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Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 145 - 146
1 Mar 2006
Vasiliadis E Grivas T Mouzakis V Maziotou C Koufopoulos G Gkoltsiou K
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Aim: The study of quality of life in adolescents with Idiopathic Scoliosis (IS) that are treated conservatively with a brace.

Introduction: Study of patients’ quality of life, especially of those suffering a chronic disease that requires long term treatment, is of great interest in recent years. Although there are a lot of studies for psycological sequences in IS, only a few papers in the available literature are dealing with quality of life measurement. SF-36 generic questionnaire provides the physician with valuable outcomes of treatment in patients over 14 years old.

Material-Method: Inclusion criteria were diagnosis of IS, a curve between 20o–40o, age of the child between 14–16 years old, follow up by the same physician or team, conservative treatment of IS and minimum duration of brace treatment for 2 years. Twenty-eight children, 25 girls with a mean age 14.8 years old and 3 boys with a mean age 15 years old were included in the study and filled the form of SF-36 questionnaire. All children are still wearing the brace. A control group of 30 children were also filled SF-36 form.

Results: Mean score of SF-36 questionnaire was 76.29 (SD 9.105). Most negatively affected domains are Mental Health (mean score 54.3, SD 11.5) and Vitality (mean score 62.86, SD 16.5). Physical Functioning (mean score 79.3, SD 20.7), Role limitation due to Emotional problems (mean score 76.3, SD 25.23), Social Functioning (mean score 77.9, SD 17.13), Bodily Pain (mean score 79.6, SD 19.5) and General Health Perception (mean score 77.1, SD 19.94) are less affected domains. Best scores are achieved in Role limitation due to Physical problems (mean score 96.4, SD 9.45) and Change in Health (mean score 82.1, SD 23.78) domains.

Discussion-Conclusion: This report appears that brace treatment has negative effect on childrens’ quality of life. The use of SF-36 questionnaire through detection of most affected domains provides the physician a measurable outcome for child’s quality of life in order to 1) interfere with the selected method of conservative treatment and its modalities in a way that it would less affect the child and 2) provide the child specific psychological support by the doctor, the orthotist, the parents and the various voluntary organizations.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 172 - 172
1 Feb 2004
Grivas TB Michas K Vasiliadis E Maziotou C Karathanou S Polyzois VD
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1. Introduction. A significant correlation between handedness and laterality of the curve in scoliotic children is reported in the literature. This correlation is implicating cortical function as an aetiologic factor for scoliosis, (Goldberg and Dowling 1990). The truncal asymmetry expressed as a hump, is the sign at the presence of which there is a suspicion of a scoliotic curve. The above issue stimulated the search of existence of a possible correlation between handedness and the increasing truncal asymmetry, the existence of which represents a risk factor for development of scoliosis. Thus the aim of this study is the appraisal of the correlation of the existence of a truncal asymmetry as it is checked by the use of a scoliometer during the forward bending test and the handedness in schoolmates who were screened at school for scoliosis.

2. Material and Method

2.1 The examined children. 4345 students (2183 girls and 2158 boys), 6 – 18 years of age were examined during the school-screening program for scoliosis.

2.2 The measurements. A protocol with a checklist is filled for each student in which handedness and truncal asymmetry is included. The probability of existence of scoliosis in the child and the recommendation for further clinical and radiological assessment at hospital is based on the amount of the recorded truncal asymmetry. The sitting and standing forward bending test is performed using the Pruijs scoliometer, on which reading ≥7° is a threshold for recommendation for reexamination. Truncal asymmetry was recorded for thoracic, thoracolumbar and lumbar region.

2.3 The statistical analysis. The techniques used for the study of the sample of children included cross tabulation and ÷2.

3. Results. The statistical analysis revealed that there is no statistical difference for handedness between boys and girls therefore the correlation between handedness and truncal asymmetry was performed for both sexes together. 91% children were right-handed (1932 boys and 1996 girls), while 9% left-handed (218 boys and 169 girls) respectively. A significant statistical correlation of truncal asymmetry and handedness was found both in boys and girls at thoracic (p < 0.022) and thoracolumbar (p< 0.027), but not at the lumbar region.

4. Discussion. These findings show that there is significant correlation of truncal asymmetry and the dominant brain hemisphere in terms of handedness, in children who are entitled at risk to develop scoliosis. Thus, the correlation of the handedness and the truncal asymmetry (the scoliosis convex) is present not only at scoliotic children but and at those being at risk that is before the development of the disease. These findings correlate cortical function and the truncal asymmetry, probably as a prodrome state of scoliosis and it is of aetiologic importance.