Psaltopoulou T, Sergentanis TN, Tsitsika A. Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature. CHILDREN 2022; 9:children9050597. [PMID: 35626775 PMCID: PMC9139262 DOI: 10.3390/children9050597] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in puberty, affects 1–4% of adolescents, and disproportionately affects young women. Our aim was to comprehensively examine the association between AIS and risk for depression, anxiety, eating disorders, psychotic disorders, and personality dysfunctional mechanisms. Methods: Literature review of related articles published in PubMed, Google Scholar, and Scopus up to 15 July 2021. Results: A total of 30 studies were deemed eligible, examining the effects of AIS upon mental health, and using appropriate psychometric inventories. Studies highlighted the association of brace treatment with elevated anxiety. In addition, mental health conditions and traits (e.g., anxiety and depressive symptoms, neuroticism) were detected more frequently amongst AIS patients compared to healthy controls. Conclusions: AIS represents a risk factor for mental health disorders. More longitudinal studies, utilizing accurate psychometric instruments, are warranted, to reveal the current impact of AIS on the mental health of youngsters, along with the tailoring of well-targeted interventions to reduce the burden of mental health issues in adulthood.
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Affiliation(s)
- Ioanna Mitsiaki
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (I.M.); (A.T.); (E.P.); (T.N.S.)
| | - Athanasios Thirios
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (I.M.); (A.T.); (E.P.); (T.N.S.)
| | - Eleni Panagouli
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (I.M.); (A.T.); (E.P.); (T.N.S.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, “Agia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Dimitris Pasparakis
- Pediatric Orthopaedic Department, Athens Medical Center, 151 25 Athens, Greece;
| | - Theodora Psaltopoulou
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodoros N. Sergentanis
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (I.M.); (A.T.); (E.P.); (T.N.S.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Artemis Tsitsika
- MSc Program “Strategies of Developmental and Adolescent Health”, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (I.M.); (A.T.); (E.P.); (T.N.S.)
- Correspondence:
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Abstract
Scoliosis is an abnormal curvature of the spine, which generally develops during childhood or adolescence. It affects 2–4 percent of the global population and is more prevalent among girls. Scoliosis is classified by its etiology: idiopathic, congenital, or neuromuscular. Among these, the former is the most common. Treatment options for scoliosis vary depending on the severity of the curve. Most scoliosis diagnoses tend to be mild and only require monitoring. However, curves between 20 and 40 degrees require bracing, while 40 degrees and above require surgery. There are various bracings available, such as Boston, Charleston, and Milwaukee. In severe cases of scoliosis, either fusion or fusionless surgery may be required. This review aims to discuss etiologies and different treatment interventions for scoliosis.
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Lee SB, Chae HW, Kwon JW, Sung S, Lee HM, Moon SH, Lee BH. Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study. Clin Orthop Relat Res 2021; 479:1805-1812. [PMID: 33780404 PMCID: PMC8277277 DOI: 10.1097/corr.0000000000001716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 02/10/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Children with adolescent idiopathic scoliosis (AIS) have reduced quality of life related to poor self-image, perhaps because of cosmetic concerns. However, there has not been a large-database epidemiologic study on the association between psychiatric disorders and scoliosis. QUESTIONS/PURPOSES Using the Korean National Health Insurance database, we asked: (1) How common are psychiatric disorders among children with AIS? (2) After controlling for gender, age, insurance type, and residential district, are psychiatric disorders more common among children with AIS than among age-matched controls? METHODS A retrospective analysis was conducted using sample datasets from the Health Insurance Review and Assessment Service from 2012 to 2016, which is a 10% randomly extracted sample of total inpatients and outpatients each year. The mean number of total patients in each dataset was 1,047,603 ± 34,534. The mean number of children with AIS was 7409 ± 158 for each year. The age criteria was 10 to 19 years for the matching. Mood disorders, anxiety disorders, and behavioral disorders were selected as disorders possibly associated with AIS. We identified children with AIS who had any of the disorders above, and we obtained the prevalence of these disorders based on diagnostic codes. As an exploratory analysis, clinically meaningful variables were selected among the available codes in the dataset, and a univariable logistic regression test was performed for each variable. A multivariable logistic regression test with advanced variables was performed to identify