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Daniels AH, Balmaceno-Criss M, Criddle SL, Deck A, Daher M, Adashi EY, Diebo BG. Spinal malalignment: the rationale for updated terminology for patients with spinal deformity. Spine J 2024; 24:1267-1271. [PMID: 38432299 DOI: 10.1016/j.spinee.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Alan H Daniels
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA.
| | - Mariah Balmaceno-Criss
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA
| | - Sarah L Criddle
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA
| | - Adrian Deck
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA
| | - Mohammad Daher
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA
| | - Eli Y Adashi
- Department of Medical Science, Brown University, Providence, RI, 029012, USA
| | - Bassel G Diebo
- Department of Orthopedics, The Warren Alpert Medical School at Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA
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Zeck EJ, Glahn Castille ME. Clinician-led mental health conversations significantly associated with outcomes for scoliosis patients. Eur J Phys Rehabil Med 2023; 59:522-528. [PMID: 37746784 PMCID: PMC10548397 DOI: 10.23736/s1973-9087.23.08084-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND The psychological impact of idiopathic scoliosis has been well established in the literature. While the diagnosis of scoliosis is concerning, bracing often compounds patients' stress, and patients have expressed wanting to discuss their feelings with their healthcare providers. Counseling can be an effective coping strategy for adolescents facing chronic illness, but it has not been studied in individuals diagnosed with scoliosis. AIM To assess the frequency and effect of counseling and clinician-led mental health discussions on individuals diagnosed with scoliosis in childhood and adolescence. DESIGN Cross-sectional study. SETTING Community-based research, online. POPULATION Individuals diagnosed with scoliosis in childhood and adolescence. METHODS The online survey included the SRS-22r, the BSSQ-Brace, questions about demographics, mental health, the Scolios-us Mentor Program, and general scoliosis experience. The survey was distributed to Scolios-us Mentor Program participants and to scoliosis clinicians to provide to their patients. Responses about mental health, experiences with healthcare providers, and counseling were analyzed for group differences and associations. RESULTS Fifty-five subjects participated in the study, with a median age of 13 (IQR: 3). Our results indicate that mental health is not being discussed as much as it is desired. A desire to discuss mental health was associated with lower function (P=0.005), mental health (P<0.001), SRS-22r total scores (P=0.002), and BSSQ-Brace scores (P=0.015). Subjects who engaged in a mental health discussion with one or more scoliosis healthcare providers exhibited higher management scores (P=0.002). Only 18.2% of subjects sought counseling, and two-thirds of these subjects found counseling to be very or extremely helpful. CONCLUSIONS Mental health is not discussed by scoliosis providers as often as patients desire it, and a desire to have these conversations is negatively associated with several clinical outcomes. Although clinicians are not regularly talking about mental health, the positive associations of mental health discussions with clinical outcomes are encouraging. CLINICAL REHABILITATION IMPACT The ability to acknowledge the desire to discuss mental health, begin these discussions, and refer patients to a mental health professional may improve patient outcomes.
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Bidari S, Kamyab M, Ganjavian MS, Komeili A. A new scoliosis brace padding method based on trunk asymmetry for scoliosis treatment. Prosthet Orthot Int 2023; 47:416-423. [PMID: 36723400 DOI: 10.1097/pxr.0000000000000210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 11/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pressure pads are used with scoliosis braces to adjust the magnitude and location of corrective forces that mechanically support the torso to correct the spine deformity. In the conventional brace (C.B.) design approaches, the location and shape of pads are determined based on the visual assessment of the clinician. The accuracy of this approach could be improved because it is limited to the clinician's expertise. The present study aimed to develop a new brace (N.B.) padding method based on trunk asymmetry for adolescents with idiopathic scoliosis and compare the efficacy of the developed method with C.B. in improving the Cobb angle and body posture symmetricity. METHODS The trunk surface geometry was scanned using a 3-dimensional scanner. The best plane of symmetry was determined, and the original trunk was reflected in the plane of symmetry, creating the reflected trunk. The difference between the reflected and original trunks was computed and color-coded using deviation contour maps. The boundary of deformed regions, with a minimum of 6-mm deviation contour maps, was identified as the trim lines for brace pads. Eight participants were recruited and divided into conventional and new padding groups. The variation of Cobb angle and torso asymmetry parameters, including the trunk rotation and back surface rotation, as well as the brace satisfaction and trunk appearance perception of the 2 groups, were compared after 3 months of treatment. RESULTS Cobb angle improved equally in the N.B. and C.B. groups. However, back surface rotation improved in the N.B. group (+49.6%) and worsened in the C.B. group (-6.8%). The mean trunk rotation was improved by 30% in the N.B. and further exacerbated by -2.2% in the C.B. group. The brace satisfaction and trunk appearance perception scores were higher in the N.B. than in the C.B. group, however not statistically significant. CONCLUSIONS The present study showed that the proposed brace padding system improved the trunk appearance without negatively affecting the Cobb angle correction.
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Affiliation(s)
- Shahrbanoo Bidari
- Department of Orthotics and Prosthetics, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, California State University Dominguez Hills, Carson, CA, USA
| | - Mohammad Saleh Ganjavian
- Department of Orthopaedic Surgery, Shafa Yahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Komeili
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Alberta, Canada
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Ragborg LC, Dragsted C, Ohrt-Nissen S, Andersen T, Gehrchen M, Dahl B. Health-related quality of life in patients 40 years after diagnosis of an idiopathic scoliosis. Bone Joint J 2023; 105-B:166-171. [PMID: 36722050 DOI: 10.1302/0301-620x.105b2.bjj-2022-0897.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIMS Only a few studies have investigated the long-term health-related quality of life (HRQoL) in patients with an idiopathic scoliosis. The aim of this study was to investigate the overall HRQoL and employment status of patients with an idiopathic scoliosis 40 years after diagnosis, to compare it with that of the normal population, and to identify possible predictors for a better long-term HRQoL. METHODS We reviewed the full medical records and radiological reports of patients referred to our hospital with a scoliosis of childhood between April 1972 and April 1982. Of 129 eligible patients with a juvenile or adolescent idiopathic scoliosis, 91 took part in the study (71%). They were evaluated with full-spine radiographs and HRQoL questionnaires and compared with normative data. We compared the HRQoL between observation (n = 27), bracing (n = 46), and surgical treatment (n = 18), and between thoracic and thoracolumbar/lumbar (TL/L) curves. RESULTS The mean time to follow-up was 40.8 years (SD 2.6) and the mean age of patients was 54.0 years (SD 2.7). Of the 91 patients, 86 were female (95%) and 51 had a main thoracic curve (53%). We found a significantly lower HRQoL measured on all the Scoliosis Research Society 22r instrument (SRS-22r) subdomains (p < 0.001) with the exception of mental health, than in an age-matched normal population. Incapacity to work was more prevalent in scoliosis patients (21%) than in the normal population (11%). The median SRS-22r subscore was 4.0 (interquartile range (IQR) 3.3 to 4.4) for TL/L curves and 4.1 (IQR 3.8 to 4.4) for thoracic curves (p = 0.300). We found a significantly lower self-image score for braced (median 3.6 (IQR 3.0 to 4.0)) and surgically treated patients (median 3.6 (IQR 3.2 to 4.3)) than for those treated by observation (median 4.0 (IQR 4.1 to 4.8); p = 0.010), but no statistically significant differences were found for the remaining subdomains. CONCLUSION In this long-term follow-up study, we found a significantly decreased HRQoL and capacity to work in patients with an idiopathic scoliosis 40 years after diagnosis.Cite this article: Bone Joint J 2023;105-B(2):166-171.
