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Completion of a formal physiotherapeutic scoliosis-specific exercise training program for adolescent idiopathic scoliosis increases patient compliance to home exercise programs

Abstract

Introduction

Physiotherapeutic Scoliosis-Specific Exercise (PSSE) is a conservative approach for management of adolescent idiopathic scoliosis (AIS). Although there is Level I evidence for the efficacy of PSSE, compliance in the teenage population remains in question. The purpose of this study is to investigate the association between completion of formal PSSE training and compliance to prescribed home exercise programs (HEP).

Methods

Patients with AIS evaluated at our institution between 2013 and 2015 with a minimum of one PSSE session were enrolled. A chart review and questionnaire completed by caregivers was utilized to assess HEP compliance following the final PSSE session at 1 week, 3 months, 1 year, and 2 years. Patients were divided into two groups, those completing formal training (10 or more PSSE sessions), and those who did not complete formal training (fewer than 10 sessions).

Results

81 patients were identified (mean age of 13.1 years; major curve of 31.3°). Patients who completed training demonstrated 50% compliance at 1 week (vs. 25.6% for non-completers, Odds Ratio (OR): 2.9, p = 0.027), 41.2% at 3 months (vs. 18.9% for non-completers, OR: 3.0, p = 0.044), 23.5% at 1 year (vs. 13.5% for non-completers, OR: 2.0, p = 0.281), and 25.7% at 2 years (vs. 13.5% for non-completers, OR: 2.2, p = 0.197). The mean HEP duration (minutes) in patients who completed training was higher at 1 week (80.8 vs. 48, p = 0.010), 3 months (64.6 vs. 23.7, p ≤ 0.001), 1 year (35.3 vs. 22.7, p = 0.270), and 2 years (34.3 vs. 18.9, p = 0.140).

Conclusion

Patients who completed PSSE training maintained higher HEP compliance.

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References

  1. 1.

    Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371:1527–1537. https://doi.org/10.1016/S0140-6736(08)60658-3

    Article  PubMed  Google Scholar 

  2. 2.

    Nachemson A, Lonstein J, Weinstein S (1982) Prevalence and natural history committee report. In: Annu. Meet. Scoliosis Res. Soc. Denver, CO

  3. 3.

    Asher MA, Burton DC (2006) Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 1:2. https://doi.org/10.1186/1748-7161-1-2

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Fusco C, Zaina F, Atanasio S, Romano M, Negrini A, Negrini S (2011) Physical exercises in the treatment of adolescent idiopathic scoliosis: an updated systematic review. Physiother Theory Pract 27:80–114. https://doi.org/10.3109/09593985.2010.533342

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Weinstein SL, Dolan LA, Wright JG, Dobbs MB (2013) Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 369:1512–1521. https://doi.org/10.1056/NEJMoa1307337

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F (2018) 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 13:3. https://doi.org/10.1186/s13013-017-0145-8

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Weiss HR, Weiss G, Petermann F (2003) Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis inpatient rehabilitation (SIR): an age- and sex-matched controlled study. Pediatr Rehabil 6:23–30. https://doi.org/10.1080/1363849031000095288

    Article  PubMed  Google Scholar 

  8. 8.

    Otman S, Kose N, Yakut Y (2005) The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Saudi Med J 26:1429–35. https://www.ncbi.nlm.nih.gov/pubmed/16155663. Accessed 25 Jul 2011

  9. 9.

    Kotwicki T, Durmała J, Czaprowski D, Głowacki M, Kołban M, Snela S, Sliwiński Z, Kowalski IM (2020) SOSORT, Conservative management of idiopathic scoliosis--guidelines based on SOSORT 2006 Consensus. Ortop Traumatol Rehabil 11:379–95. https://www.ncbi.nlm.nih.gov/pubmed/19920281. Accessed 11 May 2020

  10. 10.