the adjusted odds ratios of psychiatric disorders in children with AIS. RESULTS The median (range) prevalence of psychiatric disorders in children with AIS from 2012 to 2016 was 7% (6% to 7%). Compared with children who did not have AIS, and after controlling for gender, age, insurance type, and residential district, children with AIS were more likely to have psychiatric disorders in all 5 years. The adjusted ORs of psychiatric disorders in children with AIS compared with children who did not have AIS ranged from 1.47 to 1.74 (2012: OR 1.60 [95% CI 1.46 to 1.75]; p < 0.001; 2013: OR 1.73 [95% CI 1.58 to 1.89]; p < 0.001; 2014: OR 1.74 [95% CI 1.59 to 1.91]; p < 0.001; 2015: OR 1.71 [95% CI 1.56 to 1.88]; p < 0.001; 2016: OR 1.47 [95% CI 1.33 to 1.62]; p < 0.001). CONCLUSION Considering the higher prevalence of psychiatric disorders in children with AIS compared with children who did not have AIS, children with AIS and their parents should be counseled about the increased risk of deteriorating mental health of the patients, and surgeons should provide early referral to pediatric psychiatrists. Further studies should investigate the effect of the factors related to AIS, such as curve type, Cobb angle, and treatment modality. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Soo-Bin Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, Bundang Jesaeng Hospital, Gyeonggi-do, Republic of Korea
| | - Hyun-Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji-Won Kwon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Republic of Korea
| | - Sahyun Sung
- Department of Orthopedic Surgery, Ewha Woman’s University Seoul Hospital, Seoul, Republic of Korea
| | - Hwan-Mo Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seong-Hwan Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung Ho Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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mHealth for the Monitoring of Brace Compliance and Wellbeing in Adolescents with Idiopathic Scoliosis: Study Protocol for a Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157767. [PMID: 34360060 PMCID: PMC8345733 DOI: 10.3390/ijerph18157767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/15/2022]
Abstract
Attempts to optimize monitoring of brace adherence prescribed to adolescents with idiopathic scoliosis (IS) have generally relied on sensors. Sensors, however, are intrusive and do not allow the assessment of psychological and physical consequences of brace use that might underlie poor adherence. Mobile applications have emerged as alternatives to monitor brace compliance. However, the feasibility and utility of these app-based systems to assess key psychological and physical domains associated with non-adherence remain unexplored. This feasibility study aims to test the usability, acceptability, and clinical utility of an app-based system that monitors brace use and related psychological and physical factors. Forty adolescents with IS daily respond to the app for 90 days. The patient responses may generate clinical alarms (e.g., brace non-adherence, discomfort, or distress) that will be sent daily to the medical team. Primary outcomes will be app usability, acceptability, and response rates. Secondary outcomes will include brace adherence, the number of side effects reported, number and type of clinical alarms, stress, quality of life, perceived health status, and mood. If accepted by patients and clinicians, apps may allow rapid detection and response to undesired events in adolescents undergoing brace treatment.
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Scaturro D, de Sire A, Terrana P, Costantino C, Lauricella L, Sannasardo CE, Vitale F, Mauro GL. Adolescent idiopathic scoliosis screening: Could a school-based assessment protocol be useful for an early diagnosis? J Back Musculoskelet Rehabil 2021; 34:301-306. [PMID: 33285626 DOI: 10.3233/bmr-200215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis screening still needs a considerable implementation, particularly throughout a school-based assessment protocol. OBJECTIVE This study aims to evaluate the effectiveness of clinical examinations currently in use for the diagnosis of adolescent idiopathic scoliosis, through a survey carried out in secondary schools to standardize a screening protocol that could be generalized. METHODS In their classrooms, the adolescents underwent an idiopathic scoliosis screening through three examinations: Adam's test, axial trunk rotation (ATR) and plumb line. In case of single positivity to one of the three examinations, a column X-ray examination was recommended. RESULTS The sensitivity and diagnostic specificity of Adam's test or ATR were 56.3% and 92.7%, respectively. The positivity to at least one between ATR or plumb line showed that sensitivity was higher than specificity: 91.3% versus 80.8%; the positivity to at least one between Adams's test or plumb line showed a sensitivity of 95.2% and a specificity of 81.5%. Finally, the positivity to all three examinations showed an increase in specificity (99.7%). CONCLUSIONS Taken together, our findings show that this school-based screening protocol had a very high specificity in early diagnosis of adolescent idiopathic scoliosis.
