Novel questionnaire to enhance brace wear adherence in patients with adolescent idiopathic scoliosis and the relationship of the quality of life

Abstract

Bracing is an effective non-operative treatment, in patients with adolescent idiopathic scoliosis (AIS). The relationship between patients’ quality of life (QOL) and brace wear adherence has been reported. This study aims to determine brace wear adherence for AIS patients with novel questionnaire. A nested case-control study was conducted, included patient age 10-18 years, coronal Cobb angle 20-50°, and Risser grade 0-3. Correlation between patients’ QOL and the average hours of daily brace-wear were determined. Patients were divided into 3 groups based on brace wear adherence and were compared. QOL domains associated with the incompleteness of brace-wearing were determined by Cox proportional-hazards regression. Mean age of patients was 13.3 years (range 11-17.3 years) with initial Cobb angle of 33.5° (range 20-48°). There were significant negative correlations between total QOL scores and brace wearing time. Increased social domain scores was significantly associated with less brace wearing time (HR 1.5, 95% CI 1.12-2.04). Significant correlations between patients’ QOL and the average hours per day of brace wear. Poor social QOL have a significant impact on brace wear adherence.

Why Don’t Adolescents Wear Their Brace? A Prospective Study Investigating Psychosocial Characteristics That Predict Scoliosis Brace Wear

“…Many psychosocial factors in this study were not predictive of bracewear. Consistent with prior findings, neither SES nor academic performance were related to compliance 52. Similar to the BrAIST study, curve magnitude, and body image disturbances did not influence bracewear 59.…”

“…Consistent with prior findings, neither SES nor academic performance were related to compliance. 52 Similar to the BrAIST study, curve magnitude, and body image disturbances did not influence bracewear. 59 Finally, baseline mental health diagnoses had no association with bracing.…”

“…In contrast, adolescents with low self-esteem and poor peer relationships may be seeking a way to meet their need for relatedness through improving their appearance by bracewear. Although previous research has found that poor social quality of life is related to worse wear, this opposite finding may have been due to the time at which the survey is administered (ie, after brace use had already begun) 52. Specifically, post hoc administration may be more likely to identify low compliance in those who have already stopped wearing the brace due its perceived impact on social quality of life.…”

“…Although previous research has found that poor social quality of life is related to worse wear, this opposite finding may have been due to the time at which the survey is administered (ie, after brace use had already begun). 52 Specifically, post hoc administration may be more likely to identify low compliance in those who have already stopped wearing the brace due its perceived impact on social quality of life. Finally, positive peer relationships may also be related to time spent in extracurricular activities (not directly measured in this study), which could have an impact on brace compliance.…”

Scoliosis Bracing: Details Make the Difference

“…32 Understanding patient-reported outcomes, such as the importance of peer relationships, can shed light on social dynamics that might influence brace use. 33 Potential barriers to brace use need to be investigated early, with a focus on behavioral, physiological, or other impediments expressed by the patient or parents. For example, sleep hygiene can often be neglected in evaluation of bracing barriers; however, it is an essential factor to consider.…”