    Schreiber S, Parent EC, Moez EK, Hedden DM, Hill D, Moreau MJ, Lou E, Watkins EM, Southon SC (2015) The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: “SOSORT 2015 Award Winner.” Scoliosis. https://doi.org/10.1186/s13013-015-0048-5

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Schreiber S, Parent EC, Moez EK, Hedden DM, Hill DL, Moreau M, Lou E, Watkins EM, Southon SC (2016) Schroth physiotherapeutic scoliosis-specific exercises added to the standard of care lead to better cobb angle outcomes in adolescents with idiopathic scoliosis—an assessor and statistician blinded randomized controlled trial. PLoS ONE. https://doi.org/10.1371/journal.pone.0168746

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Kuru T, Yeldan Ï, Dereli EE, Özdinçler AR, Dikici FATIH, Çolak Ï (2016) The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil 30:181–190. https://doi.org/10.1177/0269215515575745

    Article  PubMed  Google Scholar 

  13. 13.

    Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S (2014) Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J 23:1204–1214. https://doi.org/10.1007/s00586-014-3241-y

    Article  PubMed  Google Scholar 

  14. 14.

    Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD (2018) The physical activity guidelines for Americans. JAMA J Am Med Assoc 320:2020–2028. https://doi.org/10.1001/jama.2018.14854

    Article  Google Scholar 

  15. 15.

    Datye KA, Moore DJ, Russell WE, Jaser SS (2015) A review of adolescent adherence in type 1 diabetes and the untapped potential of diabetes providers to improve outcomes. Curr Diab Rep 15:51. https://doi.org/10.1007/s11892-015-0621-6

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Zindani GN, Streetman DD, Streetman DS, Nasr SZ (2006) Adherence to treatment in children and adolescent patients with cystic fibrosis. J Adolesc Heal 38:13–17. https://doi.org/10.1016/j.jadohealth.2004.09.013

    Article  Google Scholar 

  17. 17.

    Aulisa AG, Giordano M, Falciglia F, Marzetti E, Poscia A, Guzzanti V (2014) Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner. Scoliosis 9:6. https://doi.org/10.1186/1748-7161-9-6

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Karol LA, Virostek D, Felton K, Wheeler L (2016) Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Jt Surg Am 98:9–14. https://doi.org/10.2106/JBJS.O.00359

    Article  Google Scholar 

  19. 19.

    Brox JI, Lange JE, Gunderson RB, Steen H (2012) Good brace compliance reduced curve progression and surgical rates in patients with idiopathic scoliosis. Eur Spine J 21:1957–1963. https://doi.org/10.1007/s00586-012-2386-9

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Rahman T, Bowen JR, Takemitsu M, Scott C (2005) The association between brace compliance and outcome for patients with idiopathic scoliosis. J Pediatr Orthop 25:420–422. https://www.ncbi.nlm.nih.gov/pubmed/15958887.

  21. 21.

    Jack K, McLean SM, Moffett JK, Gardiner E (2010) Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Man Ther 15:220–228. https://doi.org/10.1016/j.math.2009.12.004

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Williams B, Mukhopadhyay S, Dowell J, Coyle J (2007) From child to adult: an exploration of shifting family roles and responsibilities in managing physiotherapy for cystic fibrosis. Soc Sci Med 65:2135–2146. https://doi.org/10.1016/j.socscimed.2007.07.020

    Article  PubMed  Google Scholar 

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No funding was provided for this research study.

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Authors

Contributions

MS: Analysis of data, drafting and revising manuscript, and final approval. MF: Analysis of data, drafting and revising manuscript, and final approval. KG: Design, acquisition, analysis of data, drafting and revising manuscript, and final approval. PB: Analysis of data, drafting and revising manuscript, and final approval. HM: Analysis of data, drafting and revising manuscript, and final approval. AB: Analysis of data, drafting and revising manuscript, and final approval. HB: Analysis of data, drafting and revising manuscript, and final approval. BR: Conception and design of work, drafting and revising manuscript, and final approval. DR: Conception and design of work, drafting and revising manuscript, and final approval. MV: Conception and design of work, drafting and revising manuscript, and final approval.

Corresponding author

Correspondence to Hiroko Matsumoto.

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Approved by the Columbia University Institutional Review Board.

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Simhon, M.E., Fields, M.W., Grimes, K.E. et al. Completion of a formal physiotherapeutic scoliosis-specific exercise training program for adolescent idiopathic scoliosis increases patient compliance to home exercise programs. Spine Deform 9, 691–696 (2021). https://doi.org/10.1007/s43390-020-00253-8

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Keywords

  • Adolescent idiopathic scoliosis
  • Physiotherapeutic scoliosis-specific exercise
  • Patient compliance