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Baumann AN, Orellana K, Oleson CJ, Curtis DP, Cahill P, Flynn J, Baldwin KD. The impact of patient scoliosis-specific exercises for adolescent idiopathic scoliosis: a systematic review and meta-analysis of randomized controlled trials with subgroup analysis using observational studies. Spine Deform 2024; 12:545-559. [PMID: 38243155 DOI: 10.1007/s43390-023-00810-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is a common pediatric spinal deformity frequently treated with patient scoliosis-specific exercises (PSSE). The purpose of this study is to perform a systematic review and meta-analysis of randomized controlled trials and sensitivity analysis of observational studies to determine the impact of PSSE on outcomes for AIS. METHODS A systematic review and meta-analysis on impact of PSSE for patients with AIS was performed. Databases used included PubMed, CINAHL, MEDLINE, Cochrane, and ScienceDirect database inception to October 2022. Inclusion criteria included use of PSSE, patient population of AIS, and full text. RESULTS A total of 26 articles out of 628 initial retrieved met final inclusion criteria (10 randomized controlled trials (RCTs), 16 observational studies). Total included patients (n = 2083) had a frequency weighted mean age of 13.2 ± 0.9 years and a frequency weighted mean follow-up of 14.5 ± 20.0 months. Based on only data from RCTs with direct comparison groups (n = 7 articles), there was a statistically significant but clinically insignificant improvement in Cobb angle of 2.5 degrees in the PSSE group (n = 152) as compared to the control group (n = 148; p = 0.017). There was no statistically significant improvement in Cobb angle when stratified by small curve (< 30 degrees) or large curve (> 30 degrees) with PSSE (p = 0.140 and p = 0.142, respectively). There was no statistically significant improvement in ATR (p = 0.326) or SRS-22 score (p = 0.370). CONCLUSION PSSE may not provide any clinically significant improvements in Cobb angle, ATR, or SRS-22 scores in patients with AIS. PSSE did not significantly improve Cobb angle when stratified by curve size. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Anthony N Baumann
- Department of Rehabilitation Services, University Hospitals, Cleveland, OH, USA
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kevin Orellana
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Caleb J Oleson
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Deven P Curtis
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Patrick Cahill
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - John Flynn
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Keith D Baldwin
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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Sha L, Zhang T, Sui W, Fan Q, Yang J, Deng Y, Huang Z, Yang J. Comparison of the efficacy of thoracolumbosacral and lumbosacral orthosis for adolescent idiopathic scoliosis in patients with major thoracolumbar or lumbar curves: a prospective controlled study. Front Pediatr 2024; 12:1368201. [PMID: 38628358 PMCID: PMC11018990 DOI: 10.3389/fped.2024.1368201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Thoracolumbosacral orthosis (TLSO) is the most commonly used type of brace for the conservative treatment of adolescent idiopathic scoliosis (AIS). Although lumbosacral orthosis (LSO) is designed to correct single thoracolumbar or lumbar (TL/L) curves, its effectiveness remains underexplored. This novel article aims to compare the effectiveness of LSO with TLSO in treating AIS with main TL/L curves. Methods This prospective controlled cohort study enrolled patients with AIS with main TL/L curves and minor thoracic curves who were treated with either TLSO or LSO. Demographic and radiographic data were compared between the two groups. Treatment outcomes were also assessed. Risk factors for minor curve progression were identified, and a cut-off value was determined within the LSO group. Results Overall, 82 patients were recruited, including 44 in the TLSO group and 38 in the LSO group. The initial TL/L curves showed no difference between both groups. However, the baseline thoracic curves were significantly larger in the TLSO group compared to the LSO group (25.98° ± 7.47° vs. 18.71° ± 5.95°, P < 0.001). At the last follow-up, LSO demonstrated similar effectiveness to TLSO in treating TL/L curves but was less effective for thoracic curves. The initial magnitude of thoracic curves was identified as a risk factor for minor curve outcomes in the LSO group. The ROC curve analysis determined a cut-off value of 21° for thoracic curves to predict treatment outcomes. Discussion In contrast to TLSO, LSO exhibits comparable effectiveness in treating main TL/L curves, making it a viable clinical option; however, it is less effective for thoracic minor curves. The initial magnitude of the minor thoracic curves may guide the selection of the appropriate brace type for patients with AIS with main TL/L curves.