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Affiliation(s)
- Dalila Scaturro
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Palermo, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Pietro Terrana
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Palermo, Italy
| | - Claudio Costantino
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", Università degli Studi di Palermo, Palermo, Italy
| | - Lorenza Lauricella
- Physical Medicine and Rehabilitation Unit, "P. Giaccone" University Hospital, Palermo, Italy
| | - Claudia Emilia Sannasardo
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Palermo, Italy
| | - Francesco Vitale
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", Università degli Studi di Palermo, Palermo, Italy
| | - Giulia Letizia Mauro
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Palermo, Italy
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15
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Lertudomphonwanit T, Pengrung N, Kriwattanapong C, Angsanuntsukh C, Leelapattana P, Chanplakorn P. Novel questionnaire to enhance brace wear adherence in patients with adolescent idiopathic scoliosis and the relationship of the quality of life. Orthop Rev (Pavia) 2021; 13:8840. [PMID: 33907613 PMCID: PMC8056326 DOI: 10.4081/or.2021.8840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/24/2020] [Indexed: 11/24/2022] Open
Abstract
Bracing is an effective non-operative treatment, in patients with adolescent idiopathic scoliosis (AIS). The relationship between patients’ quality of life (QOL) and brace wear adherence has been reported. This study aims to determine brace wear adherence for AIS patients with novel questionnaire. A nested case-control study was conducted, included patient age 10-18 years, coronal Cobb angle 20-50°, and Risser grade 0-3. Correlation between patients’ QOL and the average hours of daily brace-wear were determined. Patients were divided into 3 groups based on brace wear adherence and were compared. QOL domains associated with the incompleteness of brace-wearing were determined by Cox proportional-hazards regression. Mean age of patients was 13.3 years (range 11-17.3 years) with initial Cobb angle of 33.5° (range 20-48°). There were significant negative correlations between total QOL scores and brace wearing time. Increased social domain scores was significantly associated with less brace wearing time (HR 1.5, 95% CI 1.12-2.04). Significant correlations between patients’ QOL and the average hours per day of brace wear. Poor social QOL have a significant impact on brace wear adherence.
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Affiliation(s)
- Thamrong Lertudomphonwanit
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nachapan Pengrung
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaiwat Kriwattanapong
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chanika Angsanuntsukh
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pittavat Leelapattana
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pongsthorn Chanplakorn
- Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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16
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Wang H, Tetteroo D, Arts JJC, Markopoulos P, Ito K. Quality of life of adolescent idiopathic scoliosis patients under brace treatment: a brief communication of literature review. Qual Life Res 2021; 30:703-711. [PMID: 33098493 PMCID: PMC7952337 DOI: 10.1007/s11136-020-02671-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To identify the life domains that are most frequently reported to be affected in scoliosis patients undergoing brace treatment. METHODS A search within the PubMed database was conducted and a total of 60 publications were selected. We classified the studies based on the methods used to measure patients' quality of life (QoL) and categorized the life domains reported to be affected. RESULTS Self-image/body configuration was the most reported affected domain of patients' QoL, identified in 32 papers, whilst mental health/stress was the second most reported affected domain. Mental health was identified in 11 papers, and 11 papers using the BSSQ questionnaire reported medium stress amongst their participants. Vitality was the third most reported affected domain, identified in 12 papers. CONCLUSIONS Our review indicates that scoliotic adolescents treated with bracing suffer in their quality of life most from psychological burdens. To improve these patients' life quality, more attention should be focussed on supporting their mental health.
