Does rigid spinal orthosis carry more psychosocial implications than the flexible brace in AIS patients? A cross-sectional study

BACKGROUND

A small body of data exists concerning psychosocial issues in adolescent idiopathic scoliosis (AIS) subjected to soft braces. No study was yet performed on the detailed psychosocial implications in AIS patients.

OBJECTIVE

To compare the psychosocial implications of the flexible SpineCor with the Cheneau orthosis in AIS females.

METHODS

Patients (aged 10-18 years) deliberately assigned to undergo SpineCor (SC group, 30 patients) or Cheneau brace (Ch group, 41 patients) intervention completed the Scoliosis Research Society-22 (SRS-22), the Spinal Appearance Questionnaire (SAQ), the Brace Questionnaire (BrQ) and the Pediatric Outcomes Data Collection Instrument (PODCI).

RESULTS

Concerning the BrQ, study groups differ in regards to emotional functioning (p= 0.014), vitality (p= 0.022) and social functioning (p= 0.048), indicating better functioning in the Ch group. Considering the SAQ, the Ch group assesses body curve (p= 0.024) less critically. Regarding the PODCI, the Ch group scored higher in the Global Functioning Scale (p= 0.023), the Upper Extremity and Physical Function Scale (p= 0.000), the Transfer and Basic Mobility Scale (p= 0.088), the Pain/Comfort Scale (p= 0.009) and the Happiness Scale (p= 0.022).

CONCLUSIONS

This study shows that patients treated with the rigid brace assess their vitality, physical function, emotional and social functioning better and are less critical towards body curve, in comparison to patients treated with the SpineCor.

Objective compliance of adolescent girls with idiopathic scoliosis in a dynamic SpineCor brace

PURPOSE

Dynamic SpineCor was designed to overcome the disadvantages of rigid orthoses-bulkiness, physical constraint and warming-and to improve the acceptance and compliance as limiting factors of brace treatment. Those theoretical benefits have not been proved by compliance studies yet.

METHODS

SpineCor braces of 12 adolescent scoliotic girls were equipped with flexible temperature loggers, which were sandwiched between gel foam and the brace's pelvic base. Patients and parents were blinded for the observation period of 14 days and gave post-hoc consent. The logger yielded 672 time-stamped values at 30-min intervals. Pilot testing revealed values beyond the 30°C threshold as indicative for brace wear.

RESULTS

The average overall compliance (% wearing hours/prescribed 23 h) was 54% ± 22.3 (range, 11.8-95.8%). The youngest patients (aged 10-12 years) were significantly more compliant than the others (P < 0.05). Most patients had a scattered wearing pattern: one was a day-wearer, one a night-wearer and only the two high adherers showed a consistent daily pattern. There was no significant difference between weekdays, weekdays and weekends, nor between day and night wear.

CONCLUSION

The current study showed that the compliance of patients in a dynamic SpineCor is as limited as in a conventional brace. This is in line with earlier data on patients' SpineCor and rigid brace acceptance evaluated by a questionnaire and on temperature logging in rigid braces.