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Affiliation(s)
- Lin Sha
- Department of Pediatric Orthopedics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyuan Zhang
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyuan Sui
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Fan
- Department of Pediatric Orthopedics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingfan Yang
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaolong Deng
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zifang Huang
- Department of Spine Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Junlin Yang
- Department of Pediatric Orthopedics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Fregna G, Rossi Raccagni S, Negrini A, Zaina F, Negrini S. Personal and Clinical Determinants of Brace-Wearing Time in Adolescents with Idiopathic Scoliosis. SENSORS (BASEL, SWITZERLAND) 2023; 24:116. [PMID: 38202978 PMCID: PMC10780905 DOI: 10.3390/s24010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spine and trunk deformity. Bracing is an effective treatment for medium-degree curves. Thermal sensors help monitor patients' adherence (compliance), a critical issue in bracing treatment. Some studies investigated adherence determinants but rarely through sensors or in highly adherent cohorts. We aimed to verify the influence of personal and clinical variables routinely registered by physicians on adherence to brace treatment in a large cohort of consecutive AIS patients from a highly adherent cohort. We performed a cross-sectional study of patients consecutively recruited in the last three years at a tertiary referral institute and treated with braces for one year. To ensure high adherence, for years, we have provided specific support to brace treatment through a series of cognitive-behavioural interventions for patients and parents. We used iButton thermal sensor systematic data collection to precisely analyse the real brace-wearing time. We included 514 adolescents, age 13.8 ± 1.6, with the worst scoliosis curve of 34.5 ± 10.3° Cobb. We found a 95% (95CI 60-101%) adherence to the brace prescription of 21.9 ± 1.7 h per day. Determinants included gender (91% vs. 84%; females vs. males) and age < 14 years (92% vs. 88%). Brace hours prescription, BMI, and all clinical variables (worst curve Cobb degrees, angle of trunk rotation, and TRACE index for aesthetics) did not influence adherence.
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Affiliation(s)
- Giulia Fregna
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, 44121 Ferrara, Italy
| | - Sara Rossi Raccagni
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Alessandra Negrini
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, 20122 Milan, Italy;
- IRCCS Istituto Ortopedico Galeazzi, 20157 Milan, Italy
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Del Prete CM, Tarantino D, Viva MG, Murgia M, Vergati D, Barassi G, Sparvieri E, Di Stanislao E, Perpetuini D, Russo EF, Filoni S, Pellegrino R. Spinal Orthosis in Adolescent Idiopathic Scoliosis: An Overview of the Braces Provided by the National Health Service in Italy. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:3. [PMID: 38276037 PMCID: PMC10818494 DOI: 10.3390/medicina60010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral, rotated curvature of the spine. It is a 3-dimensional deformity that arises in otherwise healthy children at or around puberty. AIS is the most common form of scoliosis in the pediatric population. The etiology is multifactorial, including genetic and environmental factors. The incidence is roughly equal between males and females, while there is a higher risk of progression in females. Guidelines for AIS treatment identify three levels of treatment: observation, physiotherapy scoliosis-specific exercises, and braces. In this paper, we carried out a review of the scientific literature about the indication and success rates of the braces provided for free by the National Health Service in Italy (SSN). Despite a general consensus on the efficacy of rigid bracing treatment and its use in AIS, an important heterogeneity about the treatment is present in the scientific literature, demonstrating a high degree of variability. The overall success rate of the braces provided by the SSN is high, suggesting an important therapeutic role in the treatment of AIS. Robust guidelines are needed to ensure uniform and effective treatments.
