The effect of time on qualitative compliance in brace treatment for AIS

Mak, Ian; Lou, Edmond; Raso, James; Hill, Doug; Parent, Éric; Mahood, James; Moreau, Marc; Hedden, Douglas

doi:10.1080/03093640802015839

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…Although they did not find any long-term changes in the health-related quality of life (HRQoL) questionnaire [17, 25, 62, 78, 79, 82], these authors as well as others confirm that patients who wear a brace are more concerned about their body image than those who undergo surgical treatment [11, 17, 38, 39, 42, 52, 66]. The same authors showed that the range of lumbar motion diminishes both in the brace-wearing group and in the group that underwent surgery (37% and 61%, respectively) [30, 32, 34, 35, 53, 54]. In our study, 54% of the entire population assessed felt that motor basic activities were somehow affected.…”

Section: Discussionmentioning

confidence: 84%

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

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 84%

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

et al. 2018

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“…Nicholson et al [ 10 ] considered that psychological feature could alter the amount of orthosis wearing hours. Daytime and nighttime wearing patterns are another two factors that could impact patient compliance, but which one is better is still controversial [ 2 , 9 , 10 , 21 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The sensing area of the sensor is 5.08 mm and its thickness is 0.3 mm. The maximum force that the transducer could measure is 20 N, which is suitable to this application based on other studies [ 21 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, electronic devices were developed to measure medication compliance objectively. The electronic solution can be divided into three categories: temperature-based systems [2,[10][11][12][13][14][15][16][17][18], forcebased systems [19][20][21][22][23][24], and force and temperaturecombined systems [9]. A temperature-based system, with its temperature sensors, can record the brace wearing time (quantity) of the patients accurately, but cannot measure the wearing tightness (quality).…”

Section: Introductionmentioning

confidence: 99%

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A compliance real-time monitoring system for the management of the brace usage in adolescent idiopathic scoliosis patients: a pilot study

Zhu

Xiao

et al. 2021

BMC Musculoskelet Disord

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Background Patient compliance is essential to the effectiveness of brace treatment for adolescent idiopathic scoliosis (AIS) patients. Subjective measurements like questionnaires and inquiries proved to be arguably inaccurate. Although some scholars have applied temperature/force monitors to measuring patient compliance objectively, few studies to date could monitor patient compliance in real time. The objective of this study is to describe and evaluate a compliance real-time monitoring system of the brace usage in AIS patients. Methods A compliance real-time monitoring system (specifically consisting of a compliance monitor, a WeChat Mini Program, a cloud-based storage system and a website backstage management system) was designed to manage the brace treatment. Thirty patients receiving brace treatment were enrolled. They were told to upload the data at least once a day. Clinicians downloaded the compliance data and communicated with the patients online based on their analysis of data at least once every 3 months. The measured force, quality compliance (measured force / baseline force), measured time, and quantity compliance (measured time/ prescribed time) were used to evaluate patient compliance. Patients were also asked to rate their satisfaction at the final follow-up. Results Twenty-eight patients were included in the final analysis. The mean baseline force was 1.23 ± 0.28 N. The mean measured force was 0.79 ± 0.29 N. The mean quality compliance was 64.8 ± 22.2%. The prescribed time of all patients was 23 h. The mean measured time was 14.1 ± 2.9 h. The mean quantity compliance was 61.3 ± 12.6%. Both the quality and quantity compliance during the first 3 months of treatment was significantly lower than the latter 3 months. In this study, 96.4% (27/28) patients were satisfied with the use of the monitoring system, among whom 21.4% (6/28) are very satisfied and 75.0% (21/28) are somewhat satisfied. Conclusions The compliance real-time monitoring system, without evaluating the clinical and radiographic outcomes for now, has already shown some feasibility and effectiveness for the management of the brace usage in AIS patients. This system, as a useful tool for online patient management and patient-clinician communication, would be potentially employed on a large scale in future for clinicians to improve the compliance and satisfaction of AIS patients who have received brace treatment.

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“…Secondary effects like pain, psychological problems with wearing a brace and the supposed negative feedback by classmates may all influence good compliance [24-26]. Brace treatment should be part of a more complex variety of supportive measurements where subjective scores are important, as children have to live with the brace for a prolonged period of time.…”

Section: Discussionmentioning

confidence: 99%

A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

et al. 2012

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Study designA prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis.Summary of background dataConservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention). Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis.MethodsA consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve <25 degrees in the coronal plane. Standing radiographs were made i) at start, ii) in brace at beginning and iii) after one year treatment without brace.ResultsBefore treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p < 0.001, pelvic obliquity p < 0.001). After one year of brace treatment in scoliosis and kyphosis group the measurements on radiographs made without brace revealed an improvement in 3 Cobb angles each.ConclusionConservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

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The effect of time on qualitative compliance in brace treatment for AIS

Cited by 13 publications

References 17 publications

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

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

A compliance real-time monitoring system for the management of the brace usage in adolescent idiopathic scoliosis patients: a pilot study

A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

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