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Study design <p>Prospective multicenter longitudinal observational cohort study.</p> Purpose <p>Longer brace wear reduces the risk of curve progression in patients with adolescent idiopathic scoliosis (AIS); however, determinants of achieving adequate wear time remain unclear. Therefore, the purpose of this study is to identify factors associated with prolonged brace wear in patients with AIS undergoing brace treatment.</p> Methods <p>This multicenter study included consecutive AIS patients who initiated brace treatment between January 2022 and October 2023. Brace adherence was categorized as &lt; 6, 6–12, 12–18, or &gt; 18 h/day based on patient-reported wear time. Cobb angles and patient-reported outcomes including Scoliosis Research Society-22 revised (SRS-22r) and the Japanese version of the Bad Sobernheim Stress Questionnaire for brace treatment (JBSSQ-brace) were assessed before bracing and at 1 and 2 years. Patients were compared according to high (&gt; 18 h/day) versus low (≤ 18 h/day) compliance at 1 year. Multivariate logistic regression identified factors associated with high compliance.</p> Results <p>Among 202 patients (188 females, 14 males), the proportion wearing the brace &gt; 18 h/day decreased from 52.5% at 1 month to 30.7% at 1 year and 19.3% at 2 years. Multivariate analysis identified greater baseline major curve magnitude and implementation of multidisciplinary intervention as independent factors associated with high compliance. The high-compliance group showed significantly less curve progression, particularly in the thoracolumbar/lumbar and major curves. However, the high-compliance group had significantly lower function scores on the SRS-22r and lower JBSSQ-brace scores compared with the low-compliance group.</p> Conclusion <p>In this multicenter study, multidisciplinary intervention and greater baseline major curve magnitude were associated with prolonged brace wear. Sustained high brace compliance may help optimize treatment effectiveness, while regular assessment of brace-related stress and psychological well-being should be incorporated into long-term brace treatment.</p>

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Factors associated with prolonged brace wear in adolescents with idiopathic scoliosis: a prospective multicenter cohort study

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Tomohiro Banno,
  • Hideyuki Arima,
  • Yu Yamato,
  • Satoru Demura,
  • Toshiaki Kotani,
  • Yusuke Hori,
  • Akira Matsumura,
  • Takashi Namikawa,
  • Kei Watanabe,
  • Masayuki Ohashi,
  • Hideki Tashi,
  • Shinji Takahashi,
  • Hidetomi Terai,
  • Takumi Takeuchi,
  • So Kato,
  • Yuki Taniguchi,
  • Hiroki Oba,
  • Ryo Sugawara,
  • Tomoyuki Asada,
  • Shoji Seki,
  • Toru Doi,
  • Haruki Ueda,
  • Satoshi Suzuki,
  • Naobumi Hosogane

摘要

Study design

Prospective multicenter longitudinal observational cohort study.

Purpose

Longer brace wear reduces the risk of curve progression in patients with adolescent idiopathic scoliosis (AIS); however, determinants of achieving adequate wear time remain unclear. Therefore, the purpose of this study is to identify factors associated with prolonged brace wear in patients with AIS undergoing brace treatment.

Methods

This multicenter study included consecutive AIS patients who initiated brace treatment between January 2022 and October 2023. Brace adherence was categorized as < 6, 6–12, 12–18, or > 18 h/day based on patient-reported wear time. Cobb angles and patient-reported outcomes including Scoliosis Research Society-22 revised (SRS-22r) and the Japanese version of the Bad Sobernheim Stress Questionnaire for brace treatment (JBSSQ-brace) were assessed before bracing and at 1 and 2 years. Patients were compared according to high (> 18 h/day) versus low (≤ 18 h/day) compliance at 1 year. Multivariate logistic regression identified factors associated with high compliance.

Results

Among 202 patients (188 females, 14 males), the proportion wearing the brace > 18 h/day decreased from 52.5% at 1 month to 30.7% at 1 year and 19.3% at 2 years. Multivariate analysis identified greater baseline major curve magnitude and implementation of multidisciplinary intervention as independent factors associated with high compliance. The high-compliance group showed significantly less curve progression, particularly in the thoracolumbar/lumbar and major curves. However, the high-compliance group had significantly lower function scores on the SRS-22r and lower JBSSQ-brace scores compared with the low-compliance group.

Conclusion

In this multicenter study, multidisciplinary intervention and greater baseline major curve magnitude were associated with prolonged brace wear. Sustained high brace compliance may help optimize treatment effectiveness, while regular assessment of brace-related stress and psychological well-being should be incorporated into long-term brace treatment.