The effect of compliance to a Rigo System Cheneau brace and a specific exercise programme on idiopathic scoliosis curvature: a comparative study: SOSORT 2014 award winner

Abstract

BackgroundThere is controversy as to whether conservative management that includes wearing a brace and exercises is effective in stabilising idiopathic scoliosis curves. A brace only prevents progression of the curve and has been shown to have favourable outcomes when patients are compliant. So the aim of this study was to: determine the effect of compliance to the Rigo System Cheneau (RSC) brace and a specific exercise programme on Idiopathic Scoliosis curvature; and to compare the Quality of Life (QoL) and psychological traits of compliant and non compliant subjects.MethodsA pre/post test study design was used with a post study comparison between subjects who complied with the management and those who did not. Fifty one subjects, girls aged 12-16 years, Cobb angles 20-50 degrees participated in the study. Subjects were divided into two groups, according to their compliance, at the end of the study. The compliant group wore the brace 20 or more hours a day and exercised three or more times per week. The non-compliant group wore the brace less than 20 hours a day and exercised less than three times per week. Cobb angles, vertebral rotation, scoliometer readings, peak flow, quality of life and personality traits were compared between groups, using the student’s two sample t-test and an analysis of covariance.ResultsThe compliant group, wore the brace 21.5 hours per day and exercised four times a week, and significantly improved in all measures compared to non compliant subjects, who wore the brace 12 hours per day, exercised 1.7 times a week and significantly deteriorated (p < 0.0001). The major Cobb angles in the compliant group improved 10.19°(±5.5) and deteriorated 5.52°(±4.3) in the non compliant group (p < 0.0001). Compliant subjects had a significantly better QoL than the non compliant subjects (p = 0.001). The compliant group were significantly more emotionally mature, stable and realistic than the non compliant group (p = 0.03).ConclusionsGood compliance of the RSC brace and a specific exercise regime resulted in a significant improvement in curvatures, poor compliance resulted in progression/deterioration. A poorer QoL in the non compliant group possibly was caused by personality traits of the group, being more emotionally immature and unstable.

Scoliosis Research Society members attitudes towards physical therapy and physiotherapeutic scoliosis specific exercises for adolescent idiopathic scoliosis

“…Of those prescribing PT or PSSE, the number prescribing either or both was similar. In addition, despite the impression that PT and PSSE are more widely used in Europe [ 7 – 9 , 15 , 19 , 20 , 22 ] compared to North America, our study showed that there was no difference in prescribing patterns among the respondents based on region. Although, there was no difference in prescribing pattern for standard PT based on the surgeon’s years in practice, older surgeons were more likely to prescribe PSSE.…”

Sticking to It: A Scoping Review of Adherence to Exercise Therapy Interventions in Children and Adolescents With Musculoskeletal Conditions

“…With respect to motivation, personal experience during exercise was the most commonly identified barrier, with pain, 18,27,48,83,85 boredom, 8,18,22,96 and an overall lack of enjoyment 2,83,88 identified. Barriers related to capability included psychological traits (eg, lack of confidence, forgetfulness), 18,39,78,83 physical traits (eg, fatigue), 29,83 and not understanding the purpose of the exercises. 2,18…”

Krankheitsspezifisches Wissen in der konservativen Therapie der idiopathischen Adoleszentenskoliose

“…Bezüglich der LQ haben wir bei den Patienten, die eine Tragezeit von über 22 Stunden angaben, einen signifikant höheren SRS-Gesamt-Score sowie einen höheren Wert in der Kategorie "Mentale Gesundheit" gefunden. Dies ist vereinbar mit den Ergebnissen von Rivetti und Kollegen, welche höhere SRS-Scores bei Patienten mit hoher Compliance fanden [17]. Dennoch zeigten andere Studien auch, dass IAS-Patienten unter Korsetttherapie eine niedrigere Lebensqualität in den Sektionen Aktivität und Selbstwahrnehmung genossen als vergleichbare Patienten, die nur beobachtet wurden [46].…”