Department of Orthopedics Pediatric Surgery, Normandie University, UNICAEN, CHU de Caen Normandie, 14000 Caen, France.
Department of Orthopedics Pediatric Surgery, Normandie University, UNICAEN, CHU de Caen Normandie, 14000 Caen, France.
Med Eng Phys. 2020 Mar;77:137-141. doi: 10.1016/j.medengphy.2020.01.003. Epub 2020 Jan 25.
The main issue that may be encountered during brace treatment of idiopathic scoliosis is the patient's compliance. While compliance with full-time brace treatment has been well documented, compliance with night-time brace treatment has not. The main feature of night-time braces is their ability to overcorrect the scoliotic curvature, which could decrease compliance. The primary aim of this study was to evaluate objectively the compliance of patients with idiopathic scoliosis when undergoing treatment by means of a night-time overcorrection brace. Twenty patients with adolescent idiopathic scoliosis were prescribed treatment with an overcorrection brace for 8 h per night. Compliance was determined by the percentage of actual hours the brace was worn relative to the prescribed regimen. Compliance was measured during 1 year via a hidden temperature monitor embedded within the brace. Patients were informed that their compliance was monitored. The brace acceptance period and the full acceptance period were analysed, and correlations were measured. The average compliance (% wearing hours/prescribed regimen) was 90.7%; 45% of the participants met or exceeded the prescribed brace time. Three girls were lost to follow-up. The mean acceptance period was 22,8 days, and half of the patients succeeded in achieving the acceptance period in less than 7 days. The mean full acceptance period was 26,9 days. The acceptance period was significantly and negatively correlated with the mean wearing time (r = -0,61, P = 0,004). There was no correlation between the in-brace overcorrection and the wearing time. These results suggest that patients with an overcorrection night-time brace had good compliance. The overcorrection did not seem to influence compliance. The first weeks of treatment seemed to be crucial for treatment compliance.
特发性脊柱侧凸支具治疗中可能遇到的主要问题是患者的依从性。虽然全时支具治疗的依从性已有充分记录，但夜间支具治疗的依从性却没有。夜间支具的主要特点是能够过度矫正脊柱侧凸的曲率，这可能会降低依从性。本研究的主要目的是客观评估特发性脊柱侧凸患者在夜间过度矫正支具治疗下的依从性。20 例青少年特发性脊柱侧凸患者被处方夜间使用过度矫正支具治疗，每晚 8 小时。依从性通过支具实际佩戴时间与规定方案的百分比来确定。通过嵌入支具内的隐藏温度监测器在 1 年内测量依从性。告知患者其依从性受到监测。分析了支具接受期和完全接受期，并测量了相关性。平均依从性（实际佩戴时间/规定方案）为 90.7%；45%的参与者符合或超过规定的支具佩戴时间。有 3 名女孩失访。平均接受期为 22.8 天，一半的患者在不到 7 天的时间内成功达到接受期。完全接受期的平均时间为 26.9 天。接受期与平均佩戴时间呈显著负相关（r=-0.61，P=0.004）。支具内过度矫正与佩戴时间之间没有相关性。这些结果表明，使用过度矫正夜间支具的患者依从性良好。过度矫正似乎不会影响依从性。治疗的最初几周对治疗依从性至关重要。