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Affiliation(s)
- Lærke C Ragborg
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Casper Dragsted
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Søren Ohrt-Nissen
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Andersen
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martin Gehrchen
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Benny Dahl
- Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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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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Bernard J, Bishop T, Herzog J, Haleem S, Lupu C, Ajayi B, Lui DF. Dual modality of vertebral body tethering : anterior scoliosis correction versus growth modulation with mean follow-up of five years. Bone Jt Open 2022; 3:123-129. [PMID: 35119295 PMCID: PMC8886322 DOI: 10.1302/2633-1462.32.bjo-2021-0120.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aims Vertebral body tethering (VBT) is a non-fusion technique to correct scoliosis. It allows correction of scoliosis through growth modulation (GM) by tethering the convex side to allow concave unrestricted growth similar to the hemiepiphysiodesis concept. The other modality is anterior scoliosis correction (ASC) where the tether is able to perform most of the correction immediately where limited growth is expected. Methods We conducted a retrospective analysis of clinical and radiological data of 20 patients aged between 9 and 17 years old, (with a 19 female: 1 male ratio) between January 2014 to December 2016 with a mean five-year follow-up (4 to 7). Results There were ten patients in each group with a total of 23 curves operated on. VBT-GM mean age was 12.5 years (9 to 14) with a mean Risser classification of 0.63 (0 to 2) and VBT-ASC was 14.9 years (13 to 17) with a mean Risser classification of 3.66 (3 to 5). Mean preoperative VBT-GM Cobb was 47.4° (40° to 58°) with a Fulcrum unbend of 17.4 (1° to 41°), compared to VBT-ASC 56.5° (40° to 79°) with 30.6 (2° to 69°)unbend. Postoperative VBT-GM was 20.3° and VBT-ASC Cobb angle was 11.2°. The early postoperative correction rate was 54.3% versus 81% whereas Fulcrum Bending Correction Index (FBCI) was 93.1% vs 146.6%. The last Cobb angle on radiograph at mean five years’ follow-up was 19.4° (VBT-GM) and 16.5° (VBT-ASC). Patients with open triradiate cartilage (TRC) had three over-corrections. Overall, 5% of patients required fusion. This one patient alone had a over-correction, a second-stage tether release, and final conversion to fusion. Conclusion We show a high success rate (95%) in helping children avoid fusion at five years post-surgery. VBT is a safe technique for correction of scoliosis in the skeletally immature patient. This is the first report at five years that shows two methods of VBT can be employed depending on the skeletal maturity of the patient: GM and ASC. Cite this article: Bone Jt Open 2022;3(2):123–129.
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Affiliation(s)
- Jason Bernard
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Timothy Bishop
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Jan Herzog
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Shahnawaz Haleem
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Cristina Lupu
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Bisola Ajayi
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
| | - Darren F Lui
- Complex Spinal Division, Neurosciences Atkinson Morley Wing, St. George's Hospital, London, UK
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Dufvenberg M, Diarbakerli E, Charalampidis A, Öberg B, Tropp H, Aspberg Ahl A, Möller H, Gerdhem P, Abbott A. Six-Month Results on Treatment Adherence, Physical Activity, Spinal Appearance, Spinal Deformity, and Quality of Life in an Ongoing Randomised Trial on Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS). J Clin Med 2021; 10:4967. [PMID: 34768487 PMCID: PMC8585057 DOI: 10.3390/jcm10214967] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/23/2022] Open
Abstract
Adolescents with idiopathic scoliosis (AIS) often receive conservative treatments aiming to prevent progression of the spinal deformity during puberty. This study aimed to explore patient adherence and secondary outcomes during the first 6 months in an ongoing randomised controlled trial of three treatment interventions. Interventions consisted of physical activity combined with either hypercorrective Boston brace night shift (NB), scoliosis-specific exercise (SSE), or physical activity alone (PA). Measures at baseline and 6 months included angle of trunk rotation (ATR), Cobb angle, International Physical Activity Questionnaire short form (IPAQ-SF), pictorial Spinal Appearance Questionnaire (pSAQ), Scoliosis Research Society (SRS-22r), EuroQol 5-Dimensions Youth (EQ-5D-Y) and Visual Analogue Scale (EQ-VAS). Patient adherence, motivation, and capability in performing the intervention were reported at 6 months. The study included 135 patients (111 females) with AIS and >1-year estimated remaining growth, mean age 12.7 (1.4) years, and mean Cobb angle 31 (±5.3). At 6 months, the proportion of patients in the groups reporting high to very high adherence ranged between 72 and 95%, while motivation ranged between 65 and 92%, with the highest proportion seen in the NB group (p = 0.014, p= 0.002). IPAQ-SF displayed significant between group main effects regarding moderate activity (F = 5.7; p = 0.004; ηp2 = 0.10), with a medium-sized increase favouring the SSE group compared to NB. Walking showed significant between group main effects, as did metabolic equivalent (MET-min/week), with medium (F = 6.8, p = 0.002; ηp2 = 0.11, and large (F = 8.3, p = < 0.001, ηp2 = 0.14) increases, respectively, for the SSE and PA groups compared to NB. From baseline to 6 months, ATR showed significant between group medium-sized main effects (F = 1.2, p = 0.019, ηp2 = 0.007) favouring the NB group compared to PA, but not reaching a clinically relevant level. In conclusion, patients reported high adherence and motivation to treatment, especially in the NB group. Patients in the SSE and PA groups increased their physical activity levels without other clinically relevant differences between groups in other clinical measures or patient-reported outcomes. The results suggest that the prescribed treatments are viable first-step options during the first 6 months.
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Affiliation(s)
- Marlene Dufvenberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Elias Diarbakerli
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Anastasios Charalampidis
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Birgitta Öberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Hans Tropp
- Department of Biomedical and Clinical Sciences, Linköping University, SE 581 83 Linköping, Sweden;
- Center for Medical Image Science and Visualization, Linköping University, SE 581 83 Linköping, Sweden
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
| | - Anna Aspberg Ahl
- Department of Orthopaedics, Ryhov County Hospital, SE 551 85 Jönköping, Sweden;
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Stockholm Center for Spine Surgery, SE 171 64 Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Allan Abbott
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
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Schroth exercises improve health-related quality of life and radiographic parameters in adolescent idiopathic scoliosis patients. Chin Med J (Engl) 2021; 134:2589-2596. [PMID: 34653079 PMCID: PMC8577664 DOI: 10.1097/cm9.0000000000001799] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3–5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3–5) and moderate scoliosis (Cobb angle 20°–40°). Methods: From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation. Results: In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = −3.918, P = 0.001), and 3.7 ± 0.4 (t = −6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = −2.825, P = 0.088) and mental health domain (t = −3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = −1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group. Conclusions: For AIS patients with a Risser 3–5 and a Cobb angle 20°–40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.
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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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Pehlivanoglu T, Oltulu I, Erdag Y, Korkmaz E, Sarioglu E, Ofluoglu E, Aydogan M. Double-sided vertebral body tethering of double adolescent idiopathic scoliosis curves: radiographic outcomes of the first 13 patients with 2 years of follow-up. 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 2021; 30:1896-1904. [PMID: 33611658 DOI: 10.1007/s00586-021-06745-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE In skeletally immature patients with adolescent idiopathic scoliosis (AIS), vertebral body tethering (VBT) as a fusionless minimally invasive treatment option has been shown to correct the deformity by growth modulation. This prospective cohort study aimed to present the minimum 2 years' results of double-sided VBT applied to double curves of 13 skeletally immature patients with AIS. METHODS Thirteen skeletally immature patients with AIS and double curves were included. All patients were followed up within a brace for at least 6 weeks. A decision to proceed with surgery was established after the detection of curve progression within the brace (> 40° thoracic, > 35° lumbar) with a minimum curve flexibility of 30%. RESULTS Patients had an average age of 11.8 years, average follow-up duration of 36.4 months (range 24 to 46), average preoperative main thoracic/thoracolumbar or lumbar curve magnitudes of 48.2°/45.3°. An average of 11.8 levels of tethering was undertaken. Thoracic screws were placed thoracoscopically, while mini-thoracotomy/lumbotomy was added for thoracolumbar levels. Postoperatively, an average first erect thoracic/thoracolumbar major curve magnitudes of 17.3°/14.3° were acquired, while they improved to 9.7°/8.2° at the last follow-up. No neurologic or implant-related complications were acquired. CONCLUSION Double-sided VBT was detected to provide 80% of thoracic (48.2° to 9.7°) and 82% of thoracolumbar-lumbar curve correction (45.3° to 8.2°) as a result of average two years. As being a growth modulating treatment option, double-sided VBT as applied under strict inclusion criteria was shown to be safe and effective for the correction of double curves in skeletally immature patients with AIS, by yielding a gradual, growth-assisted correction of both curves together with the preservation of coronal-sagittal balance without any major complications.
