Brace Compliance Improves Cobb Angle Correction and Quality of Life in Adolescents with Idiopathic Scoliosis

Abstract

Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity among adolescents and may negatively affect physical and psychosocial well-being. Brace treatment is widely used to prevent curve progression; however, treatment success largely depends on patient compliance. Evidence examining the relationship between brace compliance, spinal correction, and quality of life in adolescents with AIS remains limited. This study aimed to evaluate the effect of brace compliance on Cobb angle, height change, and quality of life in adolescents with AIS. A quasi-experimental longitudinal study was conducted among 50 female adolescents aged 13 to 18 years with Cobb angles of 20° to 35° at the Orthotic and Prosthetic Clinic Mojokerto, Indonesia. Participants underwent brace treatment for three months. Mean wear time was 16.3 ± 3.4 hours/day. Brace compliance was assessed using a structured questionnaire, while quality of life was evaluated using the PedsQL Scoliosis Module. Cobb angle and height measurements were performed before and after treatment. The results demonstrated a significant mean Cobb angle reduction of 2.6° after treatment (p < 0.001). Higher brace compliance was associated with greater Cobb angle reduction (p = 0.003) and better quality of life scores (p < 0.001). However, no significant correlation was found between brace wear duration and height change (r = 0.11; p = 0.42). In conclusion, brace compliance significantly improved spinal curve correction and quality of life in adolescents with AIS. Strategies to improve brace adherence are essential to optimize conservative treatment outcomes.

Keywords: adolescent idiopathic scoliosis; brace compliance; cobb angle; quality of life; conservative treatment