Le 15/10/2021 de 14:00 à 15:30
Freins et leviers au port du corset chez l'adulte atteint de scoliose dégénérative douloureuse: étude pilote transversale monocentrique de faisabilité à méthode mixte
Flora Dureigne (Paris, France), Marie-Ombeline Chagnas (Paris, France), Alexandra Roren (Paris, France), Emmanuel Couzi (Paris, France), Camille Daste (Paris, France), Stéphanie Goret (Paris, France), Marie-Martine Lefevre-Colau (Paris, France), Sylvain Moreau (Paris, France), Vanina Nicol (Paris, France), François Rannou (Paris, France), Christelle Nguyen (Paris, France)
Objective : Conservative treatments including bracing and exercise therapy are prescribed on the first-line to reduce pain and improve activity and participation in adults with degenerative scoliosis (ADS). However, adherence to bracing frequently decreases overtime. We aimed to assess barriers and facilitators to bracing in painful ADS.
Material / Patients and Methods : We conducted a cross-sectional monocentric mixed-method pilot and feasibility study. All patients appointed for a multidisciplinary custom bracing consultation, from July 2019 to January 2020, were screened. The primary outcome was assessed by a qualitative approach using semi-structured interviews and was barriers and facilitators to bracing experienced by participants. Secondary outcomes were assessed by a quantitative approach and were changes in back pain intensity with a self-administered numeric rating scale and user satisfaction with the self-administered QUEST questionnaire.
Results : 56 patients were eligible and 14 of 56 (25%) accepted to participate in the study. Mean age was 68.2 (12.3) years. Barriers to bracing were enhanced activity limitations, burden from appearance changes and discomfort in hot weather. Facilitators to bracing were ease of use, pain reduction and improved spinal alignment. Participants self-implemented some solutions: contacts with the orthotist for adjustments when needed and loose clothing. At 11 months, quantitative assessments were available for 12 of 14 participants : 6 of 12 (50%) had pain intensity < 4 of 10 points (patient acceptable symptom state) and mean score QUEST was 4.2(0.5)
Discussion - Conclusion : For people with ADS, bracing is a feasible intervention. However, barriers should be overcome by implementing specific measures to reduce the burden of treatment.
Keywords : bracing, scoliosis