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Affiliation(s)
- Huan Wang
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands.
| | - Daniel Tetteroo
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - J J Chris Arts
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Orthopaedic Surgery, Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
| | - Panos Markopoulos
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Keita Ito
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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Baker CE, Kiebzak GM, Neal KM. Anterior vertebral body tethering shows mixed results at 2-year follow-up. Spine Deform 2021; 9:481-489. [PMID: 33113121 DOI: 10.1007/s43390-020-00226-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/10/2020] [Indexed: 12/20/2022]
Abstract
STUDY DESIGN Retrospective chart review. OBJECTIVE To report 2-4-year outcomes of anterior vertebral body tethering (AVBT) for adolescent idiopathic scoliosis (AIS). AVBT is a relatively new procedure to correct AIS spine curvature and few outcomes studies have been published. METHODS Patients from 2015 to 2017 with 2-year follow-up were included. Successful outcomes were defined as curves 35° or less without revision surgery. We also compared outcomes between thoracic and lumbar ABVT. RESULTS There were 19 AVBTs in 17 patients, 13 thoracic and 6 lumbar. Nine curves (47%) in nine patients (53%) were successful. Preoperative kyphosis averaged 26° in the successful group and 14° in the unsuccessful group (P = 0.0337). Immediate correction for lumbar ABVTs (76%) was greater than thoracic ABVTs (43%) (P = 0.0140). Correction per level per month was greater in lumbar ABVTs (2.9° vs. 0.1°) (0.0440). Preoperative Sanders Maturity Scale (SMS) was 3.7 for successful cases and 2.5 for unsuccessful cases (P = 0.0232). Final SMS was 7.7 for successful cases and 5.7 for unsuccessful cases (P = 0.0518). All successful cases and 50% of unsuccessful cases were mature at final follow-up (P = 0.0294). There were four (24%) revision procedures, and three involving lumbar AVBTs. There were nine (47%) broken tethers. CONCLUSIONS Despite several final curves > 35°, four revisions, and nine broken tethers, the majority of patients (53%) were considered successful. Lumbar ABVTs correct more intraoperatively and faster postoperatively. Patients who are tethered during or slightly after the curve acceleration phase of growth may have more successful outcomes than patients tethered prior to the curve acceleration phase. AVBT requires further study with longer outcomes to define best practices for indications, level selections, and surgical techniques. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Courtney E Baker
- Department of Orthopedics, Mayo Clinic, Rochester, MN, 55903, USA
| | - Gary M Kiebzak
- Department of Orthopaedics and Sports Medicine, Nemours Children's Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA.
| | - Kevin M Neal
- Department of Pediatric Orthopedic Surgery, Nemours Children's Specialty Care, 807 Children's Way, Jacksonville, FL, 32207, USA
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Ng BW, Chau WW, Hung AH. Gender difference in health-related quality of life of adolescent idiopathic scoliosis patients between the 2 nd and 5 th year of bracing treatment using scoliosis research society-22 questionnaire. JOURNAL OF ORTHOPEDICS, TRAUMATOLOGY AND REHABILITATION 2021. [DOI: 10.4103/jotr.jotr_37_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cheung PWH, Wong CKH, Cheung JPY. Comparative study of the use of Paediatric Quality Of Life Inventory 4.0 generic core scales in paediatric patients with spine and limb pathologies. Bone Joint J 2020; 102-B:890-898. [PMID: 32600144 DOI: 10.1302/0301-620x.102b7.bjj-2019-1766.r2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The health-related quality of life (HRQoL) of paediatric patients with orthopaedic conditions and spinal deformity is important, but existing generic tools have their shortcomings. We aim to evaluate the use of Paediatric Quality of Life Inventory (PedsQL) 4.0 generic core scales in the paediatric population with specific comparisons between those with spinal and limb pathologies, and to explore the feasibility of using PedsQL for studying scoliosis patients' HRQoL. METHODS Paediatric patients attending a speciality outpatient clinic were recruited through consecutive sampling. Two groups of patients were included: idiopathic scoliosis, and paediatric orthopaedic upper and lower limb condition without scoliosis. Patients were asked to complete PedsQL 4.0 generic core scales, Youth version of 5-level EuroQol-5-dimension questionnaire, and Refined Scoliosis Research Society 22-item (SRS-22r) questionnaire. Statistical analyses included scores comparison between scoliosis and limb pathology patients using independent-samples t-test, and correlation tests of PedsQL and SRS-22r. RESULTS A total of 566 paediatric patients were recruited: 357 (63.0%) having idiopathic scoliosis, and 209 (37.0%) with limb conditions. Patients with limb pathology had lower functioning scale, summary, and total scores of PedsQL than scoliosis patients (p < 0.05 to p < 0.001). No floor or ceiling effects (< 15%) were detected for PedsQL Psychosocial Health Summary and total scores in both groups. PedsQL was sensitive in differentiating patients with/without problems in their daily lives (p < 0.05 to p < 0.01). PedsQL summary and total scores correlated with SRS-22r total score. CONCLUSION PedsQL is an effective HRQoL measure for both paediatric orthopaedic groups with minimal ceiling and floor effects, and is capable of detecting worse HRQoL in patients with limb pathology. The multidimensional PedsQL is sensitive in differentiating among those with daily life problems, especially for scoliosis patients. Cite this article: Bone Joint J 2020;102-B(7):890-898.
