Bracing Outcomes in Adolescent Idiopathic Scoliosis: The Role of Generalised Joint Hypermobility.

OBJECTIVE

To evaluate the effects of generalised joint hypermobility (JHM) on bracing outcomes in adolescent idiopathic scoliosis (AIS).

METHODS

Twenty-two female participants with a mean age of 12 ± 2 years who were diagnosed with AIS and planned to use a brace were included in the study. Assessments were performed at three different time points. Visit 1, 1-7 days before bracing; Visit 2, in-brace condition in the fourth week of bracing; Visit 3, out-brace condition in the sixth month of bracing. At Visit 1, the participants' Risser sign, curve type according Rigo classification and sagittal spinal range of motion defined in modified Schober's test were recorded. The nine-point Beighton scale and Hakim-Graham's five-part questionnaire were used to determine the presence of JHM. The following data were recorded from the antero-posterior radiographs at each of the three visits: coronal curvature, apical vertebral rotation, spine height, global coronal balance and apical translation.

RESULTS

In the in-brace evaluation, there was no difference in radiographic measurements between the groups defined as JHM present (n = 11) and JHM absent (n = 11). At the out-brace evaluation performed at the sixth month of brace use, the change in the Cobb angle representing the coronal curvature between the groups was found to be significant in favour of the JHM-present group (JHM-absent: 4 (1, 7) vs. JHM-present: 10 (6, 15)), and no difference was found in the other radiographic measurements.

CONCLUSION

In AIS, scoliosis indicators such as coronal curvature, apical vertebral rotation, and coronal balance can be improved with bracing. Furthermore, the presence of JHM may have a possible impact when bracing is included in AIS management.

TRIAL REGISTRATION: National Library of Medicine platform (NCT06021314) (record verification on 25.08.2023).