Routinely, adolescent idiopathic scoliosis (AIS) curves that progress beyond 40° in skeletally immature adolescents require surgery. However, some adolescents with AIS and their parents utterly refuse surgery and insist on wearing a brace. Debate continues regarding the appropriateness of bracing for AIS curves exceeding 40° in patients who have rejected surgical intervention. This systematic review and meta-analysis was conducted to review the literature on the effectiveness of bracing and its predictive factors in largermagnitude AIS curves ≥40°. This study replicated the search strategy used by the PICOS system for formulating study questions, which include consideration of the patient/population (P), intervention (I), comparison (C), outcome (O), and study design (S). The search was conducted up to January 2022 in the following bibliographic online databases only in the English language: PubMed, Google Scholar, Scopus, and Web of Science. Two assessors reviewed the articles for qualification. Eligible studies were assessed for risk of bias at the study level using the Newcastle-Ottawa Scale. The effect size across the studies was determined using standardized mean differences (Cohen's d) and 95% confidence intervals for the meta-analysis. Among the eight included moderate quality studies, evidence of potential publication bias (p<0.05) for the trials included was found in the Cobb angle outcome. Results obtained through meta-analysis indicated that the effectiveness of bracing in controlling Cobb angle progression in curves ≥40° is significantly positive. Additionally, initial curve severity, Risser stage, in-brace curve correction, curve type, and apical vertebral rotation were considered risk factors associated with brace effectiveness. This systematic review revealed that bracing could alter the normal course of AIS curves ≥40° in patients refusing posterior spinal fusion (PSF). However, the suggested course for patients refusing PSF remains unclear because of the significant heterogeneity in the risk factors associated with bracing failure.
Objectives: This study aimed to evaluate the effect of brace treatment on the stress level and quality of life (QoL) of adolescents with idiopathic scoliosis. Patients and methods: A total of 194 adolescent individuals were evaluated in two groups: the adolescent idiopathic scoliosis (AIS) group with 97 patients (20 males, 77 females; mean age: 13.9±1.8 years; range 10 to 18 years) and the control group with 97 age-and sex-matched participants (20 males, 77 females; mean age: 14.3±1.7 years; range 10 to 18 years) with no spinal deformity. The AIS group wore the Milwaukee brace or a thoracolumbosacral orthosis based on the location of the apical vertebra. All participants of the AIS group filled the Persian versions of the revised Scoliosis Research Society 22-item questionnaire (SRS-22r), the eight-item Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity, and BSSQ-Brace. The control group only answered the first 20 items (subtotal items) of the SRS-22r. The brace-related QoL and stress level were assessed based on sex, brace, and deformity types. Results: The subtotal score of the SRS-22r in the AIS group was significantly lower than the control group (p<0.001). There was a significant difference between deformity-related stress and brace-related stress (p<0.001). Regarding the type of treatment, there were no significant differences in QoL and stress level between the Milwaukee brace and thoracolumbosacral orthosis groups (p>0.05). Moreover, there was a weak correlation between the BSSQ-Brace and the self-image, mental-health scores, and the total scores of the SRS-22r (r=0.39 to 0.42, p<0.001); the low level of perceived stress was associated with a high level of perceived QoL. Conclusion: The stress due to brace treatment can decrease function/activity and self-image of adolescents with idiopathic scoliosis.
Objectives: Foot disorders, especially pain and deformities, are common patient complaints. Foot Health Status Questionnaire (FHSQ) was developed to assess general and foot health specifically in chronic foot disorders. The purpose of the current study was the cross-cultural adaptation of the FHSQ to Persian and evaluating the psychometric properties of the translated version. Methods: As per the International Quality of Life Assessment guideline, the forward and backward translations of the questionnaire were conducted by two independent translators. Accordingly, the final version was approved by a committee and confirmed by the developer. The psychometric properties of the Persian version of the FHSQ were tested in 101 participants (Mean±SD age: 42.98±15.03 y) with chronic foot disorders. Face validity by impact score calculation; criterion validity through correlation to the Manchester-Oxford Foot Questionnaire (MOXFQ) scores; internal consistency by Cronbach’s alpha coefficient, and test-retest reliability by calculating intra-class correlation were tested to describe the psychometric features of its Persian version. Results: Face validity was confirmed by impact scores of >1.5 for all items. The FHSQ was significantly correlated with the MOXFQ domains, supporting the criterion validity of the instrument, except for the shoe domain of the Persian FHSQ, i.e., not correlated with the pain domain of the MOXFQ (r=0.26). Cronbach’s alpha coefficients for pain, function, shoe, and general foot health were measured as 0.93, 0.92, 0.90, and 0.96 respectively. Thus, it suggested an excellent internal consistency for all domains. The intra-class correlation coefficient ranged from 0.73 to 0.93 for all domains, reflecting its good to excellent reliability. Discussion: The Persian version of the FHSQ is a valid and reliable patient satisfaction measurement instrument for evaluating foot conditions. Moreover, the current study results supported the potential of applying it as an appropriate instrument in research and clinical setting. Implementing this tool could help to evaluate the effects of an intervention or estimate the prevalence of a disorder in Persian-speaking populations
This is a report of a diabetic transtibial amputee with severe pain and ulcer in the antero‐distal of the tibia. A novel prosthetic socket with an antero‐distal silicone wall was designed. The result showed that the patient's satisfaction was increased and the average peak pressure was reduced by using the new socket design.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.