Prospective evaluation of physical activity in patients with idiopathic scoliosis or kyphosis receiving brace treatment.
Bracing has become established as an effective non-surgical treatment modality in moderate adolescent idiopathic scoliosis (AIS) and adolescent kyphosis (AK). Treatment success largely depends on patients’ compliance of wearing the brace on a regular basis (recommended 23h a day = 100% compliance). Reasons for non-adherence are cosmetic issues, fear of reduced trunk muscle strength and restrictions in daily physical activities (PA). The aim of this prospective study was to investigate the effect of bracing on PA in AIS and AK patients.
PA in 48 patients was assessed twice for 7 days by means of accelerometry: before and eight weeks after the start of brace treatment. Simultaneously, patients completed the SRS-22 questionnaire. Brace wearing times were recorded using temperature probes implanted in the braces to measure compliance.
No significant difference in daily PA was found. AIS and AK patients took 10072 steps/day and 790 steps/hour before, and 9760 steps/day and 806 steps/hour during brace treatment on average. In the follow-up measurement, no difference in PA was found during brace treatment when the brace was worn or discarded. Overall adherence was 72.7% with girls showing higher compliance levels than boys. The SRS-22 total score showed no difference between both measurements, but a significant improvement in the subscale “function” during brace treatment.
The results demonstrate that bracing in AIS and AK patients does not interfere with PA. However, PA seems to be already reduced before bracing therapy in comparison with healthy peers, indicating the need for additional physiotherapy > From Müller et al. Eur Spine J 20 (2011) 1127-1136. All rights reserved to Springer-Verlag.
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(Image by: Carsten Müller)