Determination of quality of life in adolescents with idiopathic scoliosis subjected to conservative treatment

Abstract

Introduction and objectivesPhysical deformities caused by adolescent idiopathic scoliosis (AIS) coupled with conservative treatment of AIS with orthesis unavoidably impacts on patients' quality of life (QoL). The present study aimed at evaluating the QoL in patients affected by AIS treated with brace. The study also sought to determine the ability of different QoL questionnaires to monitor QoL over the course of treatment.Materials and methodsData were collected in 108 consecutive patients (96 females, 16 males) affected by AIS admitted to the outpatient orthopaedic clinic of the Catholic University of the Sacred Heart in Rome (Italy). Patients were subjected to full-time (i.e., 22 hrs per day) conservative treatment with the progressive action short brace (PASB), the Lyon brace or a combination of PASB + Lyon brace. Three instruments were used for QoL determination: the Scoliosis Research Society 22 (SRS-22), Bad Sobernheim Stress Questionnaire (BSSQ) and the Brace Questionnaire (BrQ).ResultsA significant correlation was detected among the 3 scores (p < 0.001). The BrQ possesses a higher capacity to detect changes in QoL in relation to the patient gender, type of brace, curve severity at baseline and at the completion of treatment, and curve type. Overall, boys displayed a higher QoL than girls. In all 3 questionnaires, higher QoL scores were determined in patients treated with the PASB compared with those using the Lyon brace. QoL scores were significantly correlated with the curve severity. Higher QoL scores were obtained by participants with thoraco-lumbar curves as compared with those with other curves.ConclusionsThe 3 questionnaires are effective in capturing changes in QoL in AIS patients subjected to conservative treatment. However, the BrQ possesses a higher discriminatory capacity compared with the other questionnaires tested. PASB-based treatment is associated with better QoL than the Lyon bracing.

Outcome instruments to assess scoliosis surgery

“…The authors [53] suggest a grading of 0-8 for intense stress, 9-16 for moderate stress, and 17-24 for low stress. The questionnaire was originally designed in German, and an adapted version is available in English [53], Polish [54], Italian [55], and Spanish [56]. The instrument has shown excellent internal consistency and reliability.…”

“…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.…”

“…The instrument's dimensions are similar to those of SRS-22, although a number of questions refer specifically to the brace; hence, it can only be used in patients who receive this treatment. Nonetheless, a significant correlation between the two questionnaires has been reported [55].…”

Health Related Quality of Life in Adolescents with Idiopathic Scoliosis

“…It measures 8 areas: general health perception, physical functioning, emotional functioning, self-esteem and aesthetics, vitality, school activity, bodily pain and social functioning. BrQ has been validated in Italian (Aulisa et al, 2010) and in Polish (Kinel, 2011).…”

“…The questionnaire has good psychometric properties: test-retest reliability is high (r = 0.88) as its internal consistency (α = 0.97), although there is not any validity measurement. It was translated and validated into Polish In an Italian study (Aulisa et al, 2010), BrQ had the highest capacity among SRS-22 and BSSQ (mit Korsett) in detecting changes in HRQOL in relation to the sex of patients, brace type and severity of curve. This finding could be related to the higher BRQ items number, allowing to explore more areas than the other instruments.…”