Correlation between quantity and quality of orthosis wear and treatment outcomes in adolescent idiopathic scoliosis

Lou, E.; Raso, James; Hill, Douglas L.; Mahood, James; Moreau, Marc

doi:10.3109/03093640409167925

Cited by 40 publications

(30 citation statements)

References 5 publications

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“…It was also observed that during walking for all the types of curve, there was a significant progressive reduction ( p <0.05) of the force value, because of the change of the brace’s right position and the brace straps’ stretching. 14 Aubin et al 2 who quantified the strap tension noted a reduction of the strap tension during activity, which explain the reduction we noticed. So, during everyday activities, the strap tension must be checked, in order to be the appropriate, independently of the body posture and the patient’s activity.…”

Section: Discussionsupporting

confidence: 53%

Analysis of the corrective forces exerted by a dynamic derotation brace (DDB)

Loukos

Zachariou

Nicolopoulos³

et al. 2011

Prosthetics &Amp; Orthotics International

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Background: Discrepancies exist in the current literature for bracing of spinal curvature conditions. This can be explained by the diversity of brace types, the different curve patterns and the various measurement methods and instruments. Objectives: The aim of this study was the analysis of the corrective forces exerted by a dynamic derotation brace (DDB), at the skin-brace interface, altering the strap tension and body posture. Study Design: We analysed the direct forces exerted by a DDB's main pad, on 44 (38 girls, 6 boys) idiopathic scoliotic patients. Twenty-seven patients had a single right thoracic and 17 a single left or right thoracolumbar curve. Methods: We used the F-Socket 9801 pressure sensor and the MatScan Research BETA STAM 6.30 software, while patients adopted nine different postures. The patients were divided into three different groups: those who wore the brace for the first time, those who were changing their brace for a new one, and those who were having adjustments made to their existing brace. Results: These patients who were having adjustments made to their existing brace caused the highest mean exerted force. Changes in strap tension and body posture resulted in statistically significant alterations of the interface pressure and the forces exerted on the patient's body. Conclusions: Tightening the brace's straps always produces a significant force increase, independent of the body posture and the curve type. Also there are some body postures which significantly modify the exerted force. The body posture of maximum inspiration for thoracolumbar curves and, additionally, prone and lying left for thoracic curves. Clinical relevanceAnalysis of forces does not provide information on the correction of spinal curvature, but seem to be helpfully trying to achieve the brace's optimal fit and the best therapeutic result.

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Section: Discussionsupporting

confidence: 53%

Analysis of the corrective forces exerted by a dynamic derotation brace (DDB)

Loukos

Zachariou

Nicolopoulos³

et al. 2011

Prosthetics &Amp; Orthotics International

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“…Recent studies have focused on the assessment of the quality of life of the patients related to hours of daily use of the brace and long-term results [27–31, 36]. Other studies have evaluated the use of the brace and the outcome of the treatment associated with health, self-esteem, and quality of life [1, 64–75].…”

Section: Introductionmentioning

confidence: 99%

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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“…The patient and their parents were unaware of the existence of a sensor in the brace. We believe that this is the strength of our study because in most previous studies that have used a sensor, the patient knew about its presence, and this may have interfered with true compliance and resulted in biased results [23,24]. In a study Miller et al [23], the patient’s knowledge of the sensor’s presence in his or her brace was introduced as a factor that enhanced patient compliance.…”

Section: Discussionmentioning

confidence: 99%

“…In a study Miller et al [23], the patient’s knowledge of the sensor’s presence in his or her brace was introduced as a factor that enhanced patient compliance. Lou et al [24] described the patient’s knowledge of the presence of the sensor as a potential contributing factor to the study.…”

Section: Discussionmentioning

confidence: 99%

Objective Monitoring of Brace Wearing Time in Adolescents with Scheuermann’s Kyphosis

et al. 2019

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Study DesignThis was a prospective cohort study.PurposeThis study aimed to evaluate the potential differences between the objective and subjective bracing compliances of adolescents with Scheuermann’s kyphosis.Overview of LiteratureBracing is a well-documented intervention for managing adolescents with progressive thoracic Scheuermann’s kyphosis, and the brace should be worn 23 hours every day. Most research studies that have investigated the efficacy of bracing have assumed that the patients wore the braces as advised or that the bracing time was measured subjectively. This may be one of the reasons for the conflicting reports regarding the efficacy of bracing.MethodsNineteen volunteers (11 girls and 7 boys, 12.89±1.77 years) who were prescribed Milwaukee braces for Scheuermann’s kyphosis were enrolled. Each brace was equipped with a miniature temperature logger to record the actual brace wearing time over a period of 3 weeks. The patients and their families were unaware of the mounted sensor. Each participants and/or parent was provided with a questionnaire to record the number of hours for which the brace was worn each day. In addition, the therapist asked each patient and/or his/her parent about the average number of hours that the brace was worn.Results The compliance rates measured using the temperature logger (16.00±4.90 hours daily) were significantly lower than those reported in the questionnaires (19.52±6.04 hours daily, p<0.001) and the verbal responses (20.21±6.05 hours daily, p<0.001). Moreover, there was no correlation of age, sex, and body mass index with brace compliance.ConclusionsThe braces were worn less often than reported by the patients and/or their parents. Therefore, objective compliance assessments of adolescents with Scheuermann’s kyphosis in a brace are recommended for future studies.

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Correlation between quantity and quality of orthosis wear and treatment outcomes in adolescent idiopathic scoliosis

Cited by 40 publications

References 5 publications

Analysis of the corrective forces exerted by a dynamic derotation brace (DDB)

Analysis of the corrective forces exerted by a dynamic derotation brace (DDB)

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

Objective Monitoring of Brace Wearing Time in Adolescents with Scheuermann’s Kyphosis

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