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Female Patients' and Parents' Assessment of Deformity- and Brace-Related Stress in the Conservative Treatment of Adolescent Idiopathic Scoliosis

Misterska, Ewa MSc, PhD; Glowacki, Maciej MD, PhD; Latuszewska, Joanna MSc

doi: 10.1097/BRS.0b013e31824b66d4

Study Design. A cross-sectional analysis of parents' and patients' perceptions of deformity- and brace-related stress regarding conservative treatment of adolescent idiopathic scoliosis.

Objective. The purpose of this study was to determine the agreement between patients' and parents' assessments of emotional stress and to compare these assessments with radiographical measurements of spinal deformity.

Summary of Background Data. Conservative treatment in patients with scoliosis may cause emotional stress. To our knowledge, no group has ever reported patient and parental estimation of stress related to wearing a brace and spinal deformity in girls with adolescent idiopathic scoliosis.

Methods. Sixty-three pairs of parents and girls with adolescent idiopathic scoliosis treated with a Cheneau brace were separately asked to complete the Bad Sobberheim Stress Questionnaire-Deformity and the Bad Sobberheim Stress Questionnaire-Brace. The age range of the patients was from 10 to 17 years. Patients were assessed at a mean of 14.12 (SD, 10.99) months after the start of the conservative treatment.

Results. Patients thought that a moderate level of stress was connected with conservative treatment; however, the stress level, related to perceived trunk deformation, was low. From the parents' perspective, patients experienced a moderate level of stress during conservative treatment and related to spinal deformity. The study groups differ in their perception of stress levels due to body disfigurement but not during the conservative treatment. Parent-patient stress-level disparities were not related to body mass index, age of the patient, brace application, and radiographical measurements of spinal deformity.

Conclusion. Patients and parents perceive the emotional stress related to brace treatment in the same way; however, parents overestimate the assessment of stress levels related to body deformity. From the perspective of patients and parents, brace wearing increased the level of stress induced by the deformity alone. Complete assessment of conservative treatment should include evaluation of emotional stress from the perspective of patients and parents.

The agreement between the assessments made by patients with adolescent idiopathic scoliosis and their parents of brace- and deformity-related stress was analyzed, and the comparison of these assessments with radiographical measurements of spinal deformity was performed. Children and parents perceive brace-related stress in the same way; however, parents overestimate deformity-related stress.

*Department of Pediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland; and

Department of Motor System Rehabilitation, Poznan University of Physical Education, Poznan, Poland

Address correspondence and reprint requests to Ewa Misterska, MSc, PhD, Department of Pediatric Orthopaedics and Traumatology, Poznan University of Medical Sciences, ul. 26 Czerwca 1956 135/147, 61-545 Poznan, Poland; E-mail:

Acknowledgment date: August 25, 2011. First revision date: October 13, 2011. Acceptance date: November 25, 2011.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Poznan University of Medical Science funds were received to support this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.