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Affiliation(s)
| | - Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
| | - Mattia Giuseppe Viva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00183 Rome, Italy; (M.G.V.); (M.M.)
| | - Massimiliano Murgia
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00183 Rome, Italy; (M.G.V.); (M.M.)
| | | | - Giovanni Barassi
- Center for Physiotherapy, Rehabilitation and Re-Education-CeFiRR-Gemelli Molise, 86100 Campobasso, Italy;
| | | | | | - David Perpetuini
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy;
| | | | - Serena Filoni
- I.R.R.C.S. Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano–Pazzallo, Switzerland;
- Santa Chiara Institute, 73100 Lecce, Italy
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Siripanyakhemakul W, Permpool K, Seng-Iad S. Effectiveness of orthotic treatment for adolescent idiopathic scoliosis: a scoping review protocol of systematic reviews. BMJ Open 2023; 13:e078064. [PMID: 37940156 PMCID: PMC10632824 DOI: 10.1136/bmjopen-2023-078064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION Spinal orthosis is a common conservative treatment for adolescent idiopathic scoliosis (AIS), and a large body of compelling evidence from systemic review studies strongly supports the use of spinal orthosis treatment in patients with this condition. To further improve our understanding of the available data, the aim of this study is to develop and propose a protocol for a scoping review of systematic reviews of studies that investigated the effectiveness of orthotic treatment in patients with AIS. Systematic synthesis and understanding of the data will improve the efficacy of spinal orthosis treatment in this patient population. METHOD AND ANALYSIS Using the scoping review methodological framework proposed by Arksey and O'Malley in 2005, we developed and herewith propose a scoping review protocol to evaluate systematic reviews of studies that investigated the effectiveness of orthotic treatment in AIS. Our proposed scoping review proposal is briefly described, as follows. A search of seven online databases will be conducted to identify systematic reviews published in English language from 1 January 2000 to 31 December 2023, and grey literature and reference lists of included articles will also be searched. A two-stage screening process consisting of a title and abstract screening and a full-text review will be used to determine articles' eligibility. All eligible articles will be extracted, charted and evaluated using Assessing the MeaSurement Tool to Assess systematic Reviews Version 2 (AMSTAR-2) critical appraisal tool. The charted data will be quantitatively analysed and summarised, and qualitatively analysed using narrative synthesis. ETHICS AND DISSEMINATION No primary data will be collected; therefore, ethics approval is not required. Findings will be disseminated through national and international conferences and publication in a peer-reviewed journal.
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Affiliation(s)
- Wichuda Siripanyakhemakul
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kwannate Permpool
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirirat Seng-Iad
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Liu S, Ho LY, Hassan Beygi B, Wong MS. Effectiveness of Orthotic Treatment on Clinical Outcomes of the Patients with Adolescent Idiopathic Scoliosis Under Different Wearing Compliance Levels: A Systematic Review. JBJS Rev 2023; 11:01874474-202310000-00010. [PMID: 38079521 DOI: 10.2106/jbjs.rvw.23.00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Wearing spinal orthosis for 16 to 23 hours a day during the teenage years could be challenging and stressful for patients with adolescent idiopathic scoliosis (AIS). The investigation of clinical outcomes under various orthosis-wearing compliances can provide helpful insight into orthotic treatment dosage. This systematic review aims to investigate actual orthosis-wearing compliance and evaluate the effectiveness of orthotic treatment in controlling scoliotic curvature and preventing surgery for patients with AIS under various levels of orthosis-wearing compliance. METHODS A literature search of 7 electronic databases, namely PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL Complete, Web of Science, and Embase, was conducted on May 19, 2023. Participant characteristics, orthotic treatment protocols, compliance information, outcome measures, and key findings were extracted. The Newcastle-Ottawa Scales were used to evaluate the quality of included cohort and case-control studies. RESULTS This study systematically