Determination of quality of life in adolescents with idiopathic scoliosis subjected to conservative treatment.

<p>Abstract</p> <p>Introduction and objectives</p> <p>Physical deformities caused by adolescent idiopathic scoliosis (AIS) coupled with conservative treatment of AIS with orthesis unavoidably impacts on patients' quality of life (QoL). The present study aimed at evaluating the QoL in patients affected by AIS treated with brace. The study also sought to determine the ability of different QoL questionnaires to monitor QoL over the course of treatment.</p> <p>Materials and methods</p> <p>Data were collected in 108 consecutive patients (96 females, 16 males) affected by AIS admitted to the outpatient orthopaedic clinic of the Catholic University of the Sacred Heart in Rome (Italy). Patients were subjected to full-time (i.e., 22 hrs per day) conservative treatment with the progressive action short brace (PASB), the Lyon brace or a combination of PASB + Lyon brace. Three instruments were used for QoL determination: the Scoliosis Research Society 22 (SRS-22), Bad Sobernheim Stress Questionnaire (BSSQ) and the Brace Questionnaire (BrQ).</p> <p>Results</p> <p>A significant correlation was detected among the 3 scores (p < 0.001). The BrQ possesses a higher capacity to detect changes in QoL in relation to the patient gender, type of brace, curve severity at baseline and at the completion of treatment, and curve type. Overall, boys displayed a higher QoL than girls. In all 3 questionnaires, higher QoL scores were determined in patients treated with the PASB compared with those using the Lyon brace. QoL scores were significantly correlated with the curve severity. Higher QoL scores were obtained by participants with thoraco-lumbar curves as compared with those with other curves.</p> <p>Conclusions</p> <p>The 3 questionnaires are effective in capturing changes in QoL in AIS patients subjected to conservative treatment. However, the BrQ possesses a higher discriminatory capacity compared with the other questionnaires tested. PASB-based treatment is associated with better QoL than the Lyon bracing.</p

Braces for idiopathic scoliosis in adolescents. A cochrane review

STUDY DESIGN. Cochrane systematic review. OBJECTIVE. To evaluate the efficacy of bracing in adolescent patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA. AIS is a 3-dimensional deformity of the spine. Although AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Braces are traditionally recommended to stop curvature progression in some countries and criticized in others. They generally need to be worn full time, with treatment extending over years. METHODS. The following databases (up to July 2008) were searched with no language limitations: the Cochrane Central Register of Controlled Trials, MEDLINE (from January 1966), EMBASE (from January 1980), and CINHAL (from January 1982), and reference lists of the articles. An extensive handsearch of the gray literature was also conducted. Randomized controlled trials (RCTs) and prospective cohort studies were searched for comparing braces with no treatment, other treatment, surgery, and different types of braces. Two review authors independently assessed trial quality and extracted data. RESULTS. We included 2 studies. There was very low quality evidence from 1 prospective cohort study with 286 girls that a brace curbed curve progression at the end of growth (success rate, 74 95% confidence interval {CI}: 52%-84%), better than observation (success rate, 34% 95% CI: 16%-49%) and electrical stimulation (success rate, 33% 95% CI: 12%-60%). There is low-quality evidence from 1 RCT with 43 girls that a rigid brace is more successful than an elastic one (SpineCor) at curbing curve progression when measured in Cobb degrees, but there were no significant differences between the 2 groups in the subjective perception of daily difficulties associated with wearing the brace. CONCLUSION. There is very low quality evidence in favor of using braces, making generalization very difficult. Further research could change the actual results and our confidence in them; in the meantime, patients' choices should be informed by multidisciplinary discussion. Future research should focus on short- and long-term patient-centered outcomes, in addition to measures such as Cobb angles. RCTs and prospective cohort studies should follow both the Scoliosis Research Society and Society on Scoliosis Orthopedic and Rehabilitation Treatment criteria for bracing studies. © 2010, Lippincott Williams & Wilkins

Identification of the local stiffness reduction of a damaged composite plate using the virtual fields method

In the present study, a damage detection problem is formulated as the identification of the spatial stiffness distribution in a damaged composite plate. Full-field heterogeneous curvature fields obtained from an optical deflectometry technique are processed by using the virtual fields method adapted to retrieve the 2D stiffness distribution map of a damaged carbon-epoxy plate. The method not only picks up the location of the damage but also provides a fairly good estimate of the stiffness reduction in the damaged area. In this paper, the procedure is described, validated on simulated measurements and some initial experimental results are given. � 2007 Elsevier Ltd. All rights reserved