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Affiliation(s)
- Tuna Pehlivanoglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey. .,Faculty of Health Sciences, Yeni Yüzyıl University, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26, Cevizlibağ, Zeytinburnu, 34010, İstanbul, Turkey.
| | - Ismail Oltulu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Yigit Erdag
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Emre Korkmaz
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Ender Sarioglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Ender Ofluoglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
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11
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Tavakoli M, Hasanpoor-Azghady SB, Farahani LA. Predictors of mothers' postpartum body dissatisfaction based on demographic and fertility factors. BMC Pregnancy Childbirth 2021; 21:8. [PMID: 33402110 PMCID: PMC7784021 DOI: 10.1186/s12884-020-03501-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022] Open
Abstract
Background There are fundamental and rapid changes in body shape during pregnancy, some of which persist for an extended time after delivery and may cause dissatisfaction with body shape. Therefore, we conducted this study to determine predictors of body dissatisfaction at six months postpartum based on demographic and fertility factors. Methods This cross-sectional study was conducted on 300 women who referred to seven health centers affiliated with Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage and we collected data from a demographic and fertility questionnaire and Cooper’s Body Shape Questionnaire (BSQ-34). The independent t-test, Mann-Whitney U test, chi-square test, one-way ANOVA, Kruskal-Wallis, Pearson correlation coefficient, and multiple linear regression were used for data analysis. The level of significance was set at P < 0.05. Results The mean age of participating women was 29.77 (standard deviation: 5.9) years. Body dissatisfaction had a statistically significant association with variables such as body mass index (BMI) at six months postpartum, gestational age, the receipt of information about body shape, spouse’s views on the shape of a woman’s body, and mode of delivery. These variables predicted 34% of body dissatisfaction based on multiple linear regression. Conclusion Postpartum body dissatisfaction is related to a several variables. Paying attention to these variables will help to plan and improve postpartum counseling and educational programs.
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Affiliation(s)
- Mehrri Tavakoli
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran
| | - Seyedeh Batool Hasanpoor-Azghady
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran.
| | - Leila Amiri Farahani
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran
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Yagci G, Karatel M, Yakut Y. Body Awareness and its Relation to Quality of Life in Individuals with Idiopathic Scoliosis. Percept Mot Skills 2020; 127:841-857. [PMID: 32423304 DOI: 10.1177/0031512520924945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An individual's body awareness depends on the integration of bodily signals from both inside and outside the body. The etiology of idiopathic scoliosis includes a variety of somatosensorial and biomechanical alterations that may affect an individual's body awareness. In this study, we investigated body awareness and its relation to quality of life among individuals with idiopathic scoliosis. We studied 96 participants with scoliosis and 71 healthy control participants. We evaluated both participant groups' body awareness using the Awareness-Body-Chart, and we assessed the quality of life of those with scoliosis using the Scoliosis Research Society-22 (SRS-22) questionnaire. The overall body awareness score and the body awareness values for the face, cervical/lumbar region, back, shoulder, upper arm, lower arm/elbow, hand, genital area, thigh/hip, lower leg, and foot were all found to be significantly lower among the participants with scoliosis than among healthy participants. Among participants with scoliosis, the body awareness value for the back region was positively correlated with pain, body image, mental health, and overall quality of life scores on the SRS-22, whereas the pain score on the Awareness-Body-Chart was negatively correlated with the function/activity, pain, mental health, and overall scores for the SRS-22. This study showed that participants with idiopathic scoliosis have poorer body awareness than control participants without scoliosis, and body awareness among participants with scoliosis was correlated with their self-reports of pain, body image, function, and mental health. These findings highlight the particular importance of body awareness to quality of life for individuals with scoliosis.
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Affiliation(s)
- Gozde Yagci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Karatel
- Faculty of Health Sciences, School of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yavuz Yakut
- Faculty of Health Sciences, School of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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13
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Ekşi MŞ, Özcan-Ekşi EE, Huet SE, Dinç T, Özmen BB, Akçal MA. Prevalence of Thoracic Scoliosis in Adolescents in Turkey: Analysis of 1065 Chest Radiographs. World Neurosurg 2020; 135:e527-e540. [DOI: 10.1016/j.wneu.2019.12.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 11/30/2022]
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14
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Larson AN, Baky F, Ashraf A, Baghdadi YM, Treder V, Polly DW, Yaszemski MJ. Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis. Spine Deform 2019; 7:417-427. [PMID: 31053312 DOI: 10.1016/j.jspd.2018.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/28/2018] [Accepted: 09/02/2018] [Indexed: 10/26/2022]
Abstract
STUDY DESIGN Longitudinal cohort. OBJECTIVES To determine the patient-reported functional outcomes and need for related surgical procedures in a US cohort of adolescent idiopathic scoliosis (AIS) patients with minimum 20-year follow-up. SUMMARY OF BACKGROUND DATA There is limited information regarding the long-term outcomes of scoliosis treatment in the US population. METHODS A novel population of patients who underwent pediatric treatment for AIS with minimum 20-year follow-up was identified. Search of a single-center diagnostic registry generated 337 patients who fulfilled the inclusion criteria (AIS, curve magnitude >35°, and childhood treatment with bracing, surgery, or observation from 1975 to 1992). Any additional spine surgery as well as EQ5D, ODI, SRS 22, SAQ were determined. A total of 180 patients were included (mean of 30-year follow-up, range 20-37). Childhood treatment entailed bracing (41 patients), surgery (103 patients), and observation (36 patients). RESULTS During the study period, only 1 of the 41 bracing patients underwent additional scoliosis-related spine surgery, whereas 5 of the 36 patients in the observation cohort underwent scoliosis surgery as adults. Seven of 103 childhood surgical patients required additional revision surgery as adults. Fifteen patients (4 braced, 7 fusion, and 4 observed) underwent chest wall surgery as adults. SRS scores were around 10% worse compared to population-based controls, with the exception of SRS mental health scores, which were similar to controls. Overall, 5.6% of patients were on disability, with no difference between operative and nonoperative groups. CONCLUSION We found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years' follow-up. LEVEL OF EVIDENCE Level III, therapeutic.
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Affiliation(s)
- A Noelle Larson
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
| | - Fady Baky
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Ali Ashraf
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Yaser M Baghdadi
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Vickie Treder
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - David W Polly
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55455, USA
| | - Michael J Yaszemski
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
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Piantoni L, Tello CA, Remondino RG, Bersusky ES, Menéndez C, Ponce C, Quintana S, Hekier F, Francheri Wilson IA, Galaretto E, Noël MA. Quality of life and patient satisfaction in bracing treatment of adolescent idiopathic scoliosis. SCOLIOSIS AND SPINAL DISORDERS 2018; 13:26. [PMID: 30564635 PMCID: PMC6295031 DOI: 10.1186/s13013-018-0172-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/26/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Bracing is used as a valid non-surgical treatment for adolescent idiopathic scoliosis (AIS) to avoid progression of the deformity and thereby surgery. The effect of bracing treatment on quality of life of patients with AIS has been a topic of interest in the international literature. The aim of this study was to evaluate the quality of life and patient satisfaction during bracing treatment for AIS of a pediatric hospital. MATERIAL AND METHOD We assessed a total of 43 non-consecutive female patients (mean age at questionnaire, 13 years and 1 month and 10 years and 8 months to 14 years and 5 months; mean period of usage of brace, 1 year and 7 months), with adolescent idiopathic scoliosis (AIS), older than 10 years of age until skeletal maturity, with a Risser sign less than 3 and scoliosis between 20 and 45°, treated with thoracolumbosacral orthosis (TLSO) for a period longer than 6 months, and without other comorbidities or previous surgeries, were evaluated. The patients were administered a previously validated to Spanish questionnaire on quality of life (Brace Questionnaire (BrQ); Grivas TB et al.). BrQ is a validated tool and is considered a disease-specific instrument; its score ranges from 20 to 100 points, and higher BrQ scores are associated with better quality of life. RESULTS The patients reported using the brace for a mean of 17.6 h daily and for a mean period of 1 year and 7 months at the time of the study. Overall, 72% of the study population reported to be in some way psychologically affected by the brace wearing, 56% felt their basic motor activities were affected, 54% felt socialization with their environment was affected, 46% considered their quality of life deteriorated due to pain, and 40% reported conflicts in the school environment. CONCLUSION Patients with AIS treated with bracing reported a negative impact (53.5% overall) on quality of life and treatment satisfaction in terms of psychological, motor, social, and school environment aspects. An interdisciplinary approach would be important for the integrated psychosocial care of these patients.