reviewed 17 of 1,799 identified studies, including 1,981 subjects. The actual compliance was inconsistent and ranged from 7.0 to 18.8 hours daily. The proportion of compliant subjects in each study varied from 16.0% to 78.6% due to the heterogeneity of calculation period, measurement methods, and orthosis prescription time. Thirteen studies were investigated to determine the effectiveness of orthotic treatment in controlling curve deformity under different compliance groups, and 2 studies compared the compliance under different treatment outcomes. The rate of curve progression, defined as surpassing the measurement error threshold of 5° or 6° after orthotic treatment, varied from 1.8% to 91.7% across the studies. Ten studies defined the treatment failure, surgery, or surgery indication as Cobb angle progressing to a certain degree (e.g., 40°, 45°, or 50°) and reported failure/surgery/surgery indication rates ranging from 0.0% to 91.7% among different compliance level groups. CONCLUSION This review found that the actual compliance with orthotic treatment was generally lower than the prescribed wearing time and exhibited wide variation among different studies. The electronic compliance monitors show promise in regular orthotic treatment practice. More importantly, the group with higher and consistent compliance has significantly less curve progression and lower surgery or failure rate than the group with lower and inconsistent compliance. Further studies are proposed to investigate the minimal orthosis-wearing compliance in patients with AIS treated with different types of orthoses. LEVEL OF EVIDENCE Level III, Systematic Review. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Shan Liu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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Cordani C, Malisano L, Febbo F, Giranio G, Del Furia MJ, Donzelli S, Negrini S. Influence of Specific Interventions on Bracing Compliance in Adolescents with Idiopathic Scoliosis-A Systematic Review of Papers Including Sensors' Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:7660. [PMID: 37688117 PMCID: PMC10490632 DOI: 10.3390/s23177660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common disease that, in many cases, can be conservatively treated through bracing. High adherence to brace prescription is fundamental to gaining the maximum benefit from this treatment approach. Wearable sensors are available that objectively monitor the brace-wearing time, but their use, combined with other interventions, is poorly investigated. The aims of the current review are as follows: (i) to summarize the real compliance with bracing reported by studies using sensors; (ii) to find out the real brace wearing rate through objective electronic monitoring; (iii) to verify if interventions made to increase adherence to bracing can be effective according to the published literature. We conducted a systematic review of the literature published on Medline, EMBASE, CINAHL, Scopus, CENTRAL, and Web of Science. We identified 466 articles and included examples articles, which had a low to good methodological quality. We found that compliance a greatly varied between 21.8 and 93.9% (weighted average: 58.8%), real brace wearing time varied between 5.7 and 21 h per day (weighted average 13.3), and specific interventions seemed to improve both outcomes, with compliance increasing from 58.5 to 66% and brace wearing increasing from 11.9 to 15.1 h per day. Two comparative studies showed positive effects of stand-alone counseling and information on the sensors' presence when added to counseling. Sensors proved to be useful tools for objectively and continuously monitoring adherence to therapy in everyday clinical practice. Specific interventions, like the use of sensors, counseling, education, and exercises, could increase compliance. However, further studies using high-quality designs should be conducted in this field.
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Affiliation(s)
- Claudio Cordani
- Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, 20122 Milan, Italy; (C.C.); (S.N.)
- IRCCS Istituto Ortopedico Galeazzi, 20157 Milan, Italy;
| | - Lia Malisano
- Postgraduate School of Physical Therapy and Rehabilitative Medicine, University “La Statale”, 20122 Milan, Italy; (L.M.); (G.G.)
| | - Francesca Febbo
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy;
| | - Giorgia Giranio
- Postgraduate School of Physical Therapy and Rehabilitative Medicine, University “La Statale”, 20122 Milan, Italy; (L.M.); (G.G.)
| | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, 20122 Milan, Italy; (C.C.); (S.N.)
