The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis

Karol, Lori A.; Wingfield, Jessica; Virostek, Donald; Felton, Kevin; Jo, Chan Hee

doi:10.1097/bpo.0000000000001420

Cited by 13 publications

(20 citation statements)

References 22 publications

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“…Goodbody et al ( 34 ) pointed out that compared with normal BMI, patients with excessively high (>85%) or excessively low (<20%) BMI showed less effective brace treatment, and low BMI was an independent risk factor for brace treatment failure. Similarly, the operation rate among patients with low BMI is higher than that of controls ( 35 ). Therefore, maintaining proper BMI is essential to reduce the risk of scoliosis.…”

Section: Discussionmentioning

confidence: 98%

Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China

Guo

Chen²,

Yang³

et al. 2022

Front. Public Health

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ObjectivesTo determine the influence of ethnic disparities, socioeconomic status (SES) and hukou on the incidence of scoliosis.MethodsWe enrolled 2,445 junior high school students (Han: 1,153; ethnic minorities: 1,292) aged 12–16 years from two schools in Tianzhu Tibetan Autonomous County, Gansu Province from November 2020 to February 2021. We measured the angle of trunk rotation (ATR) using a scoliometer. Two-factor analysis of variance was used to comparatively analyze differences in the ATR according to ethnicity, age, sex, body mass index (BMI), and SES between the groups. Associations between risk factors and scoliosis were estimated using odds ratios and 95% confidence intervals with an unconditional multivariate logistic regression model for the two groups.ResultsAdolescents with Han ethnicity were more likely to have scoliosis than their ethnic minority counterparts (10.8% vs. 7.1%, P < 0.05). The ATR value in the Han group decreased with age whereas the minority group showed an upward trend (P < 0.05). The difference between ethnic groups was not significant, only at level 3. In particular, the ATR values among Han girls were significantly higher than those of ethnic minority girls (P < 0.05). Compared with Han adolescents, the BMI of ethnic minorities had a greater impact on the ATR. A statistically significant difference in SES was found between the two ethnic groups (P < 0.05). Hukou and parents' occupation had an important influence on the onset of scoliosis.ConclusionsHan adolescents had higher ATR values and were more likely to have scoliosis than ethnic minority adolescents in our study. Growth and development indicators (height and BMI) and differences in SES between the two groups played an important role.

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Section: Discussionmentioning

confidence: 98%

Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China

Guo

Chen²,

Yang³

et al. 2022

Front. Public Health

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“…BMI is also found to be irrelevant to the result of bracing, contrary to the belief that obese patients experience poor brace correction and outcome. 44 This study has several limitations. First, this study did not use 3D reconstruction measurements for morphological factors, which may produce inaccurate estimates for certain factors such as vertebral wedging.…”

Section: Discussionmentioning

confidence: 92%

“…BMI is also found to be irrelevant to the result of bracing, contrary to the belief that obese patients experience poor brace correction and outcome. 44 …”

Section: Discussionmentioning

confidence: 99%

Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Wong

Cheung

2022

The Bone & Joint Journal

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Aims The aim of this study was to assess the ability of morphological spinal parameters to predict the outcome of bracing in patients with adolescent idiopathic scoliosis (AIS) and to establish a novel supine correction index (SCI) for guiding bracing treatment. Methods Patients with AIS to be treated by bracing were prospectively recruited between December 2016 and 2018, and were followed until brace removal. In all, 207 patients with a mean age at recruitment of 12.8 years (SD 1.2) were enrolled. Cobb angles, supine flexibility, and the rate of in-brace correction were measured and used to predict curve progression at the end of follow-up. The SCI was defined as the ratio between correction rate and flexibility. Receiver operating characteristic (ROC) curve analysis was carried out to assess the optimal thresholds for flexibility, correction rate, and SCI in predicting a higher risk of progression, defined by a change in Cobb angle of ≥ 5° or the need for surgery. Results The baseline Cobb angles were similar (p = 0.374) in patients whose curves progressed (32.7° (SD 10.7)) and in those whose curves remained stable (31.4° (SD 6.1)). High supine flexibility (odds ratio (OR) 0.947 (95% CI 0.910 to 0.984); p = 0.006) and correction rate (OR 0.926 (95% CI 0.890 to 0.964); p < 0.001) predicted a lower incidence of progression after adjusting for Cobb angle, Risser sign, curve type, menarche status, distal radius and ulna grading, and brace compliance. ROC curve analysis identified a cut-off of 18.1% for flexibility (sensitivity 0.682, specificity 0.704) and a cut-off of 28.8% for correction rate (sensitivity 0.773, specificity 0.691) in predicting a lower risk of curve progression. A SCI of greater than 1.21 predicted a lower risk of progression (OR 0.4 (95% CI 0.251 to 0.955); sensitivity 0.583, specificity 0.591; p = 0.036). Conclusion A higher supine flexibility (18.1%) and correction rate (28.8%), and a SCI of greater than 1.21 predicted a lower risk of progression. These novel parameters can be used as a guide to optimize the outcome of bracing. Cite this article: Bone Joint J 2022;104-B(4):495–503.

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“…According to previous evidence, bracing compliance of AIS patients can be affected by age [58], gender [59], BMI index [60], the type of braces (structure and appearance) [15,[61][62][63][64], and brace wear pattern (daytime/ nighttime or part-time/ full-time) [65,66]. As the core device…”

Section: Discussionmentioning

confidence: 99%

Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis

Huo

et al. 2022

PLoS ONE

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This review aimed to systematically review and meta-analyze the effects of interventions in improving bracing compliance among adolescent idiopathic scoliosis (AIS) patients. Eight databases were searched from their inception to April 2022. The eligibility criteria included controlled studies that used any type of intervention to enhance bracing compliance in braced AIS patients. Two researchers independently screened articles and extracted data based on the PICO (participant, intervention, comparator, and outcome) framework. Quality appraisal of included studies was performed using GRADE (overall assessment), and the risk of bias was assessed with Cochrane RoB Tool 2 for randomized controlled trials (RCT) and ROBINS-I for non-RCT studies. The primary outcome was bracing compliance and secondary outcomes included Cobb Angle and measurements for quality of life. Six eligible studies involving 523 participants were included. All studies were evaluated as low or very low quality with a high risk of bias. Four types of interventions were identified, including sensor monitoring (n = 2, RCTs), auto-adjusted brace (n = 1, RCT), more intensive or collaborated medical care (n = 2), and psychosocial intervention (n = 1). A meta-analysis of 215 patients from the three RCTs suggested that the compliance-enhancing intervention group had 2.92 more bracing hours per day than the usual care control (95%CI [1.12, 4.72], P = 0.001). In subgroup analysis, sensor monitoring significantly improved bracing wearing quantity compared to usual care (3.47 hours/day, 95%CI [1.48, 5.47], P = 0.001), while other aforementioned interventions did not show a significant superiority. Compliance-enhancing interventions may be favorable in preventing curve progression and promoting quality of life, but the improvements cannot be clarified according to limited evidence. In conclusion, although the results of this study suggested that sensor monitoring may be the most promising approach, limited high-quality evidence precludes reliable conclusions. Future well-designed RCTs are required to confirm the actual benefit of compliance-improving interventions in clinical practice.

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The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis

Cited by 13 publications

References 22 publications

Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China

Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China

Supine correction index as a predictor for brace outcome in adolescent idiopathic scoliosis

Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis

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