Longitudinal Observation On The Effects Of Bracing Combined With Physiotherapeutic Scoliosis Specific Exercises On The Cobb Angle And Psychological Status Of Female Patients With Moderate AIS

Background:Adolescent Idiopathic Scoliosis(AIS)is gradually becoming one of the major diseases affecting the physical health of Chinese adolescents.There are two types of treatment: Surgical Treatment and non-surgical treatment.Most of these cases require non-surgical treatment.In recent years,more and more scholars have conducted studies on Adolescent Idiopathic Scoliosis,but there are few longitudinal studies on the effects of brace combined with Physiotherapeutic Scoliosis Specific Exercises(PSSE)on moderate Adolescent Idiopathic Scoliosis.Purpose:1.To analyze the main factors which influence on Cobb Angle changes with the intervention of braces and PSSE for idiopathic scoliosis of female adolescents patients.2.To analyze the psychological influence of braces and PSSE on Adolescent Idiopathic Scoliosis adolescent patients.Methods:72 out of 143 with adolescent idiopathic scoliosis were selected(including three boys)with moderate(20-50°)patients who joined the intensive training program from January 2018 to September 2018.All the patients were treated with braces and PSSE.The total intervention program lasts for six months.During this period,the researcher makes the detail record every week from three aspects: daily wearing brace supporting time,the number of weekly exercise,and each exercise’s duration.Before and after the intervention,the patients are shoot the full length spine radiographs in order to analyze the changes of the angel.At the same time,the Brace-Deformity Questionnaire and also the Brace-Psychological Questionnaire change were used as instruments.Due to lost follow-ups and no retest results of 16 people,the last 56 female AIS were brought into the analysis of this study.The results:1.Overall situation: 56 moderate AIS female’s average age is 13.71(95% CI: 13.27,14.12),the average Cobb Angle is 35.21 ° bend(95% CI: 32.21,37.93);Risser sign level 0: 12 people,Ⅰ level: 3 people,level Ⅱ: 3 people,Ⅲ level: 15 people,grade Ⅳ: 24 people.According to Rigo classification,Rigo A: 22 people,Rigo B : 27 people,Rigo C : 3 people,Rigo E : 4 people.2.The main bending Cobb Angle changes: main bending Cobb Angle before the intervention(35.21 °,95% CI: 32.21 ° and 37.93 °)and after the intervention(28.29 °,95% CI: 24.61 ° and 31.89 °)had significant difference(P < 0.01).Single factor analysis shows that there were differences in Cobb Angle main bend figures among different ages(P=0.006),Rigo genotypes(P=0.032)and wearing time(P=0.001).However,Risser sign,original main bend Cobb Angle,daily PSSE time and weekly PSSE number don’t not affect this.Further binary logistic regression analysis shows that wearing time per day only(OR=0.046,P=0.044)is an independent factor for changes in the Cobb Angle of idiopathic scoliosis in female adolescents.3.Psychological status: BSSQ-deformed questionnaire before the intervention(13.47,95% CI: 10.93 ~ 15.73)and after(14.40,95% CI: 12.13 ~ 16.73),and BSSQ-the questionnaire before the intervention(13.53,95% CI: 11.00 ~ 15.73)and after(14.53,95% CI: 12.40 ~ 18.86)had significant difference;However,according to the pressure distribution,the result shows that BSSQ-pressure distribution of deformed questionnaire had mild inconsistency(Kappa = 0.216,P = 0.088),BSSQ-questionnaire with a pressure distribution was almost the same(Kappa = 0.333,P = 0.013).Conclusion1.With the combination of PSSE and brace for half year,the intervention can significantly reduce the main bending degree of Cobb Angle for moderate AIS females,and wearing time was an independent factor.2.With the combination of PSSE and brace,the intervention has a certain improvement on moderate AIS female body deformity caused by psychological stress.