https://doi.org/10.4081/ejtm.2024.12859
Lessons from the pandemic era: do we need new strategies to improve conservative treatment adherence in adolescent idiopathic scoliosis? A retrospective analysis
Published: 10 September 2024
Abstract Views: 261
PDF: 151
HTML: 2
HTML: 2
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
This study aims to examine whether the COVID-19 pandemic affected the adherence to conservative AIS treatment. Adolescent Idiopathic Scoliosis (AIS) is characterized by a lateral curvature of the spine of at least 10 degrees. Compliance rates in conservative treatments are influenced by various factors. From a database of AIS patients, we selected 30 AIS patients who were assessed before, during, and after the COVID-19 pandemic. Data regarding Cobb’s angle, brace prescription, prescribed brace wear time, brace wear compliance, and time dedicated to sports activities were collected over a six-year period from January 2018 to December 2023, divided into three 2-year time periods (before, during, and after COVID-19). There was an increased percentage of AIS patients prescribed with a brace during the pandemic. However, no significant differences in Cobb’s angle were observed. Additionally, the prescribed wear time showed a significant decrease from the pre-COVID period to the post-COVID period (p-value = 0.03). Wear compliance exhibited a decreasing trend from pre- to during- and post-COVID-19 periods without reaching statistically significant differences, and the time dedicated to sports statistically significantly decreased. These differences were statistically significant when comparing the pre- vs. post- and pre- vs. during-COVID-19 periods (p-values 0.01, 0.04, respectively). Our study highlights changes in AIS conservative treatment during and after the COVID-19 pandemic. The increase in the number of patients prescribed with a brace during the pandemic, although not supported by an increase in Cobb’s angle, may be attributed to the concerns about regular monitoring during the reduction of rehabilitation services. The observed decreases in brace compliance and involvement in sport activities, which persisted even in the post-pandemic period, emphasizes the lasting impact of the pandemic on AIS management, necessitating innovative approaches to address these ongoing concerns.
Janicki JA, Alman B. Scoliosis: Review of diagnosis and treatment. Paediatr Child Health 2007;12:771–6.
DOI: https://doi.org/10.1093/pch/12.9.771
Nuwer MR, MacDonald DB, Gertsch J. Monitoring scoliosis and other spinal deformity surgeries. Handb Clin Neurol 2022;186:179-204.
DOI: https://doi.org/10.1016/B978-0-12-819826-1.00014-4
Marya S, Tambe AD, Millner PA, Tsirikos AI. Adolescent idiopathic scoliosis. Bone Joint J 2022;104-B:915–21.
DOI: https://doi.org/10.1302/0301-620X.104B8.BJJ-2021-1638.R1
Smania N, Picelli A, Romano M, Negrini S. Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis. Disabil Rehabil 2008;30:763–71.
DOI: https://doi.org/10.1080/17483100801921311
Peng Y, Wang S-R, Qiu G-X, et al. Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis. Chin Med J (Engl) 2020;133:483–93.
DOI: https://doi.org/10.1097/CM9.0000000000000652
Pérez-Machado G, Berenguer-Pascual E, Bovea-Marco M, et al. From genetics to epigenetics to unravel the etiology of adolescent idiopathic scoliosis. Bone 2020;140:115563.
DOI: https://doi.org/10.1016/j.bone.2020.115563
Gargano G, Oliva F, Migliorini F, Maffulli N. Melatonin and adolescent idiopathic scoliosis: The present evidence. Surg 2022;20:e315–21.
DOI: https://doi.org/10.1016/j.surge.2021.07.008
Simoneau M, Mercier P, Blouin J, et al. Altered sensory-weighting mechanisms is observed in adolescents with idiopathic scoliosis. BMC Neurosci 2006;7:68.
DOI: https://doi.org/10.1186/1471-2202-7-68
Burwell RG, Dangerfield PH, Moulton A, Anderson SI. Etiologic theories of idiopathic scoliosis: autonomic nervous system and the leptin-sympathetic nervous system concept for the pathogenesis of adolescent idiopathic scoliosis. Stud Health Technol Inform 2008;140:197–207.
Shakil H, Iqbal ZA, Al-Ghadir AH. Scoliosis: Review of types of curves, etiological theories and conservative treatment. J Back Musculoskelet Rehabil 2014;27:111–5.
