Volume 9 Supplement 1

11th International Conference on Conservative Management of Spinal Deformities - SOSORT 2014 Annual Meeting

Open Access

End growth results of exercise treatment to avoid bracing in adolescents with idiopathic scoliosis: a prospective cohort controlled study

  • Stefano Negrini1,
  • Sabrina Donzelli2,
  • Alessandra Negrini2,
  • Silvana Parzini2,
  • Michele Romano2 and
  • Fabio Zaina2
Scoliosis20149(Suppl 1):O71

https://doi.org/10.1186/1748-7161-9-S1-O71

Published: 4 December 2014

Background

Doubts on the efficacy of exercise treatment for adolescents with Idiopathic Scoliosis (IS) still exists.

Aim

To verify the effectiveness of exercises in everyday clinics.

Design

Prospective observational controlled cohort study nested in a prospective database started in March 2003.

Methods

Setting: outpatient tertiary referral clinics.

Participants: consecutive patients from start of the database to 31/12/2010. Inclusion criteria: IS; Risser 0-2; 11° to 20° Cobb; age 10 years or more; first evaluation. Exclusion criteria: consultations only; immediate prescription of a brace.

Groups: Physiotherapic Specific Scoliosis Exercises - SEAS school (PSSE: at least 45 min/week, 3 cognitive-behavioral sessions/year); Controls (CON: less than 15 min/week); Usual Physiotherapy (UP: other institutes/protocols).

End-Of-Treatment (EOT): medical prescription, bracing, Risser 3.

Failures: bracing for scoliosis; EOT above 30°.

Statistical analysis: intent-to-treat (ITT: drop-outs included as failures) and efficacy (EA: only EOT patients). Relative Risk of failure (RR), 95% Confidence Interval (CI), and clinical and radiographic changes have been calculated.

Results

Out of 327 patients, 34 (10%) were excluded due to bracing at first evaluation. We included 293 adolescents: 145 PSSE, 95 UP, 53 CON, with no differences at baseline. Physicians prescribed bracing (failure) without differences among groups.

Failures and drop-outs were 84 (28.7%) and 47 (16.0%) respectively: 21.4% and 18.6% in PSSE; 33.7% and 9.5% in UP; 39.6% and 20.8% in CON.

Efficacy analysis (RR): CON vs PSSE 1.90 (IC 1.48-2.33); UP vs PSSE 1.42 (1.01-1.82); CON vs UP: not significant.

Intent-to-treat (RR): CON vs PSSE 1.51 (1.21-1.80); CON vs UP 1.40 (1.08-1.72); UP vs PSSE: not significant.

At the end of exercises, aesthetics (TRACE) improved statistically in PSSE (1.8 points out of 12) and UP (1.5), not in CON; only PSSE improvement was statistically better than CON.

Conclusion

Patients performing UP or nothing (CON), compared to those treated with PSSE (SEAS), increase the risk of failure (bracing and/or 30° at EOT) 1.9 and 1.4 times respectively (EA).

Authors’ Affiliations

(1)
University of Brescia - IRCCS Don Gnocchi
(2)
ISICO - Italian Scientific Spine Institute

Copyright

© Negrini et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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