Researchers conducted a study to evaluate psychosocial well-being, in particular body image and quality of life (QOL), and brace wear adherence in female patients with adolescent idiopathic scoliosis (AIS). The study’s authors concluded that body image and QOL do not have a significant impact on brace wear adherence and subsequently are not significantly impacted by brace wear among this group. The open access study was published online February 15 in the Journal of Pediatric Orthopaedics.
The Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) was a multicenter, controlled trial using randomized and preference assignments into an observation or brace treatment group. BrAIST patients were skeletally immature adolescents diagnosed with AIS and moderate curve sizes (20-40 degrees). Patients in the bracing group were instructed to wear a TLSO (such as a Boston, Wilmington, or one of several other TLSO brace designs) at least 18 hours per day. Using BrAIST data, the researchers analyzed scores on the Spinal Appearance Questionnaire and the PedsQL 4.0 Generic Scales from 167 female BrAIST patients who were randomized to brace treatment (n=58) and patients who chose brace treatment (n=109).
At baseline and at 12 months, no differences were found between the least adherent brace wear group (<6 hours per day) and most adherent brace wear group (>=12 hours per day) in terms of major curve, body image, and QOL. In the most adherent group, poorer body image scores were significantly correlated with poorer QOL scores at baseline, at six months, and at 12 months, but not at 18 months. In general, body image scores and QOL scores were not significantly correlated in the least adherent group. When comparing patients who had a >=6 degree increase of their major curve between baseline and 12 months to patients who did not, there were no significant differences in body image or QOL scores.
“Results from this study, in particular that the amount of time the brace was worn did not adversely impact body image and QOL, should be relayed to clinicians, adolescents, and parents so they can weigh the psychosocial risks and the lack of psychosocial risks with the clinical benefits of brace treatment,” according to the researchers.