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Affiliation(s)
- Lucas Piantoni
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Carlos A. Tello
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Rodrigo G. Remondino
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Ernesto S. Bersusky
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Celica Menéndez
- Departamento de Salud Mental, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Corina Ponce
- Departamento de Salud Mental, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Susana Quintana
- Departamento de Servicio Social, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Felisa Hekier
- Departamento de Servicio Social, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Ida A. Francheri Wilson
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Eduardo Galaretto
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
| | - Mariano A. Noël
- Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881. C1245AAM, CABA, Buenos Aires, Argentina
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Chan CYW, Gani SMA, Lim MY, Chiu CK, Kwan MK. APSS-ASJ Best Clinical Research Award: Is There a Difference between Patients' and Parents' Perception of Physical Appearance in Adolescent Idiopathic Scoliosis? Asian Spine J 2018; 13:216-224. [PMID: 30472823 PMCID: PMC6454293 DOI: 10.31616/asj.2018.0151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/16/2018] [Indexed: 01/22/2023] Open
Abstract
Study Design Prospective study. Purpose To compare patients’ and parents’ perceptions of physical attributes (PAs) of adolescent idiopathic scoliosis (AIS) patients and to report any correlations between their perceptions and Scoliosis Research Society-22r (SRS-22r) scores. Overview of Literature Few studies have looked into the differences between patients’ and parents’ perceptions of their appearance. Methods AIS patient–parent pairs (n=170) were recruited. The patients’ and parents’ perceptions of six PAs were evaluated: waist asymmetry (WA), rib hump (RH), shoulder asymmetry (SA), neck tilt, breast asymmetry (BrA), and chest prominence. These PAs were ranked, and an aggregate PA (Agg-PA) score was derived from a score assigned to the attribute (6 for the most important PA and 1 for the least important). The patients also completed the SRS-22r questionnaire. Results Ninety-nine patients (58.2%) and 71 patients (41.8%) had thoracic and lumbar major curves, respectively. WA was ranked first by 54 patients (31.8%) and 50 parents (29.4%), whereas RH was ranked first by 50 patients (29.4%) and 38 parents (22.4%). The overall Agg-PA scores were similar for patients and parents (p>0.05). However, for thoracic major curves (TMCs) >40°, a significant difference was noted between the Agg-PA scores of patients and parents for SA (3.5±1.6 vs. 4.2±1.6, p=0.041) and BrA (3.0±1.6 vs. 2.2±1.3, p=0.006). For TMCs <40°, a significant difference was found between the Agg-PA scores of patients and parents for WA (3.7±1.6 vs. 4.4±1.5, p=0.050). BrA was negatively correlated with total SRS-22r score. Conclusions There were no significant differences between patients and parents in their ranking of the most important PAs. For TMCs >40°, there were significant differences in the Agg-PA for SA and BrA. Pa¬tients were more concerned about BrA and parents were more concerned about SA. Patients’ perception of the six PAs had weak correlation with SRS-22r scores.
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Affiliation(s)
- Chris Yin Wei Chan
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Mariam Abd Gani
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Min Yuen Lim
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Kidd Chiu
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mun Keong Kwan
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Psychosocial Factors and Surgical Outcomes in Adult Spinal Deformity: Do Dementia Patients Have More Complications? Spine (Phila Pa 1976) 2018; 43:1038-1043. [PMID: 29227363 DOI: 10.1097/brs.0000000000002517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective analysis of a prospectively collected, national inpatient hospital database. OBJECTIVE We aimed to investigate comorbid psychiatric disorders in the adult spinal deformity (ASD) population. We hypothesized that a high incidence of comorbid psychiatric disorders in ASD would negatively impact perioperative outcomes. SUMMARY OF BACKGROUND DATA Patients with adult spinal fusion (ASF) suffer from severe back pain and often depression. Psychiatric comorbidities in the ASD population are not well understood, despite the apparent psychological effects of spinal deformity-related self-image. METHODS The Nationwide Inpatient Sample databases from 2001 to 2009 were queried for patients ages 18 years or older with in-hospital stays including a spine arthrodesis. Patients were divided into two groups: ASD (diagnosis of scoliosis, excluding neuromuscular and congenital) and all other ASF. Subjects were further stratified by presence of a comorbid psychiatric diagnosis. Differences between each surgical group in psychiatric frequency and complications were calculated using analysis of variance, adjusted for operative complexity. A binary logistic regression analyzed the association between psychiatric diagnoses and likelihood of complications. RESULTS A total of 3,366,352 ASF and 219,975 ASD patients were identified. The rate of comorbid psychiatric diagnoses in ASD was significantly higher (23.5%) compared to ASF patients (19.4%, P < 0.001). Complication rates were higher for ASD compared to ASF; patients without a psychiatric diagnosis had lower (or comparable) complication rates than psychiatric patients, across all disorder categories. Patients with psychotic disorders and dementia showed more complications than controls; patients with mood, anxiety and alcohol disorders showed fewer. CONCLUSION Psychiatric comorbidities are more common in the ASD population than in adult fusion patients. ASD and ASF patients with the most common psychiatric disorders (mood, anxiety, and alcohol abuse) are not at increased risk for complications compared to controls. Those patients with psychotic disorders and dementia are at a significant risk for increased complications and surgeons should be aware of these specific risks. LEVEL OF EVIDENCE 2.
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18
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Lee JS, Shin JK, Goh TS. Correlation between body image perception and spinopelvic parameters in ankylosing spondylitis. Br J Neurosurg 2018; 32:469-473. [DOI: 10.1080/02688697.2018.1490946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Jung Sub Lee
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jong Ki Shin
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea
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Kontodimopoulos N, Damianou K, Stamatopoulou E, Kalampokis A, Loukos I. Children's and parents' perspectives of health-related quality of life in newly diagnosed adolescent idiopathic scoliosis. J Orthop 2018; 15:319-323. [PMID: 29556117 PMCID: PMC5856671 DOI: 10.1016/j.jor.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/25/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022] Open
Abstract
The aim of this study is to compare child and parent perceptions of health-related quality of life in Adolescent Idiopathic Scoliosis. The scoliosis-specific SRS-22 and the generic KIDSCREEN-52 were administered to newly diagnosed patients and the latter also to a parent. Strong correlations (r > 0.5, p < 0.001) were revealed between conceptually similar dimensions of the instruments. Parents' assessments of their child's HRQoL were generally higher than the children/adolescents; however score differences were small and insignificant. The significance of parents' perceptions was also confirmed with OLS regressions. In conclusion, HRQoL is thoroughly investigated when both generic and disease-specific instruments are used.
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Affiliation(s)
- Nick Kontodimopoulos
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
- “KAT” General Hospital, Nikis 2, Kifisia, 14561, Athens, Greece
| | - Konstantia Damianou
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
| | | | | | - Ioannis Loukos
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
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Paolucci T, Piccinini G, Iosa M, Piermattei C, De Angelis S, Zangrando F, Saraceni VM. The importance of trunk perception during brace treatment in moderate juvenile idiopathic scoliosis: What is the impact on self-image? J Back Musculoskelet Rehabil 2017; 30:203-210. [PMID: 27392847 DOI: 10.3233/bmr-160733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The perception of body image and the deformity of the trunk in patients with adolescent idiopathic scoliosis (AIS) are a silver lining that has yet to be discussed in the relevant literature during brace rehabilitation treatment. OBJECTIVE To determine whether and how the use of the brace changes perception of the trunk in patients with AIS by the drawing test. METHODS We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects). Trunk perception and quality of life were evaluated using the Trunk Appearance Perception Scale and Scoliosis Research Society-22 questionnaire, and the perception of one's back was measured by the drawing test. RESULTS Pain was lower in BG versus CG (p= 0.095). Satisfaction with the treatment was higher in BG than in CG (p= 0.002). Self-image did not differ significantly between the groups in terms of TAPS. Drawings of the most severe cases of scoliosis were made by the group without the brace. CONCLUSIONS The use of the brace corrects the function of the trunk and has a positive influence on its perception.