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Affiliation(s)
- Prudence W H Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong SAR, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
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Tao L, Zhou S, Tao Z, Wen K, Da W, Meng Y, Zhu Y. The publication trends and hot spots of scoliosis research from 2009 to 2018: a 10-year bibliometric analysis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:365. [PMID: 32355809 PMCID: PMC7186647 DOI: 10.21037/atm.2020.02.67] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background This study aims to quantitatively and qualitatively investigate the trends in scoliosis research and evaluate research hotspots using bibliometric analysis. Methods All relevant publications on scoliosis from the period from 2009 to 2018 were extracted from the Web of Science and PubMed databases. Publication trends were analyzed using an Online analysis platform of literature metrology, Bibliographic Item Co-occurrence Matrix Builder (BICOMB), and CiteSpace software. Hotspots were analyzed and visualized using the gCLUTO software package. Results A total of 7,445 scoliosis research publications dated between 2009 and 2018 were found. The spine was the most popular journal in this field during this period. The United States maintained a top position in global scoliosis research throughout the 10 years and has had a pivotal influence, followed by China and Canada. Among all institutions, the University of California, San Francisco, was a leader in research collaboration. At the same time, Professors Yong Qiu and Lawrence G. Lenke made great achievements in scoliosis research. We analyzed the major Medical Subject Headings (MeSH) terms/MeSH subheadings and identified eight hotspots in scoliosis research. Conclusions We summarized the publication information of scoliosis-related literature in the 10 years from 2009 to 2018, including country and institution of origin, authors, and publication journal. We analyzed former research hotspots in the field of scoliosis and predicted future areas of interest. The development of various new orthopedic plants, artificial intelligence diagnosis, and genetic research will be future hotspots in scoliosis research.
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Affiliation(s)
- Lin Tao
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Siming Zhou
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Zhengbo Tao
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Kaicheng Wen
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Wacili Da
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Yan Meng
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
| | - Yue Zhu
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang 110001, China
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Khoshhal Y, Jalali M, Babaee T, Ghandhari H, Gum JL. The Effect of Bracing on Spinopelvic Rotation and Psychosocial Parameters in Adolescents with Idiopathic Scoliosis. Asian Spine J 2019; 13:1028-1035. [PMID: 31434463 PMCID: PMC6894968 DOI: 10.31616/asj.2018.0307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/02/2019] [Accepted: 03/19/2019] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN Retrospective study. PURPOSE To evaluate the effect of bracing on spinopelvic rotation and psychosocial parameters in adolescents with idiopathic scoliosis (AIS). OVERVIEW OF LITERATURE Complex three-dimensional deformity in AIS is proposed to influence the spinopelvic parameters and psychosocial condition in adolescents; however, few studies have quantitatively evaluated these parameters. METHODS Thirty AIS who were prescribed a brace were included in the study. The patients' standing postero-anterior and total spine radiographs were used to measure the primary curve Cobb angle, vertebral rotation, and pelvic rotation. Apical vertebral rotation (AVR), upper AVR, and lower AVR were measured using the Nash-Moe method. Pelvic rotation was determined using the left-to-right hemipelvic width ratio. The curve pattern was classified as per the Lenke classification system. In all, 14 patients had a type I curve, five had type II, six had type III, one had type IV, and four had type V curves. Brace compliance was subjectively evaluated by interviewing the patients and their parents. The health-related quality of life (HRQOL) and stress level of the recruited patients were assessed using the Brace Questionnaire and Bad Sobernheim Stress Questionnaire, respectively. RESULTS The Cobb angle significantly decreased with at least 6 months of brace use. AVR correction changed significantly; however, no such results were observed for upper and lower AVR. Pelvic rotation and psychosocial parameters were not significantly affected by brace use. No statistically significant correlation was observed between brace compliance and curve correction. CONCLUSIONS The Cobb angle and AVR are crucial measurements that help evaluate the treatment efficacy in AIS with small curves who undergo brace treatment. HRQOL and pelvic axial rotation are not influenced by the brace treatment.
