Effects of a tailor-made girdle on posture of adolescents with early scoliosis

Recent literature regarding the psychological impact of scoliosis was reviewed. To determine the impact of scoliosis on health-related quality of life (HRQL), psychosocial functioning, and body image to improve patient outcomes. Adolescents and adults with adolescent idiopathic scoliosis have been known to score lower than healthy controls on HRQL measures. However, HRQL instruments may not adequately capture psychological distress experienced by patients. Research papers concerning HRQL and psychosocial factors in patients with scoliosis were reviewed. Studies of psychosocial health and body image have revealed that functioning in these domains may affect compliance behavior and satisfaction with treatment outcomes among adolescent patients. Psychosocial and body image disturbance is less marked in patients with good social or family functioning, or patients who exercise regularly or are psychologically healthy. Adults with scoliosis generally display fewer psychological problems than adolescents. However, adults with scoliosis may experience psychosocial limitations due to poor physical health or body image disturbance. Support group membership can improve psychosocial health in adults with scoliosis. Adolescent patients with scoliosis may experience psychosocial difficulties, especially while undergoing treatment for scoliosis. Interventions aimed at managing psychosocial or body image disturbances may help to ameliorate the potentially negative impact of scoliosis on these facets of life.

A specially designed inclinometer has been used to measure one part of the clinical deformity (asymmetry of the trunk) that is seen in scoliosis. This objective measurement provides one good guideline that can effectively determine, in surveys of children, whether or not further orthopaedic evaluation is needed. A minimum significant angle of trunk rotation of 5 degrees was shown by computer-analyzed data from 1,065 patients to be a good criterion for identifying curvatures of 20 degrees or more. The specificity of scoliosis screening in this manner has a projected false-negative rate of 0.1 per cent and a high degree of sensitivity. The method is simple, reliable, and inexpensive. It is easily taught to lay personnel who can be employed in scoliosis screening procedures.

A retrospective review of 326 female patients with untreated idiopathic scoliosis was performed to determine what factors might be useful in predicting the risk of curve progression. Components such as family history, height-weight ratio, lumbosacral transitional anomalies, kyphosis, lordosis, and trunk balance were not found to be significant. Predictive indicators included gender, curve patterns, and severity and growth potential.