Wimbledon Clinics

Wimbledon Clinics

COUNSELLING ON BRACE USE IMPROVES COMPLIANCE IN ADOLESCENT SCOLIOSIS PATIENTS

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Young people with late-onset (adolescent) scoliosis benefit from monitoring and counselling on brace use, according to a study published in the Journal of Bone and Joint Surgery.

Bracing often is recommended for young people diagnosed with adolescent idiopathic scoliosis, a condition in which the shape of the spine changes during a child´s growth.

According to the American Academy of Orthopaedic Surgeons, when worn consistently and as directed, braces have been found to effectively halt or slow further progression of a spinal curve, often preventing surgery.

In the new study, researchers wanted to find out whether counselling based on data obtained from compliance monitors increases brace wear and decreases curve progression, reducing the likelihood of surgery. Patients with adolescent idiopathic scoliosis each received a brace with embedded sensors to monitor use. They were then divided into two groups.

In the first group, 93 patients were told about the monitors in their brace and were counselled at each visit regarding downloaded usage data. The 78 patients in the second group were not told about the purpose of the monitors, and no compliance data was made available to the patients or their physicians.

“Patients who were aware that their device measured brace use wore their brace, on average, an additional three hours each day,” said orthopaedic surgeon and lead study author Dr. Lori Karol.

The spinal curve did not progress more than six degrees between the start of bracing and brace termination in 59% of patients in the counselled group, and 36% of patients in the non-counselled group.

Patients in both groups who had curve progression to a magnitude requiring surgery wore their brace less than their counterparts for whom bracing was successful, the researchers found.

“Shared information between the teen, parents, orthotist (who oversees the creation and fit of the custom brace) and physician resulted in improved brace compliance,” Dr. Karol concluded. “These findings emphasise the role that open doctor-patient communication plays in encouraging treatment effectiveness in the adolescent age group.”

http://newsroom.aaos.org/media-resources/news/monitoring-counseling-adolescent-scoliosis-patients-on-brace-use-prevents-curve-progression-and-the-need-for-surgery.htm

http://jbjs.org/content/98/1/9

http://www.sauk.org.uk/about-scoliosis/idiopathic-scoliosis/late-onset-scoliosis.html