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Affiliation(s)
- Teresa Paolucci
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Giulia Piccinini
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Santa Lucia Foundation, Rome, Italy
| | - Cristina Piermattei
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Simona De Angelis
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Federico Zangrando
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Vincenzo Maria Saraceni
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
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Motivations for Compliance With Bracing in Adolescent Idiopathic Scoliosis. Spine Deform 2017; 5:46-51. [PMID: 28038693 DOI: 10.1016/j.jspd.2016.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/20/2016] [Accepted: 09/13/2016] [Indexed: 11/24/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE To determine motivations for compliance with bracing among female patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA Bracing prevents the need for surgery for the majority of girls with AIS with curves of 20° to 40° and 2 or more years of growth remaining. The main obstacle to success is compliance. The factors that either promote or impede compliance previously have not been fully clarified. METHODS Participants were females 10 to 16 years of age who were prescribed a brace to be worn 16 hours per day for AIS. Each completed a "Scoliosis Compliance Questionnaire" composed of the SRS-22r and five original sections focused on patients' attitudes to scoliosis, situations in which they found wearing the brace to be most and least difficult, factors that motivate brace wear, and interventions that could potentially improve compliance. RESULTS Thirty-nine subjects completed the study, mean age 13 years (range 11-15 years), at a mean of 15.4 months (range 4-39 months) of brace wear at the time of recruitment. More than 90% of patients stated that their main motivations for compliance were the desire to avoid surgery and to prevent curve progression. Compliance was most challenging during the summer and while at school. Many patients reported pain and skin irritation in the brace. The majority reported they would likely improve their hours of wear if they were able to communicate with a peer in the same situation. SRS-22r scores were similar to those of healthy adolescents. CONCLUSIONS The most important influences promoting brace wear are the patient's desire to avoid surgery and to prevent curve progression. Peer support potentially may improve compliance. LEVEL OF EVIDENCE Level III.
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Ko EJ, Sung IY, Yun GJ, Kang JA, Kim J, Kim GE. Effects of lateral electrical surface stimulation on scoliosis in children with severe cerebral palsy: a pilot study. Disabil Rehabil 2016; 40:192-198. [DOI: 10.1080/09638288.2016.1250120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eun Jae Ko
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In Young Sung
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Gi Jeong Yun
- Department of Rehabilitation Medicine, Chunghae Geriatric Hospital, Kyungju, Republic of Korea
| | - Jung-A Kang
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JaYoung Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Go Eun Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Cheung PWH, Wong CKH, Samartzis D, Luk KDK, Lam CLK, Cheung KMC, Cheung JPY. Psychometric validation of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) in Chinese patients with adolescent idiopathic scoliosis. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:19. [PMID: 27525314 PMCID: PMC4973368 DOI: 10.1186/s13013-016-0083-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/21/2016] [Indexed: 01/08/2023]
Abstract
Background Scoliosis is a common spinal deformity that occurs often during adolescence. Previous studies suggested that adolescent idiopathic scoliosis (AIS) patients can have various aspects of their lives being affected, due to disease presentation and/or treatment received. It is important to define a reliable instrument based on which the affected patients’ health-related quality of life can be assessed. This study aims to assess the validity, reliability and sensitivity of the EuroQoL 5-dimension 5-level (EQ-5D-5L) in Chinese patients with AIS. Methods Adolescent idiopathic scoliosis patients of Chinese descent were prospectively recruited to complete both the traditional Chinese versions of the EQ-5D-5L and the refined Scoliosis Research Society-22 (SRS-22r) questionnaires. Patients’ demographic profiles and corresponding clinical parameters including treatment modalities, spinal curve pattern and magnitude, and duration of bracing were recorded. Telephone interviews were then conducted at least two weeks later for the assessment of test-retest reliability. Statistical analysis was performed: construct validity of the EQ-5D-5L domains were assessed using Spearman’s correlation test against the SRS-22r; whereas intra-class correlation coefficient (ICC) was used to assess the test-retest reliability, and agreement over the test-retest period was expressed in percentages. Also, the sensitivity of the EQ-5D-5L in differentiating various clinical known groups was determined by effect size, independent t-test and analysis of variance. Results A total of 227 AIS patients were recruited. Scores of domains of the EQ-5D-5L correlated significantly (r: 0.57-0.74) with the scores of the SRS-22r domains that were intended to measure similar constructs, supporting construct validity. The EQ-5D-5L domain responses and utility scores showed good test-retest reliability (ICC: 0.777; agreement: 76.4 -98.1 %). Internal consistency was good (Cronbach’s α: 0.78) for the EQ-5D-5L utility score. The EQ-5D-5L utility score was sensitive in detecting differences between subjects who had different treatment modalities and bracing duration, but not for curve pattern and its magnitude. Conclusions The EQ-5D-5L is found to be a valid, reliable and sensitive measure to assess the health-related quality of life in Chinese AIS patients. This potentiates the possibility of utilizing the EQ-5D-5L to estimate AIS patients’ health-related quality of life, based on which the outcome of various treatment options can eventually be evaluated. Electronic supplementary material The online version of this article (doi:10.1186/s13013-016-0083-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prudence Wing Hang Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F, Professorial Block, Pokfulam, Hong Kong, SAR China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, SAR China
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F, Professorial Block, Pokfulam, Hong Kong, SAR China
| | - Keith Dip Kei Luk
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F, Professorial Block, Pokfulam, Hong Kong, SAR China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, SAR China
| | - Kenneth Man Chee Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F, Professorial Block, Pokfulam, Hong Kong, SAR China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F, Professorial Block, Pokfulam, Hong Kong, SAR China
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Lee H, Choi J, Hwang JH, Park JH. Health-related quality of life of adolescents conservatively treated for idiopathic scoliosis in Korea: a cross-sectional study. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:11. [PMID: 27299160 PMCID: PMC4900241 DOI: 10.1186/s13013-016-0071-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/18/2016] [Indexed: 11/25/2022]
Abstract
Background Young adolescents with scoliosis are more likely than adults to experience psychological distress affecting health-related quality of life (HRQoL). Adolescence is a sensitive period of psychological development, and thus physical deformity from scoliosis can negatively affect body image and appearance of adolescents. The present study evaluated HRQoL in young Korean adolescents with idiopathic scoliosis and identified related factors. Methods One hundred and ten adolescents with idiopathic scoliosis were recruited from two tertiary hospital outpatient clinics over one year. HRQoL was measured using the Korean version of the Scoliosis Research Society 22 revision (SRS-22r) questionnaire. In addition, participant medical records were reviewed to collect data on severity of scoliosis, type of treatment and age at which they were first diagnosed with the disease. Results The mean age of the participants was 14.2 years and 48.2 % were first diagnosed at 9–12 years. Most participants (61.8 %) were under observation to follow up the curvature progression and 20.9 % received regular physiotherapy. Almost half the participants (47.3 %) had mild (10°–25°), 41.8 % moderate (25°–40°), and 10.9 % severe (>40°) scoliosis. The total score of the SRS-22r differed significantly between the groups of age at diagnosis (p = 0.033) and type of treatment (p = 0.025). Self-image, a sub-domain of the SRS 22r, was significantly lower in the severe curve deformity group than in the other groups (p = 0.031). Conclusions An earlier age of scoliosis diagnosis and conservative treatment were related to higher HRQoL scores of Korean adolescents with scoliosis. Although the overall HRQoL did not significantly differ by severity of disease, self-image was significantly decreased in adolescents with severe spinal deformity. HRQoL of adolescent patients with idiopathic scoliosis can be affected by several factors that medical staff needs to consider in order to produce the best and most effective treatment outcomes.
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Affiliation(s)
- Hyejung Lee
- College of Nursing, Yonsei University, 250 Seongsan-ro, Seodaemun-gu, 03722 Seoul Korea
| | - Jihea Choi
- Department of Nursing, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, 26426 Gangwon-do Korea
| | - Jin-Ho Hwang
- Department of Orthopaedic Surgery, Severance Children's Hospital, Division of Pediatric Orthopedics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, 06273 Seoul Korea
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Abstract
STUDY DESIGN The Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) included skeletally immature high-risk patients with adolescent idiopathic scoliosis (AIS) with moderate curve sizes (20°- 40°). BrAIST was a multicenter, controlled trial using both randomized and preference treatment arms into either an observation group or a brace treatment group. OBJECTIVE The aim of this study was to analyze and compare body image and quality-of-life (QOL) in female AIS patients who were observed or treated with a brace. SUMMARY OF BACKGROUND DATA Brace treatment is an effective means for controlling progressive scoliosis and preventing the need for surgery, but there is no consensus regarding the effect of brace treatment on body image or on QOL in adolescents with AIS. METHODS Data from female BrAIST patients in the randomized (n = 132) or preference (n = 187) arms and were observed (n = 120) or brace treated (n = 199) were analyzed. Patients completed the Spinal Appearance Questionnaire (SAQ) and the Pediatric Quality of Life Inventory (PedsQOL) 4.0 Generic Scales at baseline and 6 month follow-up visits up to 2 years. Items on the SAQ measured three body image constructs (self, ideal, and overall). The PedsQOL measured health, activities, feelings, social factors, and school. RESULTS . In general, there were no significant differences within or between study arms or treatments regarding body image or QOL through 2 years of follow-up. Poorer body image was significantly correlated with poorer QOL during the first 2 years of follow-up regardless of study arm or treatment. Patients who crossed-over to a different treatment and patients with largest Cobb angles ≥ 40 degrees had significantly poorer body image, in particular self-body image, compared with those that did not. CONCLUSION This study does not support findings from previous research indicating that wearing a brace has a negative impact on or is negatively impacted by body image or QOL. LEVEL OF EVIDENCE 2.
