“The silent strain: Exploring self-image and mental health in braced adolescents with scoliosis”: a scoping review

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-09-27 DOI:10.1016/j.jcot.2025.103217

Sari Wathiq Al Hajaj , Dawod Al Hajaj , Prabhjit Singh , Sanjeevi Bharadwaj , VishnuV. Nair , Sriram harish srinivasan

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引用次数: 0

Abstract

Background

Adolescent Idiopathic Scoliosis (AIS) is a common spinal deformity. It can create surface deformities that affect adolescents' psychosocial health. Bracing is a non-surgical method to prevent curve progression and avoid surgery. However, the psychosocial effects of long-term brace use during adolescence are often overlooked. issues like decreased self-esteem, social withdrawal, and appearance anxiety may hinder compliance and impact quality of life.

Methods

A comprehensive literature review used PubMed, Cochrane Library, and ScienceDirect to identify studies from 2015 to 2025. It was prospectively registered with the PROSPERO database (Registration ID: CRD420251083129). The search terms included: "adolescent idiopathic scoliosis,” "bracing and self-image,” "bracing compliance,” and "psychological impact of bracing.” Two independent reviewers screened studies based on PICOS criteria: (1) adolescents with AIS, (2) bracing or conservative treatment, (3) control or observational groups, (4) outcomes like self-image, quality of life, or compliance, and (5) RCTs, observational studies, systematic reviews, or meta-analyses. Exclusions included surgical interventions, non-adolescents, or non-English publications.

Results

We found 807 studies; after removing duplicates, irrelevant titles, and abstracts, 26 full texts were screened. Of these, 10 met all criteria and were included. Adolescents in brace treatment often face negative self-image, low self-esteem, and social anxiety, especially at therapy start, affecting adherence. Concerns about appearance and discomfort hinder compliance. Some adapt over time, but others continue to experience mental health issues. Interventions like cognitive-behavioural therapy (CBT), peer support, and special exercise programs improve coping, adherence, and psychological well-being.

Conclusion

Bracing treats Adolescent Idiopathic Scoliosis (AIS) but affects psychosocial well-being, lowering adherence and quality of life. A multidisciplinary, patient-centred approach with mental health support is essential. Early psychological distress identification and interventions like Cognitive Behavioural Therapy (CBT) and peer support can enhance compliance and outcomes. Protocols should include psychosocial screening and holistic care to lessen the adverse effects of brace treatment.

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“沉默的压力：探索自我形象和心理健康的支撑青少年脊柱侧凸”：范围审查

背景：青少年特发性脊柱侧凸是一种常见的脊柱畸形。它会造成表面畸形，影响青少年的心理健康。支具是一种非手术的方法，可以防止弯曲进展，避免手术。然而，青少年长期使用支具的心理社会影响往往被忽视。自尊心下降、社交退缩和外表焦虑等问题可能会阻碍依从性并影响生活质量。方法采用PubMed、Cochrane Library和ScienceDirect进行综合文献综述，选取2015 - 2025年的研究。前瞻性地在PROSPERO数据库中注册（注册ID: CRD420251083129）。搜索词包括：“青少年特发性脊柱侧凸”、“支撑与自我形象”、“支撑依从性”和“支撑的心理影响”。两名独立评论者基于PICOS标准筛选研究：(1)患有AIS的青少年；(2)支具或保守治疗；(3)对照组或观察组；(4)自我形象、生活质量或依从性等结果；(5)随机对照试验、观察性研究、系统评价或荟萃分析。排除包括手术干预、非青少年或非英文出版物。结果共发现807项研究；在删除重复、不相关的标题和摘要后，筛选了26篇全文。其中10个符合所有标准并被列入。接受支架治疗的青少年往往面临消极的自我形象、低自尊和社交焦虑，尤其是在治疗开始时，影响了依从性。对外观和不适的担忧阻碍了依从性。随着时间的推移，一些人适应了，但另一些人继续经历心理健康问题。认知行为疗法（CBT）、同伴支持和特殊锻炼项目等干预措施可以改善应对能力、依从性和心理健康。结论支具治疗青少年特发性脊柱侧凸，但影响心理社会健康，降低依从性和生活质量。多学科、以病人为中心的精神卫生支持方法至关重要。早期的心理困扰识别和干预，如认知行为疗法（CBT）和同伴支持，可以提高依从性和结果。方案应包括社会心理筛查和整体护理，以减少支架治疗的不良影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.