Quality of life and patient satisfaction in bracing treatment of adolescent idiopathic scoliosis

Abstract

BackgroundBracing 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 methodWe 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.ResultsThe 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.ConclusionPatients 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.

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

“…Results from this study are consistence with prior reports. 13 , 16 , 22 Rivett et al . studied the relationship between quality of life and brace compliance, and they found that poor compliance patients, wearing brace <20 hours/day, was associated with poorer QOL.…”

“…24 Piantoni et al revealed that the majority of the patients (75%) in their cohort concerned about their social function during brace treatment and half of them had difficulties at school. 22 Donelly et al found that braced patients often had conflict with their parents over brace wearing and they thought that their classmates treated them differently. Some patients reported that when teachers taught about AIS in their class, it made their friends more open-minded and sympathy toward patients with AIS.…”

The Influence of Lumbar Modifiers on Functional and Radiological Outcomes in the Brace Treatment of Lenke Type 1 Adolescent Idiopathic Scoliosis

“…In the current study, the increase in the SRS-22 score and the improvement of truncal shift and shoulder asymmetry are consistent. One of the biggest problems of conservative treatment of AIS is that patient compliance is low and patients who use a brace feel physiologically and psychologically sick [30]. Also, it has been reported in the literature that depression symptoms can be seen in patients who use a brace [31].…”

The effectiveness and safety of acupuncture for scoliosis

“…[ 24 , 25 ] Living with braces still remains a potential ingredient of curvation and patients poor brace compliance [ 26 , 27 ] and can have a negative effect on patients psychological, motor, social, and school environment. [ 28 ]…”