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Affiliation(s)
- Yalda Khoshhal
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Maryam Jalali
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Taher Babaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Hassan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Jeffrey L. Gum
- Department of Orthopedic Surgery, Norton Leatherman Spine Center, Louisville, KY, USA
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Rezaee S, Jalali M, Babaee T, Kamali M. Reliability and Concurrent Validity of a Culturally Adapted Persian Version of the Brace Questionnaire in Adolescents With Idiopathic Scoliosis. Spine Deform 2019; 7:553-558. [PMID: 31202370 DOI: 10.1016/j.jspd.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 10/06/2018] [Accepted: 10/14/2018] [Indexed: 10/26/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To determine the validity and reliability of culturally adapted Persian version of the Brace Questionnaire (P-BrQ). SUMMARY OF BACKGROUND DATA The BrQ has proved to be a reliable and valid instrument for evaluating the quality of life of adolescents with idiopathic scoliosis and has been translated to different languages. But, lack of a Persian translated version makes its use impractical in the Persian speaking scoliotic patients. METHODS Forward and backward translation of P-BrQ was conducted according to the International Quality of Life Assessment guidelines. The final version of the P-BrQ was administered to 51 adolescents (1 boy and 50 girls) with idiopathic scoliosis. The mean age of the participants was 13.88 ± 2.14 years. The questionnaire's internal consistency was determined using Cronbach's alpha. A subgroup of 38 participants were randomly selected to complete the BrQ for a second time one week later. The test-retest reliability was then analyzed using the intraclass correlation coefficient, while the concurrent validity was assessed by comparing the BrQ with the Scoliosis Research Society-22 questionnaire. RESULTS The total Cronbach's alpha coefficient of the P-BrQ was 0.96, and the overall intraclass correlation coefficient of the questionnaire was also 0.96. The intraclass correlation coefficients for the corresponding domains were as follows: general health perception, 0.96; physical functioning, 0.96; emotional functioning, 0.98; self-esteem, 0.80; vitality, 0.97; school activity, 0.98; pain, 0.97; and social functioning, 0.98. CONCLUSIONS The culturally adapted Persian version of the BrQ can be used to assess the quality of life of adolescents with idiopathic scoliosis who wear a brace. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Sedighe Rezaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran Avenue, Shahnazari St., Madar square, Mirdamad Blvd., Tehran, Iran
| | - Maryam Jalali
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran Avenue, Shahnazari St., Madar square, Mirdamad Blvd., Tehran, Iran.
