Psychologic management of brace therapy for patients with idiopathic scoliosis.
METHODS
A trial of brace therapy modified by a measured personality pattern of patients with idiopathic scoliosis was performed.


OBJECTIVE
To evaluate the effectiveness of performing personality tests for patients with idiopathic scoliosis who undergo brace therapy.


BACKGROUND
Brace therapy has often been used for the treatment of scoliosis. However, emotional distress can result from this therapy. Few attempts have been made to reduce such stress.


METHODS
A test using the Maudsley Personality Inventory was performed on 145 adolescent females with idiopathic scoliosis, treated with brace therapy alone, before the start of brace therapy and 1 month after the start of brace therapy. On the basis of test results, the patients were rated as normal type and four abnormal types. Brace therapy was continued considering the personality pattern of patients. For all patients, changes in psychologic test results, compliance with braces wearing instructions, and correction of scoliosis were analyzed.


RESULTS
Of the 134 patients rated as normal before the start of therapy, 108 patients were rated as abnormal pattern when tested 1 month after the start of therapy. After performing autogenic training for patients with E-N+ and E-N- personalities, and giving advice to school teachers to decrease the emotional stress for patients with E+N+ personality, 47 patients were finally rated as abnormal pattern. In total, 12 (8%) of the 145 patients dropped out. In dropouts, the average pretreatment deformity of 29 degrees (range: 21 degrees -37 degrees ) had increased to an average of 37 degrees (range, 31 degrees -48 degrees ).


CONCLUSIONS
Psychologic tests may be useful and provide a means of modifying brace therapy tailored to the psychologic conditions of individual patients.
Matsunaga
Shunji
S
Department of Orthopaedic Surgery, Kagoshima Graduate School of Medicine and Dental Sciences, Kagoshima, Japan. shunji@m.kufm.kagoshima-u.ac.jp
Hayashi
Kyoji
K
Naruo
Tetsuro
T
Nozoe
Shin-ichi
S
Komiya
Setsuro
S
D000293:Adolescent; D001915:Braces / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002648:Child; D019468:Disease Management; D005260:Female; D006801:Humans; D016015:Logistic Models; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D011581:Psychological Tests / Q000706:statistics & numerical data; D012600:Scoliosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*