Factors Influencing Optimal Bracing Compliance in Adolescent Idiopathic Scoliosis: A Single-center Prospective Cohort Study.

STUDY

DESIGN

Retrospective cohort study.

OBJECTIVE

To identify factors contributing to optimal bracing compliance in adolescent idiopathic scoliosis (AIS).

SUMMARY OF BACKGROUND DATA: Poor brace compliance is a key factor affecting brace treatment success in AIS. Predictive factors influencing optimal brace compliance to achieve brace treatment success remain unknown.

MATERIALS AND

METHODS

This study included AIS patients aged 10 to 15, with a Cobb angle of 20° to 40°. Demographics data, radiographic assessments, and patient-reported outcomes (including the SRS-22r patient questionnaire) were collected. Brace compliance was monitored using in-brace thermometers, defining optimal bracing time as >18 h/d. Multivariable logistic regression analysis was used to identify predictors of optimal bracing time from the demographic and patient-reported outcomes score before bracing.

RESULTS

Among 122 patients, 59.0% achieved optimal bracing time by six months. The achieved group indicated higher scores in the satisfaction domain before bracing (3.3±0.7 vs. 3.1±0.6; P =0.034). Multivariable logistic regression analysis demonstrated that the satisfaction domain before bracing was an independent factor associated with the achievement of the optimal bracing time [OR 1.97 (95% CI: 1.00-3.89), P =0.049]. The model with bracing at one-month follow-up also demonstrated the bracing at 1 month was a significant factor [OR 1.52 (95% CI: 1.30-1.79), P <0.001].

CONCLUSIONS

Optimal bracing compliance in AIS is significantly influenced by prebracing satisfaction and brace compliance at earlier time points. These findings highlight the need to address psychological factors and early compliance in AIS bracing treatment. SRS-22r can be useful to identify the need for psychological support.