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Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study

Abstract

Purpose

Overweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AIS patients.

Methods

Design: retrospective cohort study. Population: 351 AIS patients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2. Inclusion criteria: no previous treatment, full-time prescription of brace at first visit (18–23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated. Outcome: improved, progressed, and stable according to the 5° Cobb agreed threshold. Statistics: a stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied.

Results

BMI is poorly correlated with final results. Confounders’ adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively.

Discussion

Brace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.

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Correspondence to Fabio Zaina.

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Zaina, F., Donzelli, S. & Negrini, S. Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study. Eur Spine J 26, 1670–1675 (2017). https://doi.org/10.1007/s00586-017-4985-y

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  • DOI: https://doi.org/10.1007/s00586-017-4985-y

Keywords

  • Scoliosis
  • Braces
  • BMI
  • Overweight