DOI: https://doi.org/10.3233/BMR-130438
Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 2018;13:3.
DOI: https://doi.org/10.1186/s13013-017-0145-8
Landauer F, Trieb K. Scoliosis: Brace treatment – from the past 50 years to the future. Medicine (Baltimore) 2022;101:e30556.
DOI: https://doi.org/10.1097/MD.0000000000030556
Cheung JPY, Cheung PWH, Yeng WC, Chan LCK. Does curve regression occur during underarm bracing in patients with adolescent idiopathic scoliosis? Clin Orthop Relat Res 2020;478:334–45.
DOI: https://doi.org/10.1097/CORR.0000000000000989
Marti CL, Glassman SD, Knott PT, et al. Scoliosis Research Society members attitudes towards physical therapy and physiotherapeutic scoliosis specific exercises for adolescent idiopathic scoliosis. Scoliosis 2015;10:16.
DOI: https://doi.org/10.1186/s13013-015-0041-z
Konieczny MR, Hieronymus P, Krauspe R. Time in brace: where are the limits and how can we improve compliance and reduce negative psychosocial impact in patients with scoliosis? A retrospective analysis. Spine J 2017;17:1658–64.
DOI: https://doi.org/10.1016/j.spinee.2017.05.010
van den Bogaart M, van Royen BJ, Haanstra TM, et al. Predictive factors for brace treatment outcome in adolescent idiopathic scoliosis: a best-evidence synthesis. Eur Spine J 2019;28:511–25.
DOI: https://doi.org/10.1007/s00586-018-05870-6
Hawary R El, Zaaroor-Regev D, Floman Y, et al. Brace treatment in adolescent idiopathic scoliosis: risk factors for failure—a literature review. Spine J 2019;19:1917–25.
DOI: https://doi.org/10.1016/j.spinee.2019.07.008
Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 2013;369:1512–21.
DOI: https://doi.org/10.1056/NEJMoa1307337
Rahman T, Bowen JR, Takemitsu M, Scott C. The association between brace compliance and outcome for patients with idiopathic scoliosis. J Pediatr Orthop 2005;25:420–2.
DOI: https://doi.org/10.1097/01.bpo.0000161097.61586.bb
Rahimi S, Kiaghadi A, Fallahian N. Effective factors on brace compliance in idiopathic scoliosis: a literature review. Disabil Rehabil Assist Technol 2020;15:917–23.
DOI: https://doi.org/10.1080/17483107.2019.1629117
Newman M, Hannink E, Barker KL. Associations between physical activity and adolescent idiopathic scoliosis: a systematic review and meta-analysis. Arch Phys Med Rehabil 2023;104:1314–30.
DOI: https://doi.org/10.1016/j.apmr.2023.01.019
Dermott JA, Kim DJ, Lebel DE. The impact of COVID-19 on idiopathic scoliosis referrals: cause for concern. Spine Deform 2021;9:1501–7.
DOI: https://doi.org/10.1007/s43390-021-00418-z
Maccarone MC, Masiero S. The important impact of COVID-19 pandemic on the reorganization of a rehabilitation unit in a national healthcare system hospital in Italy. Am J Phys Med Rehabil 2021;100:327–30.
Rapin A, Noujaim P-J, Taiar R, et al. Characteristics of COVID-19 inpatients in rehabilitation units during the first pandemic wave: a cohort study from a large hospital in champagne region. Biology (Basel) 2022;11:937.
DOI: https://doi.org/10.3390/biology11060937
Badenoch JB, Rengasamy ER, Watson C, et al. Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain Commun 2022;4(1).
DOI: https://doi.org/10.1093/braincomms/fcab297
Malik P, Patel K, Pinto C, et al. Post‐acute COVID‐19 syndrome (PCS) and health‐related quality of life (HRQoL)—A systematic review and meta‐analysis. J Med Virol 2022;94:253–62.
DOI: https://doi.org/10.1002/jmv.27309
Pereira Duarte M, Joncas J, Parent S, et al. A dangerous curve: impact of the COVID-19 pandemic on brace treatment in adolescent idiopathic scoliosis. Glob Spine J 2022;219256822211134.
DOI: https://doi.org/10.1177/21925682221113487
Pesarin F, Salmaso L. Permutation Tests for Complex Data. Wiley; 2010.
