Observational retrospective study on socio-economic and quality of life outcomes in 41 patients with adolescent idiopathic scoliosis 5 years after bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE)

Abstract

Purpose: We analysed socio-economic- and health-related quality of life (primary outcome) and radiological outcome (secondary outcome) 5 years after full time rigid bracing (FTRB) plus physiotherapeutic scoliosis-specific exercises (PSSE) in adolescent idiopathic scoliosis.

Methods: We included 41 patients (38 female and 3 male) treated with FTRB (Chênau brace) and PSSE (Schroth) between 2001 and 2010. The study protocol included a clinical and radiological examination, the completion of the SRS-24 questionnaire and acquisition of data on socio-economic factors (educational and employment status) and physical activity. Descriptive statistics were used to analyse the data; differences between patients with mild (< 30°) and severe curves (30°-50°) regarding hrQoL outcomes were analysed using the Mann-Whitney U Test.

Results: Primary outcomes showed full employment (higher education, 39%, and full-time work, 61%) and the majority of the patients (79.9%) performing moderate sports two to four times per week. The SRS-24 questionnaire produced a total mean score (MS) of 4.0 (79.9%). Patients with mild curves had a significantly better total score (MS 4.1 vs. MS 3.8, p = 0.020) and were more satisfied with the treatment (MS 4.3 vs MS 3.9, p = 0.020). As to the secondary outcomes, from start of bracing to follow-up (a mean of 6.7 years after brace weaning), the average Cobb angle changed from 28.6° to 25.6° (range 4°-48°); in 51.2% the curve angles could be maintained after weaning.

Conclusions: Compared with the literature, our results showed similar curve development and hrQoL (pain, self-image and function) and better results regarding satisfaction with treatment. In comparison with the average population, there were no disadvantages as to occupation, education and sports. These slides can be retrieved under Electronic Supplementary Material.

Keywords: Adolescent idiopathic scoliosis; Conservative treatment; Full time rigid bracing; Physiotherapeutic scoliosis-specific exercises; Quality of life questionnaire.