| | - Taher Babaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran Avenue, Shahnazari St., Madar square, Mirdamad Blvd., Tehran, Iran
| | - Mohammad Kamali
- Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran Avenue, Shahnazari St., Madar square, Mirdamad Blvd., Tehran, Iran
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An Insight Into the Health-Related Quality of Life of Adolescent Idiopathic Scoliosis Patients Who Are Braced, Observed, and Previously Braced. Spine (Phila Pa 1976) 2019; 44:E596-E605. [PMID: 31046000 DOI: 10.1097/brs.0000000000002918] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective cross-sectional study. OBJECTIVE To determine the health-related quality of life (HRQoL) of adolescent idiopathic scoliosis (AIS) patients undergoing bracing, previously braced and observation only. SUMMARY OF BACKGROUND DATA HRQoL is an important treatment outcome measure for AIS. A poor HRQoL may also negatively influence the success of bracing by reducing the likelihood of good brace compliance. Yet, the HRQoL thresholds for patients undergoing observation only, brace treatment or previous brace treatment is not well understood. METHODS Chinese AIS patients with refined Scoliosis Research Society 22-item (SRS-22r) Questionnaire and 5-level EQ-5D (EQ-5D-5L) Questionnaire scores were consecutively recruited for this cross-sectional study. Patients were grouped based on their treatment modality (observation only, bracing, previously braced, and postoperatively). Coronal and sagittal Cobb angles, degree of apical vertebral rotation, and curve type were studied. Spearman correlation test, independent t test, and one-way analysis of variance (ANOVA) with Tukey Post-hoc test were performed for statistical analysis. RESULTS A total of 652 AIS patients with mean age of 14.8 ± 1.9 years and mean Cobb angle of 18.6° ± 10.0° was studied. The respective mean SRS-22r total scores for bracing, observation, and previously braced groups were 4.20, 4.54, and 4.42, and mean EQ-5D-5L scores were 0.87, 0.95, and 0.92. The total and domain scores were correlated with coronal Cobb angles (P < 0.001) while only EQ-5D-5L correlated with sagittal Cobb angles (P < 0.001). Curves greater than 40° had worse HRQoL (P < 0.001). Currently braced patients had significantly worse HRQoL than those under observation, as indicated by lower EQ-5D-5L (0.08) and SRS-22r (0.35) scores (P < 0.001 to P < 0.05). Previously braced patients had better HRQoL than currently braced patients, with 0.05 higher EQ-5D-5L score (P < 0.001), and 0.23 higher SRS-22r score (P < 0.001). However, currently braced patients were more satisfied with treatment (1.94 difference; P < 0.001) than previously braced. There were no gross differences between patients previously braced and undergoing observation only. CONCLUSION The negative impact of bracing on HRQoL is only transient as previously braced patients have superior HRQoL. It appears as though the EQ-5D-5L scores are more sensitive to changes in the sagittal profile as compared with SRS-22r. Our study highlights the differences in HRQoL between patients only being observed, undergoing bracing or previous brace treatment and the importance of monitoring HRQoL throughout follow-up. Further longitudinal studies may help determine the timing and threshold of HRQoL changes during the entire duration of bracing as well as after brace weaning. LEVEL OF EVIDENCE 2.
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Wibmer C, Trotsenko P, Gilg MM, Leithner A, Sperl M, Saraph V. Observational retrospective study on socio-economic and quality of life outcomes in 41 patients with adolescent idiopathic scoliosis 5 years after bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 28:611-618. [PMID: 30145658 DOI: 10.1007/s00586-018-5746-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 08/17/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE We analysed socio-economic- and health-related quality of life (primary outcome) and radiological outcome (secondary outcome) 5 years after full time rigid bracing (FTRB) plus physiotherapeutic scoliosis-specific exercises (PSSE) in adolescent idiopathic scoliosis. METHODS We included 41 patients (38 female and 3 male) treated with FTRB (Chênau brace) and PSSE (Schroth) between 2001 and 2010. The study protocol included a clinical and radiological examination, the completion of the SRS-24 questionnaire and acquisition of data on socio-economic factors (educational and employment status) and physical activity. Descriptive statistics were used to analyse the data; differences between patients with mild (< 30°) and severe curves (30°-50°) regarding hrQoL outcomes were analysed using the Mann-Whitney U Test. RESULTS Primary outcomes showed full employment (higher education, 39%, and full-time work, 61%) and the majority of the patients (79.9%) performing moderate sports two to four times per week. The SRS-24 questionnaire produced a total mean score (MS) of 4.0 (79.9%). Patients with mild curves had a significantly better total score (MS 4.1 vs. MS 3.8, p = 0.020) and were more satisfied with the treatment (MS 4.3 vs MS 3.9, p = 0.020). As to the secondary outcomes, from start of bracing to follow-up (a mean of 6.7 years after brace weaning), the average Cobb angle changed from 28.6° to 25.6° (range 4°-48°); in 51.2% the curve angles could be maintained after weaning. CONCLUSIONS Compared with the literature, our results showed similar curve development and hrQoL (pain, self-image and function) and better results regarding satisfaction with treatment. In comparison with the average population, there were no disadvantages as to occupation, education and sports. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Christine Wibmer
