Motivations for Compliance With Bracing in Adolescent Idiopathic Scoliosis

Study Design Cross-sectional study. Objective To determine motivations for compliance with bracing among female patients with adolescent idiopathic scoliosis (AIS). Summary of Background Data Bracing prevents the need for surgery for the majority of girls with AIS with curves of 20° to 40° and 2 or more years of growth remaining. The main obstacle to success is compliance. The factors that either promote or impede compliance previously have not been fully clarified. Methods Participants were females 10 to 16 years of age who were prescribed a brace to be worn 16 hours per day for AIS. Each completed a “Scoliosis Compliance Questionnaire” composed of the SRS-22r and five original sections focused on patients’ attitudes to scoliosis, situations in which they found wearing the brace to be most and least difficult, factors that motivate brace wear, and interventions that could potentially improve compliance. Results Thirty-nine subjects completed the study, mean age 13 years (range 11–15 years), at a mean of 15.4 months (range 4–39 months) of brace wear at the time of recruitment. More than 90% of patients stated that their main motivations for compliance were the desire to avoid surgery and to prevent curve progression. Compliance was most challenging during the summer and while at school. Many patients reported pain and skin irritation in the brace. The majority reported they would likely improve their hours of wear if they were able to communicate with a peer in the same situation. SRS-22r scores were similar to those of healthy adolescents. Conclusions The most important influences promoting brace wear are the patient's desire to avoid surgery and to prevent curve progression. Peer support potentially may improve compliance. Level of Evidence Level III.