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Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:438452. [PMID: 26618169 PMCID: PMC4649085 DOI: 10.1155/2015/438452] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 09/23/2015] [Accepted: 10/12/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE We report a comparison study of vertebral body stapling (VBS) versus a matched bracing cohort for immature patients with moderate (25 to 44°) idiopathic scoliosis (IS). METHODS 42 of 49 consecutive patients (86%) with IS were treated with VBS and followed for a minimum of 2 years. They were compared to 121 braced patients meeting identical inclusion criteria. 52 patients (66 curves) were matched according to age at start of treatment (10.6 years versus 11.1 years, resp. [P = 0.07]) and gender. RESULTS For thoracic curves 25-34°, VBS had a success rate (defined as curve progression <10°) of 81% versus 61% for bracing (P = 0.16). In thoracic curves 35-44°, VBS and bracing both had a poor success rate. For lumbar curves, success rates were similar in both groups for curves measuring 25-34°. CONCLUSION In this comparison of two cohorts of patients with high-risk (Risser 0-1) moderate IS (25-44°), in smaller thoracic curves (25-34°) VBS provided better results as a clinical trend as compared to bracing. VBS was found not to be effective for thoracic curves ≥35°. For lumbar curves measuring 25-34°, results appear to be similar for both VBS and bracing, at 80% success.
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Bissolotti L, Isacco-Grassi F, Orizio C, Gobbo M, Berjano P, Villafañe JH, Negrini S. Spinopelvic balance and body image perception in Parkinson's disease: analysis of correlation. 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 2015; 24 Suppl 7:898-905. [PMID: 26441255 DOI: 10.1007/s00586-015-4265-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/27/2015] [Accepted: 09/27/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to describe the association between body image perception and sagittal balance (SB) parameters in Parkinson's Disease (PD) patients. METHODS 77 consecutive PD patients were included: 44 males, 33 females; 68.9 ± 6.8 years; 5.3 ± 3.8 years from diagnosis (YFD); Hoehn Yahr (HY) 2.0 ± 0.8, Unified Parkinson's Disease rating Score-Motor section (UPDRS-M) 11.8 ± 9.3. Spinopelvic angles and SB were radiographically assessed. Body image perception was assessed through Trunk appearance scale (TAPS) and Stunkard Figure rating scale for BMI. Beck Depression Inventory (BDI) was used to evaluate depressive mood. RESULTS We detected 32 (41.5 % of cohort) Parkinson Disease patients with scoliosis ≥15° Cobb. The mean calculated BMI was 27.1 ± 3.9 kg/m(2). According to the Figure Rating Scale, the perceived BMI averaged 27.2 ± 4.5 kg/m(2), while the mean desired BMI was 24.4 ± 2.7 kg/m(2), TAPS scored 3.4 ± 0.9 points, while BDI 12.3 ± 7.9 points. TAPS had a weak negative correlation with the duration of disease (r = -0.25, p < 0.05) and a correlation with H&Y score (r = 0.28, p < 0.05). Sacral Slope was weakly correlated to the calculated BMI (r = -0.24, p < 0.05). SSA and SPA had a negative correlation with the TAPS mean score (respectively, r = -0.36 and -0.24, p < 0.05). BDI presented a weak correlation with TAPS (r = 0.27, p < 0.05) but not with self esteemed BMI values (p > 0.05). CONCLUSIONS Spinopelvic parameters and depression had a specific and concurrent influence on trunk deformity perception but not on BMI self-esteem.
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Affiliation(s)
- Luciano Bissolotti
- Casa di Cura Domus Salutis, Brescia, Italy. .,LARIN: Neuromuscular and Adapted Physical Activity Laboratory, Brescia, Italy.
| | | | - Claudio Orizio
- LARIN: Neuromuscular and Adapted Physical Activity Laboratory, Brescia, Italy. .,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Massimiliano Gobbo
- LARIN: Neuromuscular and Adapted Physical Activity Laboratory, Brescia, Italy. .,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | | | | | - Stefano Negrini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. .,IRCCS Don Gnocchi Foundation, Milan, Italy.
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Hui W, Jinyuan X, Zhong J, Shuliang Y, Hongquan S, Xitao N, Huanmin H, Wei C, Jianwei P, Nengyi J, Shao C, Honggen D. Effect of a Traditional Chinese Medicine combined therapy on adolescent idiopathic scoliosis: a randomized controlled trial. J TRADIT CHIN MED 2015; 35:514-9. [DOI: 10.1016/s0254-6272(15)30133-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schreiber S, Parent EC, Moez EK, Hedden DM, Hill D, Moreau MJ, Lou E, Watkins EM, Southon SC. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". SCOLIOSIS 2015; 10:24. [PMID: 26413145 PMCID: PMC4582716 DOI: 10.1186/s13013-015-0048-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/28/2015] [Indexed: 11/10/2022]
Abstract
Background In North America, care recommendations for adolescents with small idiopathic scoliosis (AIS) curves include observation or bracing. Schroth scoliosis-specific exercises have demonstrated promising results on various outcomes in uncontrolled studies. This randomized controlled trial (RCT) aimed to determine the effect of Schroth exercises combined with the standard of care on quality-of-life (QOL) outcomes and back muscle endurance (BME) compared to standard of care alone in patients with AIS. Material and Methods Fifty patients with AIS, aged 10–18 years, with curves 10–45 °, recruited from a scoliosis clinic were randomized to receive standard of care or supervised Schroth exercises plus standard of care for 6 months. Schroth exercises were taught over five sessions in the first two weeks. A daily home program was adjusted during weekly supervised sessions. The assessor and the statistician were blinded. Outcomes included the Biering-Sorensen (BME) test, Scoliosis Research Society (SRS-22r) and Spinal Appearance Questionnaires (SAQ) scores. Intention-to-treat (ITT) and per protocol (PP) linear mixed effects models were analyzed. Because ITT and PP analyses produced similar results, only ITT is reported. Results After 3 months, BME in the Schroth group improved by 32.3 s, and in the control by 4.8 s. This 27.5 s difference in change between groups was statically significant (95 % CI 1.1 to 53.8 s, p = 0.04). From 3 to 6 months, the self-image improved in the Schroth group by 0.13 and deteriorated in the control by 0.17 (0.3, 95 % CI 0.01 to 0.59, p = 0.049). A difference between groups for the change in the SRS-22r pain score transformed to its power of four was observed from 3 to 6 months (85.3, 95 % CI 8.1 to 162.5, p = 0.03), where (SRS-22 pain score)4 increased by 65.3 in the Schroth and decreased by 20.0 in the control group. Covariates: age, self-efficacy, brace-wear, Schroth classification, and height had significant main effects on some outcomes. Baseline ceiling effects were high: SRS-22r (pain = 18.4 %, function = 28.6 %), and SAQ (prominence = 26.5 %, waist = 29.2 %, chest = 46.9 %, trunk shift = 12.2 % and shoulders = 18.4 %). Conclusions Supervised Schroth exercises provided added benefit to the standard of care by improving SRS-22r pain, self-image scores and BME. Given the high prevalence of ceiling effects on SRS-22r and SAQ questionnaires’ domains, we hypothesize that in the AIS population receiving conservative treatments, different QOL questionnaires with adequate responsiveness are needed. Trial registration Schroth Exercise Trial for Scoliosis NCT01610908. Electronic supplementary material The online version of this article (doi:10.1186/s13013-015-0048-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Douglas M Hedden
- University of Alberta, Alberta Health Services, Edmonton, Canada
| | - Doug Hill
- University of Alberta, Alberta Health Services, Edmonton, Canada
| | - Marc J Moreau
- University of Alberta, Alberta Health Services, Edmonton, Canada
| | - Edmond Lou
- University of Alberta, Alberta Health Services, Edmonton, Canada
| | - Elise M Watkins
- University of Alberta, Alberta Health Services, Edmonton, Canada
| | - Sarah C Southon
- University of Alberta, Alberta Health Services, Edmonton, Canada
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The Level of Self-Esteem and Sexual Functioning in Women with Idiopathic Scoliosis: A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9444-53. [PMID: 26274967 PMCID: PMC4555290 DOI: 10.3390/ijerph120809444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/31/2015] [Accepted: 08/04/2015] [Indexed: 11/18/2022]
Abstract
A person’s image, which is determined through physical appearance, considerably affects self-esteem developed from early childhood. Scoliosis causes multiple trunk deformations that can affect a person’s perception of the body. The aim of the study was to analyze the impact of scoliosis dimension and the degree of trunk deformation on the level of self-esteem and sexual functioning in women with idiopathic scoliosis. Thirty-six women diagnosed with idiopathic scoliosis were recruited to a prospective, double-blind, randomized controlled trial. The subjects were divided into two groups depending on the value of the Cobb angle. The level of self-esteem was determined by means of the Rosenberg Self-Esteem Scale (SES), whereas the sexual functioning was assessed via the Female Sexual Function Index (FSFI). The trunk deformations were specified with the Posterior Trunk Symmetry Index (POTSI). A statistically significant correlation was proved between the amount of points received in the Rosenberg scale evaluation and the POTSI index in Group A (R = −0.56, p = 0.04). Subjects with smaller deformations within the coronal plane had a higher level of self-confidence. The trunk asymmetries in the coronal plane may have a negative effect on women with scoliosis and their self-appraisal.