- Department of Orthopedic Surgery and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
| | - Pawel Trotsenko
- Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Magdalena M Gilg
- Department of Orthopedic Surgery and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Andreas Leithner
- Department of Orthopedic Surgery and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Matthias Sperl
- Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Vinay Saraph
- Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
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Gallant JN, Morgan CD, Stoklosa JB, Gannon SR, Shannon CN, Bonfield CM. Psychosocial Difficulties in Adolescent Idiopathic Scoliosis: Body Image, Eating Behaviors, and Mood Disorders. World Neurosurg 2018; 116:421-432.e1. [DOI: 10.1016/j.wneu.2018.05.104] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/20/2022]
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26
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Schwieger T, Campo S, Steuber KR, Weinstein SL, Ashida S. An exploration of information exchange by adolescents and parents participating in adolescent idiopathic scoliosis online support groups. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:22. [PMID: 27547830 PMCID: PMC4982131 DOI: 10.1186/s13013-016-0084-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 08/01/2016] [Indexed: 12/02/2022]
Abstract
Background Research indicates that healthcare providers frequently fail to adequately address patients’ health information needs. Therefore, it is not surprising that patients or parents of a sick child are seeking health information on the internet, in particular in online support groups (OSGs). In order to improve our understanding of the unmet health information needs of families dealing with adolescent idiopathic scoliosis (AIS), this study assessed and compared the types of information that adolescents and parents are seeking in OSGs. Methods This study used two publicly accessible AIS-related OSGs on the National Scoliosis Foundation (NSF) website that targeted those who are receiving brace treatment and those under observation without treatment. Information exchanges were coded as providing or seeking information. Types of information being exchanged were categorized into several AIS-specific and brace-specific categories. Through a review of over 8,000 messages, 305 adolescents with AIS and 300 parents of a child with AIS were identified and categorized based on stage of illness/treatment. One message from each individual was randomly selected and coded for analysis. Results There were significantly more (p < 0.001) parents that had a recently diagnosed child compared to recently diagnosed adolescents participating in the AIS-related OSGs, whereas there were significantly more (p = 0.004) adolescents that experienced brace treatment compared to parents of a child that experienced brace treatment. The most frequent information exchanged by adolescents and parents was AIS-related concerns regarding causes, diagnosis, and progression of the condition. However, compared to adolescents, parents exchanged this AIS-related information significantly more (p < .001) in their posts. Finally, compared to parents, adolescents exchanged significantly more information about appearance-related concerns regarding both AIS-related deformity (p < 0.002) and wearing a brace (p < 0.001). Conclusion Families dealing with AIS are participating in OSGs to exchange information, in particular information related to the condition and to treatment. This study found similarities and differences regarding how information was exchanged (providing or seeking) and regarding frequency and types of information exchanged. Knowledge of these similarities and differences may be useful for improving health communication in the healthcare setting, at home, and for development and improvement of AIS-related website support.
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Affiliation(s)
- Traci Schwieger
- Department of Biostatistics, The University of Iowa, 2400 University Capitol Centre, Iowa City, Iowa 52242 USA
| | - Shelly Campo
- Department of Community and Behavioral Health, The University of Iowa, Iowa City, Iowa 52242 USA
| | - Keli R Steuber
- Department of Communication Studies, The College of New Jersey, Ewing, New Jersey 08628 USA
| | - Stuart L Weinstein
- Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, Iowa 52242 USA
| | - Sato Ashida
- Department of Community and Behavioral Health, The University of Iowa, Iowa City, Iowa 52242 USA
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