A compliance study of the patients with adolescent idiopathic scoliosis to orthotic intervention

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A compliance study of the patients with adolescent idiopathic scoliosis to orthotic intervention


Author: Cheng, Wing-yiu
Title: A compliance study of the patients with adolescent idiopathic scoliosis to orthotic intervention
Degree: M.Sc.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations.
Scoliosis in children.
Scoliosis -- Prevention.
Orthopedic apparatus.
Orthopedic braces.
Department: Dept. of Health Technology and Informatics
Pages: xiv, 82 leaves : ill. ; 31 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2090229
URI: http://theses.lib.polyu.edu.hk/handle/200/634
Abstract: Scoliosis is an abnormal lateral curvature of the spine usually with vertebral rotation. Idiopathic (unknown cause) scoliosis is the most common form of scoliosis in young age. It can commence at any time during spinal growth. Orthotic treatment is one of the most common non-operative management of scoliosis by an attempt to prevent the progression of scoliosis in growing child through using mechanical support to the spine when it is at risk of progression. However, patient's compliance to spinal brace is always a concern especially in those places with hot and humid weather. In the first part of this study, a compliance investigation was conducted. Ten patients with adolescent idiopathic scoliosis (AIS) were recruited and evenly divided into two subject groups (Group A and Group B). They were treated with underarm braces in which a compliance monitoring system was embedded for compliance tracking. The patients of group A were required to follow the LED strap tension indicator of the monitoring system which was set by an experienced Orthotist when they tightened the straps of their braces while the patients of group B would tighten the strap according to the indication marked on the straps by the same Orthotist. The magnitudes of controlling forces under these two ways of force indication were compared. The result of the study showed that the average brace wearing hours for group A was 15.9 hours (66.5% of the prescribed time) and group B was 18.4 hours (80.1% of the prescribed time). The mean force detected from the system was 1.8N for the patients of group A and 1.9N for the patients of group B. It was found that the compliance to the brace treatment plan and the magnitude of controlling force under the two ways of force indication. After the first four months of brace treatment, the mean Cobb's angle of the thoracic spine and lumbar spine of group A were reduced 7.0 degrees and 8.2 degrees respectively while the mean trunk listing was reduced 4.1 mm. For the group B, the mean Cobb's angle of the thoracic and lumbar spine were reduced 7.5 degrees and 4.8 degrees respectively, and the mean trunk listing was reduced 5.5 mm. It was showed that the brace treatment met the expected treatment result. In the second part of this study, thirty patients with AIS and undergoing brace treatment were recruited, and the interfacial forces between the thoracic pad of the spinal brace and the patient's body were measured. Three experienced Orthotists were invited to individually prescribe the amount of interfacial forces needed for the 30 subjects. This study aimed to study the trend of the prescribed forces and the possible variations among Orthotists. The results showed that a mean force of 1.56N was found and significant differences (P<0.05) were noted among the three Orthotists in prescribing the controlling forces. Further investigations were suggested to reveal the possible reasons of these significant differences and the trend of the controlling forces for different curve patterns and flexibilities.

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