DOI: https://doi.org/10.1002/9780470689516
Winkler AM, Ridgway GR, Webster MA, et al. Permutation inference for the general linear model. Neuroimage 2014;92:381–97.
DOI: https://doi.org/10.1016/j.neuroimage.2014.01.060
Karavidas N, Tzatzaliaris D. Brace and Physiotherapeutic Scoliosis Specific Exercises (PSSE) for Adolescent Idiopathic Scoliosis (AIS) treatment: a prospective study following Scoliosis Research Society (SRS) criteria. Arch Physiother 2022;12:22.
DOI: https://doi.org/10.1186/s40945-022-00150-5
Lou E, Hill D, Hedden D, et al. An objective measurement of brace usage for the treatment of adolescent idiopathic scoliosis. Med Eng Phys 2011;33:290–4.
DOI: https://doi.org/10.1016/j.medengphy.2010.10.016
Vandal S, Rivard C, Bradet R. Measuring the compliance behavior of adolescents wearing orthopedic braces. Issues Compr Pediatr Nurs 1999;22:59–73.
DOI: https://doi.org/10.1080/014608699265293
Wong MS, Cheng CY, Ng BKW, et al. The effect of rigid versus flexible spinal orthosis on the gait pattern of patients with adolescent idiopathic scoliosis. Gait Posture 2008;27:189–95.
DOI: https://doi.org/10.1016/j.gaitpost.2007.03.007
Ugwonali OF, Lomas G, Choe JC, et al. Effect of bracing on the quality of life of adolescents with idiopathic scoliosis. Spine J 2004;4:254–60.
DOI: https://doi.org/10.1016/j.spinee.2003.12.001
Donzelli S, Zaina F, Negrini S. In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace. Scoliosis 2012;7:12.
DOI: https://doi.org/10.1186/1748-7161-7-12
Giacalone M, Agata Z, Cozzucoli PC, Alibrandi A. Bonferroni-Holm and permutation tests to compare health data: methodological and applicative issues. BMC Med Res Methodol 2018;18:81.
DOI: https://doi.org/10.1186/s12874-018-0540-8
Racioppi M, Salmaso L, Brombin C, et al. The clinical use of statistical permutation test methodology: a tool for identifying predictive variables of outcome. Urol Int 2015;94:262–9.
DOI: https://doi.org/10.1159/000365292
Maccarone MC, Masiero S. The important impact of COVID-19 pandemic on the reorganization of a rehabilitation unit in a national healthcare system hospital in Italy. Am J Phys Med Rehabil 2021;100:327–30.
DOI: https://doi.org/10.1097/PHM.0000000000001707
García-Rodríguez MT, Juanatey-Rodríguez I, Seijo-Bestilleiro R, González-Martin C. Psycho-emotional distress in children and adolescents in relation to COVID-19 confinement and pandemic: A systematized review. Ital J Pediatr 2023;49:47.
DOI: https://doi.org/10.1186/s13052-023-01450-7
Méndez J, Sánchez-Hernández Ó, Garber J, et al. Psychological Treatments for depression in adolescents: more than three decades later. Int J Environ Res Public Health 2021;18:4600.
DOI: https://doi.org/10.3390/ijerph18094600
Delmastro M, Zamariola G. Depressive symptoms in response to COVID-19 and lockdown: a cross-sectional study on the Italian population. Sci Rep 2020;10:22457.
DOI: https://doi.org/10.1038/s41598-020-79850-6
Panchal U, Salazar de Pablo G, Franco M, et al. The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. Eur Child Adolesc Psychiatry 2023;32:1151–77.
DOI: https://doi.org/10.1007/s00787-021-01856-w
Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res 2020;291:113264.
DOI: https://doi.org/10.1016/j.psychres.2020.113264
How to Cite
Maccarone, M. C., Barzizza, E., Contessa, P., Biancato, A., Caregnato, A., Fontana, R., Ceccato, R., Salmaso, L., & Masiero, S. (2024). Lessons from the pandemic era: do we need new strategies to improve conservative treatment adherence in adolescent idiopathic scoliosis? A retrospective analysis. European Journal of Translational Myology, 34(3). https://doi.org/10.4081/ejtm.2024.12859
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.