The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study

Abstract

Background: Corrective bracing for adolescent idiopathic scoliosis (AIS) has favourable outcomes when patients are compliant. However, bracing may be a stressful and traumatic experience and compliance with a bracing protocol is likely to be dependent upon patients' physical, emotional and social wellbeing. The Brace Questionnaire (BrQ), a recently-developed, conditionspecific tool to measure quality of life (QOL) has enabled clinicians to study relationships between QOL and compliance.

Psychological Aspects of Scoliosis Treatment in Children

“…However, the extent to which all these factors influence a particular patient's ability to benefit from the brace will depend on his/her physical, emotional and social wellbeing [7].High correction bracing has been shown to have favorable outcomes when the patient is compliant . However, bracing is considered to be a traumatic experience which may leave lasting emotional scars.…”

“…A sick child's imagination suggests everything in his or her mind which can be connected with the concept of a disease such as a heart failure, physical disability, being rejected by others. A negative image of the disease, its course and effects may increase a child's anxiety [7]. We must not forget that anger is one of the stages prior to the acceptance of a prolonged illness without the expression of which it is usually impossible to reconcile with the situation and thus to find strength to fight the illness [8].Deciding on the method of treatment patients must know that this is best for them and often the only form of help.…”

“…A lot of scientific research and observations [19,20,21,7]point at a lower life quality of children and teenagers being treated due to scoliosis. Although this kind of treatment is not associated with pain, it is a disturbing one for patients and tends to affect them psychologically due to disturbances of the perceptions of self and body image [6].…”

Outcome instruments to assess scoliosis surgery

“…Incompletely validated versions are available in English [58] and Italian [55]. The instrument has 34 questions that measure 8 dimensions: general health, physical functioning, emotional functioning, self-esteem, vitality, school activity, body pain, and social functioning.…”

Review of current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis

“…Force logging systems can measure in-brace forces to record the fluctuations of in-brace forces in a patient's daily routine and relate forces to brace effectiveness [45][46][47]. Lastly, multiple quality of life and patient cosmesis surveys have been developed to assess brace treatment as a patient-centred process, aiming for adequate compliance and positive patient outcomes [48][49][50]. Questionnaires have been developed to identify common sources of stress that may help to inform patients and parents of potential conflicts that may arise from brace treatment [51][52][53][54][55].…”