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Xu X, Wang F, Yang M, Huang Q, Chang Y, Wei X, Bai Y, Li M. Chinese Adaptation of the Bad Sobernheim Stress Questionnaire for Patients With Adolescent Idiopathic Scoliosis Under Brace Treatment. Medicine (Baltimore) 2015; 94:e1236. [PMID: 26252283 PMCID: PMC4616594 DOI: 10.1097/md.0000000000001236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity and BSSQ-Brace are the most widely used instruments for evaluating stress levels in adolescent idiopathic scoliosis (AIS) patients under brace treatment, and good reliability and validity have been demonstrated across different cultures. Great stress has been found among many adolescents, becoming a major concern for professionals. However, no previous research has addressed the cultural adaptations and psychometric testing of BSSQ-Deformity and BSSQ-Brace in China or the stress levels in AIS patients. The purposes of our study were to evaluate the cross-cultural adaptation and validation of the BSSQ-Deformity and BSSQ-Brace and to investigate stress levels in Chinese (AIS) patients under brace treatment.The original (German) versions of BSSQ-Deformity and BSSQ-Brace were cross-culturally translated according to international guidelines. Psychometric properties such as reliability and construct validity were tested. Eighty-six AIS patients were included in our study, and 50 patients paid a second visit 3 to 7 days later to test reproducibility. Cronbach α and the intraclass coefficient were determined to assess internal consistency and reproducibility. Scoliosis Research Society patient questionnaire-22 (SRS-22) was applied to evaluate construct validity.The mean BSSQ-Deformity and BSSQ-Brace scores were 15.3 and 13.4 points, respectively. Severe stress was observed in 12% of patients due to brace treatment. Item analysis demonstrated that each item was scored under a normal distribution with no redundancy. Psychometric analysis revealed excellent internal consistency (Cronbach α = 0.85 and 0.80, respectively) and reproducibility (intraclass correlation coefficient = 0.85 and 0.90, respectively) for BSSQ-Deformity and BSSQ-Brace. The correlation coefficients of BSSQ-Deformity, BSSQ-Brace and SRS-22 were 0.48 and 0.63, respectively.In conclusion, BSSQ-Deformity and BSSQ-Brace have been successfully adapted to a Chinese background and psychometrically validated with excellent reliability and construct validity. Brace wearing is considered the main cause of stress in AIS patients under brace treatment.
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Affiliation(s)
- Ximing Xu
- From the Department of Orthopedics (XX, FW, MY, YC, XW, YB, ML), Changhai Hospital, Second Military Medical University; and Department of Orthopedics (QH), Shanghai Pudong Hospital, Shanghai, People's Republic of China
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Negrini S, Minozzi S, Bettany‐Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2015; 2015:CD006850. [PMID: 26086959 PMCID: PMC10616811 DOI: 10.1002/14651858.cd006850.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. While adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. OBJECTIVES To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, and psychological and cosmetic issues. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015 for relevant clinical trials. We also checked the reference lists of relevant articles and conducted an extensive handsearch of grey literature. SELECTION CRITERIA Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included seven studies (662 participants). Five were planned as RCTs and two as prospective controlled trials. One RCT failed completely, another was continued as an observational study, reporting also the results of the participants that had been randomized.There was very low quality evidence from one small RCT (111 participants) that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation (mean difference (MD) -2.10, 95% confidence interval (CI) -7.69 to 3.49). There was very low quality evidence from a subgroup of 77 adolescents from one prospective cohort study showing that QoL, back pain, psychological, and cosmetic issues did not differ significantly between rigid bracing and observation in the long term (16 years).Results of the secondary outcomes showed that there was low quality evidence that rigid bracing compared with observation significantly increased the success rate in 20° to 40° curves at two years' follow-up (one RCT, 116 participants; risk ratio (RR) 1.79, 95% CI 1.29 to 2.50). There was low quality evidence that elastic bracing increased the success rate in 15° to 30° curves at three years' follow-up (one RCT, 47 participants; RR 1.88, 95% CI 1.11 to 3.20).There is very low quality evidence from two prospective cohort studies with a control group that rigid bracing increases the success rate (curves not evolving to 50° or above) at two years' follow-up (one study, 242 participants; RR 1.50, 95% CI 1.19 to 1.89) and at three years' follow-up (one study, 240 participants; RR 1.75, 95% CI 1.42 to 2.16). There was very low quality evidence from a prospective cohort study (57 participants) that very rigid bracing increased the success rate (no progression of 5° or more, fusion, or waiting list for fusion) in adolescents with high degree curves (above 45°) (one study, 57 adolescents; RR 1.79, 95% CI 1.04 to 3.07 in the intention-to-treat (ITT) analysis).There was low quality evidence from one RCT that a rigid brace was more successful than an elastic brace at curbing curve progression when measured in Cobb degrees in low degree curves (20° to 30°), with no significant differences between the two groups in the subjective perception of daily difficulties associated with wearing the brace (43 girls; risk of success at four years' follow-up: RR 1.40, 1.03 to 1.89). Finally, there was very low quality evidence from one RCT (12 participants) that a rigid brace with a pad pressure control system is no better than a standard brace in reducing the risk of progression.Only one prospective cohort study (236 participants) assessed adverse events: neither the percentage of adolescents with any adverse event (RR 1.27, 95% CI 0.96 to 1.67) nor the percentage of adolescents reporting back pain, the most common adverse event, were different between the groups (RR 0.72, 95% CI 0.47 to 1.10). AUTHORS' CONCLUSIONS Due to the important clinical differences among the studies, it was not possible to perform a meta-analysis. Two studies showed that bracing did not change QoL during treatment (low quality), and QoL, back pain, and psychological and cosmetic issues in the long term (16 years) (very low quality). All included papers consistently showed that bracing prevented curve progression (secondary outcome). However, due to the strength of evidence (from low to very low quality), further research is very likely to have an impact on our confidence in the estimate of effect. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. This challenge may prevent us from seeing increases in the quality of the evidence over time. Other designs need to be implemented and included in future reviews, including 'expertise-based' trials, prospective controlled cohort studies, prospective studies conducted according to pre-defined criteria such as the Scoliosis Research Society (SRS) and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria. Future studies should increase their focus on participant outcomes, adverse effects, methods to increase compliance, and usefulness of physiotherapeutic scoliosis specific exercises added to bracing.
