Effects of mindfulness-based intervention to improve bracing compliance in adolescent idiopathic scoliosis patients: A randomized controlled trial

Xue LI, Ngar Sze Elsa LAU, Stanley Kam Chung CHAN, Tsz Ping LAM, Jack Chun Yiu CHENG, Eric Kam Pui LEE, Samuel Yeung Shan WONG, Benjamin Hon Kei YIP

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2 Citations (Scopus)

Abstract

Objectives: Bracing is the primary treatment for preventing spine curve progression and the subsequent need for surgery among patients with adolescent idiopathic scoliosis (AIS), and poor bracing compliance is a major factor limiting its treatment benefits. We compared the effectiveness of a mindfulness-based intervention program called MBrace, which is a shorter version of the Mindfulness-Based Stress Reduction program, versus that of a supervised physiotherapy exercise (PE) program in enhancing bracing compliance among AIS patients followed for eight months. 

Method: Eighty-three AIS patients with unsatisfactory bracing compliance (< 18 hr/day) were randomly allocated to MBrace (n = 45) or PE (n = 38) program. The primary outcome was bracing compliance at Month 8 (six months post-intervention). Secondary outcomes included validated inventory of quality-of-life measures, self-compassion, emotion regulation, self-efficacy, stress, and mindfulness level at Month 2 (end of intervention) and Month 8. 

Results: Although bracing compliance was considerably improved in the MBrace program group compared with control at Month 8 (difference in changes between-group (DD), 1.64 hr/day; 95% confidence interval (CI), − 0.25 to 3.53 hr/day; p = 0.09), statistical significance was achieved only after the exclusion of outliers (DD, 2.27 hr/day; 95% CI, 0.49–4.05 hr/day; p = 0.01). At Month 2, a significant treatment effect was estimated both with and without the exclusion of outliers. No significant between-group differences were observed in other secondary outcomes. 

Conclusions: Mindfulness-based interventions may be effective to improve bracing compliance among AIS patients in the short term. Larger randomized controlled trials with longer follow-up durations are needed to confirm the long-term effects of mindfulness-based interventions. 

Trial Registration: Chinese Clinical Trial Register (ChiCTR), ChiCTR-IOR-16010299. Copyright © 2023 The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Original languageEnglish
Pages (from-to)322-334
JournalMindfulness
Volume14
Early online dateJan 2023
DOIs
Publication statusPublished - Feb 2023

Citation

Li, X., Lau, E. N. S., Chan, S. K. C., Lam, T. P., Cheng, J. C. Y., Lee, E. K. P., . . . Yip, B. H. K. (2023). Effects of mindfulness-based intervention to improve bracing compliance in adolescent idiopathic scoliosis patients: A randomized controlled trial. Mindfulness, 14, 322-334. doi: 10.1007/s12671-022-02021-3

Keywords

  • Bracing treatment
  • Compliance
  • Mindfulness-based intervention
  • Physiotherapy exercise
  • Adolescent idiopathic scoliosis

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