Is there a relationship between the results of unterberger test and convexity of scoliosis major curve?

n/

TRACE (Trunk Aesthetic Clinical Evaluation), a routine clinical tool to evaluate aesthetics in scoliosis patients: development from the Aesthetic Index (AI) and repeatability

<p>Abstract</p> <p>Background</p> <p>Aesthetic appearance is of primary importance in the treatment of adolescent idiopathic scoliosis (AIS), but to date tools for routine clinical practice have not become available. The aim of the present study is to develop such a tool and to verify its repeatability.</p> <p>Methods</p> <p>Instrumentation: At first we developed the Aesthetic Index (AI), based on a three-point scale for asymmetry of the shoulders, scapulae and waist that we tested for 5 years. From this experience we developed another tool we called TRACE, the acronym of Trunk Aesthetic Clinical Evaluation; TRACE is a 12-point scale based on four sub-scales, shoulders (0–3), scapulae (0–2), hemi-thorax (0–2) and waist (0–4).</p> <p>Population: Posterior-anterior (PA) photographs of one hundred-sixty AIS patients</p> <p>Procedures: Each photograph was scored in two independent tests by four observers using AI, and subsequently TRACE.</p> <p>Data analysis: Kappa statistical analysis and 95% level of agreement were used; we also identified the minimum significant change (95% confidence level).</p> <p>Results</p> <p>We found the intra- and inter-raters repeatability of AI to be fair. Three points out of seven was the minimum significant change between two different evaluations. For TRACE, intra-rater repeatability was fair and inter-raters poor; but the minimum significant change was three (intra-rater), or four (inter-raters) out of twelve points.</p> <p>Conclusion</p> <p>Widening the scale from 7 (AI) to 12 points (TRACE) increased the clinical sensitivity to changes of the aesthetic scale, even if TRACE has only a fair repeatability. TRACE is a no-cost tool for routine clinical practice in AIS patients. Due to the absence of other comparable validated tools, once the inherent measurement error is known and understood, its routine clinical use by physicians is advised.</p

Exercises during brace weaning can reduce loss of correction in Adolescent Idiopathic Scoliosis (AIS) patients

n/

How to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria

<p>Abstract</p> <p>Background</p> <p>Aesthetics is a main goal of both conservative and surgical treatments in adolescent idiopathic scoliosis (AIS). Previously, we developed and validated a clinical scale - the Aesthetic Index (AI)--in order to measure aesthetic impairment and changes during treatment.</p> <p>Aim</p> <p>To verify the efficacy of bracing on aesthetics in AIS.</p> <p>Study Design</p> <p>Prospective Cohort Study.</p> <p>Population</p> <p>Thirty-four consecutive patients, age 13.2 ± 3.7, initial Cobb Angle 32 ± 12°, ATR 10 ± 4° Bunnel, 11 males.</p> <p>Methods</p> <p>Patients with AI scores of at least 5/6 were included. Each of them had a brace prescription (18 to 23 hours per day), according to the SPoRT concept. AI was measured again after six months and at the end of treatment, and then the pre- and post-treatment scores compared. The Wilcoxon test was performed.</p> <p>Results</p> <p>Twenty-nine patients out of the 34 included completed the treatment and had six-month and final results; four patients were lost during the treatment, and one was fused. At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p < 0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p < 0.05 with respect to the baseline).</p> <p>Conclusion</p> <p>Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria. This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical. The use of a more sensitive tool like TRACE could more easily detect the clinical changes; nevertheless, AI proved sensible enough that its use in everyday clinical practice can be suggested.</p

Repeatability of the Aesthetic Index for adolescent scoliosis idiopathic evaluation

n/