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Affiliation(s)
- Stefano Negrini
- University of Brescia ‐ IRCCS Fondazione Don Gnocchi MilanPhysical and Rehabilitation MedicineViale EuropaBresciaItaly25121
| | - Silvia Minozzi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Josette Bettany‐Saltikov
- University of TeessideSchool of Health and Social CareVictoria RoadMiddlesbroughClevelandUKTS13BA
| | | | - Theodoros B. Grivas
- "Tzanio" General Hospital of PiraeusDepartment of Trauma and OrthopaedicsPiraeusAtticaGreece18536
| | - Tomasz Kotwicki
- University of Medical SciencesDepartment of Pediatric Orthopedics and Traumatologyul. 28 Czerwca 1956 nr 135PoznanPoland61‐545
| | - Toru Maruyama
- Saitama Medical UniversityDepartment of Orthopaedic Surgery1981 KamodaKawagoeSaitamaJapan350‐8550
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
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Pre- and postoperative photographs and surgical outcomes in patients with Lenke type 1 adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2015; 40:469-74. [PMID: 25608247 DOI: 10.1097/brs.0000000000000796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Clinical study with pre- and postoperative back photographs and postoperative Scoliosis Research Society-22 survey in patients who had undergone surgery for idiopathic scoliosis. OBJECTIVE To determine the effect of showing patients their photographs before and after surgery for idiopathic scoliosis on postoperative patient satisfaction. SUMMARY OF BACKGROUND DATA After scoliosis surgery, patient satisfaction may be limited because the patients cannot directly see their back and may forget the preoperative appearance. METHODS In 60 patients who had undergone surgery for correction of idiopathic scoliosis (Lenke type 1), pre- and postoperative photographs were taken from the anterior, posterior, and right and left lateral views. After surgery, patients in group 1 (30 patients) were shown the preoperative and most recent follow-up photographs, and patients in group 2 (30 patients) had routine evaluation but were not shown their photographs. All patients completed the Scoliosis Research Society-22 survey. RESULTS Patients in both groups had similar age, sex, distribution of Lenke type and Risser sign, follow-up, and pre- and postoperative Cobb angles and balance (coronal and sagittal). A significant difference was observed between the groups for survey question 10 (which was about self-image), question 18 (which was about function and activity), and question 21 (which was about satisfaction) (P ≤ 0.05). There were no differences between patients in groups 1 and 2 in Scoliosis Research Society-22 domain or total scores. CONCLUSION By showing patients the pre- and postoperative clinical photographs, patient satisfaction may be greater, as measured with some SRS-22 scores. This method may enable clinicians to positively change the patients' self-image perception after surgery for correction of scoliosis. LEVEL OF EVIDENCE 4.
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Carrasco MIB, Ruiz MCS. [Perceived self-image in adolescent idiopathic scoliosis: an integrative review of the literature]. Rev Esc Enferm USP 2015; 48:748-58. [PMID: 25338258 DOI: 10.1590/s0080-623420140000400024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/21/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To learn about the experiences of adolescents diagnosed with idiopathic scoliosis. METHOD Integrative review of the literature published within a specified time frame. RESULTS For both sexes, the predominant clinical symptom of this condition appears to be the negative effect that the deformity exerts on perceived self-image. Quantitative studies used numerical scores to assess perceptions of body image but did not analyse emotional aspects. Patients treated surgically were found to have a better self-image than patients treated with a brace. Quality of life was improved by a reduction in the magnitude of the curve. CONCLUSION Spinal deformity exerts a psychological effect on adolescent girls.
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Does scoliosis-specific exercise treatment in adolescence alter adult quality of life? ScientificWorldJournal 2014; 2014:539671. [PMID: 25436225 PMCID: PMC4243472 DOI: 10.1155/2014/539671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/22/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Health-related quality of life in adults, who in adolescence participated in a scoliosis-specific exercise program, was not previously studied. Design. Cross-sectional study, with retrospective data collection. MATERIAL AND METHODS Homogenous groups of 68 persons (43 women) aged 30.10 (25-39) years, with mild or moderate scoliosis, and 76 (38 women) able-bodied persons, aged 30.11 (24-38) years, who 16.5 (12-26) years earlier had completed scoliosis-specific exercise or observation regimes, participated. Their respiratory characteristics did not differ from predicted values. The WHOQOL-BREF questionnaire, Oswestry Disability Questionnaire, and pain scale (VAS) were applied. RESULTS The transformed WHOQOL-BREF scores ranged from 54.6 ± 11.19 in the physical domain in the mild scoliotic subgroup to 77.1 ± 16.05 in the social domain in the able-bodied subgroup. The ODQ values did not generally exceed 5.3 ± 7.53. Inter- and intragroup differences were nonsignificant. Age, marital status, education, and gender were significantly associated with the ODQ scores. Significant association between the ODQ and WHOQOL-BREF social relationships domain scores with the participation in exercise treatment was found. CONCLUSIONS Participants with the history of exercise treatment generally did not differ significantly from their peers who were only under observation. This study cannot conclude that scoliosis-specific exercise treatment in adolescence alters quality of life in adulthood.
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Milwaukee brace or thoracolumbosacral orthosis? Which one affects the quality of life of adolescents with idiopathic scoliosis more? A cross-sectional study using the SRS-22 questionnaire. CURRENT ORTHOPAEDIC PRACTICE 2014. [DOI: 10.1097/bco.0000000000000138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mental health of adults treated in adolescence with scoliosis-specific exercise program or observed for idiopathic scoliosis. ScientificWorldJournal 2014; 2014:932827. [PMID: 24574935 PMCID: PMC3918381 DOI: 10.1155/2014/932827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/22/2013] [Indexed: 11/17/2022] Open
Abstract
Objective. To examine general mental health in adult males and females, who in adolescence participated in a scoliosis-specific therapeutic exercise program or were under observation due to diagnosis of scoliosis. Design. Registry-based, cross-sectional study with retrospective data collection. Methods. Sixty-eight subjects (43 women) aged 30.10 (25–39) years, with mild or moderate scoliosis (11–36° Cobb angle), and 76 (38 women) nonscoliotic subjects, aged 30.11 (24–38) years, participated. The time period since the end of the exercise or observation regimes was 16.5 (12-26) years. Beck Depression Inventory (BDI) and General Health Questionnaire (GHQ-28) scores were analyzed with the χ2 and U tests. Multiple regression analyses for confounders were also performed. Results. Intergroup differences of demographic characteristics were nonsignificant. Scoliosis, gender, participation in the exercise program, employment, and marital status were associated with BDI scores. The presence of scoliosis and participation in the exercise program manifested association with the symptoms. Higher GHQ-28 “somatic symptoms” subscale scores interacted with the education level. Conclusions. Our findings correspond to the reports of a negative impact of the diagnosis of scoliosis and treatment on mental health. The decision to introduce a therapeutic program in children with mild deformities should be made with judgment of potential benefits, risks, and harm.
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Effect of spinal deformity on adolescent quality of life: comparison of operative scheuermann kyphosis, adolescent idiopathic scoliosis, and normal controls. Spine (Phila Pa 1976) 2013; 38:1049-55. [PMID: 23370683 DOI: 10.1097/brs.0b013e3182893c01] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective multicenter study and retrospective chart review. OBJECTIVE To compare health-related quality of life (HRQOL) measures and sagittal deformity in operative Scheuermann kyphosis (SK), operative adolescent idiopathic scoliosis (AIS), and normal populations. SUMMARY OF BACKGROUND DATA No study to date has evaluated patient reported HRQOL measures before surgery in operative patients with SK. METHODS HRQOL data were prospectively collected pretreatment for operative patients with SK using the SRS-22 outcomes instrument and visual analogue scale (VAS). Comparison was made with the SRS-22 from operative AIS and normal populations. Eighty-six patients with SK enrolled in the prospective study were compared with 184 patients with AIS from a prospective database and 31 normal controls. To study the correlation between T5-T12 kyphosis magnitude and SRS-22 score, patients with AIS and SK were pooled together to create a larger continuum of kyphosis. Analysis of covariance, Pearson correlation analysis, and Bonferroni pairwise comparisons were used to determine statistical differences between group demographics, HRQOL indicators, and radiographical variables. RESULTS Patients with SK had significantly lower scores in all domains of the SRS-22 than patients with AIS. Patients with SK with a thoracolumbar apex reported significantly lower mean scores in the pain domain than those with a thoracic apex. Significant negative correlations were found between all domains of the SRS-22 and T5-T12 kyphosis-the self-image domain demonstrated the highest correlation (r = 0.37). VAS score in the SK population correlated negatively to the pain, self-image, and mental health domains. CONCLUSION Increasing sagittal plane deformity as a result of SK has a significant impact on HRQOL as determined by the SRS-22 outcome instrument. In this study, patients with SK reported significantly decreased (worse) scores in all subdomains of the SRS-22 compared with patients with AIS. LEVEL OF EVIDENCE 1.
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