- IRCCS Istituto Ortopedico Galeazzi, 20157 Milan, Italy;
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Jamnik AA, Thornberg D, Jo CH, Brooks J, McIntosh A, Ramo B. The evolution of pre-operative SRS scores over time in patients with adolescent idiopathic scoliosis. Spine Deform 2023; 11:1109-1115. [PMID: 37294410 PMCID: PMC10251318 DOI: 10.1007/s43390-023-00714-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To determine if preoperative Health Related Quality of Life (HRQoL) has declined in the past two decades for patients with Adolescent Idiopathic Scoliosis (AIS), as measured by the Scoliosis Research Society (SRS) questionnaire. METHODS A retrospective review was conducted on AIS patients that underwent surgery at a single institution between 2002 and 2022. Patients were included if they completed an SRS questionnaire preoperatively. A multivariate linear regression was performed with the SRS domains as the dependent variables. The independent variables were surgery year, gender, race/ethnicity, BMI, Lenke type, and major Cobb angle. A second regression was performed where the SRS scores for AIS patients were dichotomized as being above or below normal based on a threshold set at two standard deviations below the mean SRS scores of a healthy adolescent population. The binary SRS scores were used as the outcome of interest in a second regression. RESULTS A total of 1380 patients (79.2% female, mean age 14.9 ± 2.0 years old) were included for analysis. Surgery year had a negative association with Pain (coefficient = - 0.03, p < 0.0001), Activity (coefficient = - 0.02, p < 0.0001), Mental Health (coefficient = - 0.01, p < 0.0001), and Total score (coefficient = - 0.01, p < 0.0001), indicating declining HRQoL over time. Similarly, AIS patients became more likely to fall below 2SD of the healthy adolescent means in Pain (OR: 1.061, p < 0.0001), Appearance (OR: 1.023, p = 0.0301), Activity (OR: 1.044, p = 0.0197), and Total score (OR: 1.06, p < 0.0001). CONCLUSION Over the past two decades, patients with surgical AIS have experienced a significant decline in various HRQoL domains preoperatively.
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Affiliation(s)
- Adam A Jamnik
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA
| | - David Thornberg
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA
| | - Chan-Hee Jo
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA
| | - Jaysson Brooks
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA
| | - Amy McIntosh
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA
| | - Brandon Ramo
- Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX, USA.
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Salah AH, Arem S, Fredj MB, Rekik M, Haddada I, Krifa B, Sghir M, Kessomtini W. Quality of life among adolescents with idiopathic scoliosis in Tunisia. Pan Afr Med J 2023; 45:27. [PMID: 37521762 PMCID: PMC10386519 DOI: 10.11604/pamj.2023.45.27.38575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/29/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction our study aimed to assess the quality of life (QOL) among adolescents with adolescent idiopathic scoliosis (AIS) receiving nonoperative treatment, and to identify the demographic and clinical factors associated with poor QOL. Methods this is a cross-sectional study. We included adolescents followed in the Department of Physical Medicine and Rehabilitation at Taher Sfar Hospital (Mahdia - Tunisia). The Quality-of-Life Profile for Spine Deformities (QLPSD), the Scoliosis Research Society 22 questionnaire (SRS-22) and the visual analogue scale objectifying the QOL (EVA QOL) were used. Correlations between the QOL domains and selected characteristics were performed. Results a total of 48 adolescents with AIS were included, with a mean age of 14.2 ± 2.1 years and a sex ratio (M/F) of 0.77. Adolescents who underwent rehabilitation treatment only had significantly better quality of life (QOL) scores than those with braces, as measured by three scales. Among brace wearers, we found a correlation between QOL and the degree of correction achieved by the brace, as measured by the EVA-QOL. We observed significant relationships between psychosocial status and age, correction angle, and treatment duration among braced patients, as measured by the QLPSD. Additionally, we found that dorsal flexibility was correlated with the correction angle and the treatment duration. According to the SRS-22, the overall QOL score of braced adolescents was significantly correlated with the correction obtained by the brace. Conclusion wearing a brace in adolescent with AIS leads to a significant decrease in QOL according to the three QOL assessment scales.
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Affiliation(s)
- Aymen Haj Salah
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Soumaya Arem
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, Monastir, Tunisia
| | - Meriem Rekik
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Ikram Haddada
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Bessem Krifa
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Mouna Sghir
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Wassiaa Kessomtini
- Department of Physical Medicine and Rehabilitation, University Hospital Taher Sfar, Mahdia, Tunisia
- Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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