Cantele Francesca, Posanti Elena, Pittarello Chiara, Masiero Stefano
Physical Medicine and Rehabilitation School, University of Padua, Padova, Italy.
Department of Neurosciences, Section of Rehabilitation, University of Padua, Padova, Italy.
J Back Musculoskelet Rehabil. 2023;36(5):1163-1169. doi: 10.3233/BMR-220361.
Brace treatment is the most effective tool for avoiding curve progression in moderate adolescent idiopathic scoliosis and high adherence is required to achieve therapeutic success. Despite this, the compliance often is impaired by the concern about the psychological well-being of adolescents.
This 36-month follow-up study investigated if the patients most adherent to brace treatment could report a stronger impairment in the quality of life and body image.
64 adolescents with idiopathic scoliosis responded to the Scoliosis Research Society-22 revised Patient Questionnaire at 12, 24, and 36 months after prescription of a TLSO rigid brace. Retrospectively, participants who wore a brace for more than 75% of the prescribed time were assigned to the good-compliance group (GC); the others formed the poor-compliance group (PC).
At 12 months the GC group showed higher scores in treatment satisfaction and at 36 months they did not differ from the PC group in the overall SRS-22r score. Moreover, they achieved a statistically significant improvement in the scoliosis severity, although they showed lower scores in the self-image domain.
In our patient's cohort, increased brace adherence does not compromise QoL and provides better treatment outcomes. However, more attention is needed to maintain good self-perception.
支具治疗是避免中度青少年特发性脊柱侧弯曲线进展的最有效工具，需要高度依从性才能取得治疗成功。尽管如此，依从性常常因对青少年心理健康的担忧而受到损害。
这项为期36个月的随访研究调查了最坚持佩戴支具治疗的患者是否在生活质量和身体形象方面有更严重的损害。
64名特发性脊柱侧弯青少年在佩戴胸腰骶椎矫形器（TLSO）刚性支具处方后的12个月、24个月和36个月，对脊柱侧弯研究学会-22修订版患者问卷进行了回答。回顾性地，将佩戴支具时间超过规定时间75%的参与者分配到良好依从性组（GC）；其他人组成了低依从性组（PC）。
在12个月时，GC组在治疗满意度方面得分更高，在36个月时，他们在总体SRS-22r评分上与PC组没有差异。此外，他们在脊柱侧弯严重程度方面取得了统计学上的显著改善，尽管他们在自我形象领域得分较低。
在我们的患者队列中，增加支具依从性不会损害生活质量，并能提供更好的治疗效果。然而，需要更多关注以保持良好的自我认知。
