Construct validity of the Trunk Aesthetic Clinical Evaluation (TRACE) in young people with idiopathic scoliosis / Stefano Negrini in Annals of physical and rehabilitation medicine, Vol. 63, n°3 (Mai-Juin 2020)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 63, n°3 (Mai-Juin 2020) . - p. 216-221 Titre : Construct validity of the Trunk Aesthetic Clinical Evaluation (TRACE) in young people with idiopathic scoliosis Type de document : texte imprimé Auteurs : Stefano Negrini ; Sabrina Donzelli ; Francesca Di Felice ; Fabio Zaina Année de publication : 2020 Article en page(s) : p. 216-221 Note générale : doi.org/10.1016/j.rehab.2019.10.008 Langues : Anglais (eng) Mots-clés : Idiopathic scoliosis  Aesthetics  Rehabilitation  Rasch analysis  Evaluation Résumé : Background Aesthetics is recognized as a main outcome in idiopathic scoliosis (IS) treatment, but to date, there is no criterion standard for physicians’ evaluation. Trunk Aesthetic Clinical Evaluation (TRACE) is a simple 12-point ordinal scale to quantify symmetry as a proxy of aesthetics. TRACE is already diffused worldwide and has been used in clinical research. Objective We aimed to validate TRACE and improve it with Rasch analysis. Material and methods This study involved an observational Rasch analysis validation of an evaluation tool in outpatient rehabilitation centres. From a clinical database, we randomly selected patients who had IS, were age 10 to 18, had brace prescription at first evaluation, and had at least 2 consultations. Rasch analysis (partial credit model) was used. Differential item functioning (DIF) was assessed for age, sex, disease severity, bracing and treatment. The median was chosen to dichotomize disease severity and bracing. We removed 64 outlier participants (4%). Results We included 1553 participants (1334 females; mean [SD] age 13 [1.7] years old). TRACE items showed ordered thresholds and proper fit to the Rasch model. The score-to-measure conversion table showed proper length (range −4.55 to 4.79 logit) with a mean (SE) measure of −0.52 (0.04) logit. The principal component analysis supported the TRACE unidimensionality. The TRACE was free from DIF for age, sex and bracing. Conclusions The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised. Permalink : ./index.php?lvl=notice_display&id=90798 [article] Construct validity of the Trunk Aesthetic Clinical Evaluation (TRACE) in young people with idiopathic scoliosis [texte imprimé] / Stefano Negrini ; Sabrina Donzelli ; Francesca Di Felice ; Fabio Zaina . - 2020 . - p. 216-221. doi.org/10.1016/j.rehab.2019.10.008 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 63, n°3 (Mai-Juin 2020) . - p. 216-221 Mots-clés : Idiopathic scoliosis  Aesthetics  Rehabilitation  Rasch analysis  Evaluation Résumé : Background Aesthetics is recognized as a main outcome in idiopathic scoliosis (IS) treatment, but to date, there is no criterion standard for physicians’ evaluation. Trunk Aesthetic Clinical Evaluation (TRACE) is a simple 12-point ordinal scale to quantify symmetry as a proxy of aesthetics. TRACE is already diffused worldwide and has been used in clinical research. Objective We aimed to validate TRACE and improve it with Rasch analysis. Material and methods This study involved an observational Rasch analysis validation of an evaluation tool in outpatient rehabilitation centres. From a clinical database, we randomly selected patients who had IS, were age 10 to 18, had brace prescription at first evaluation, and had at least 2 consultations. Rasch analysis (partial credit model) was used. Differential item functioning (DIF) was assessed for age, sex, disease severity, bracing and treatment. The median was chosen to dichotomize disease severity and bracing. We removed 64 outlier participants (4%). Results We included 1553 participants (1334 females; mean [SD] age 13 [1.7] years old). TRACE items showed ordered thresholds and proper fit to the Rasch model. The score-to-measure conversion table showed proper length (range −4.55 to 4.79 logit) with a mean (SE) measure of −0.52 (0.04) logit. The principal component analysis supported the TRACE unidimensionality. The TRACE was free from DIF for age, sex and bracing. Conclusions The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised. Permalink : ./index.php?lvl=notice_display&id=90798

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Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial / Stefano Negrini in Annals of physical and rehabilitation medicine, Vol. 62, n°2 (Mars 2019)  

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°2 (Mars 2019) . - p. 69-76 Titre : Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial Type de document : texte imprimé Auteurs : Stefano Negrini ; Sabrina Donzelli ; Alessandra Negrini ; et al. Année de publication : 2019 Article en page(s) : p. 69-76 Note générale : Doi : 10.1016/j.rehab.2018.07.010 Langues : Anglais (eng) Mots-clés : Scoliosis  Adolescents  Exercise Résumé : Background In an ideal experimental setting, 2 randomized controlled trials recently showed the efficacy of physiotherapeutic scoliosis-specific exercises (PSSEs) for adolescents with idiopathic scoliosis (AIS). Now large observational studies are needed to check the generalizability of these results to everyday clinical life. Objective To explore the effectiveness of PSSEs for avoiding bracing or progression of AIS in everyday clinics. Methods This was a longitudinal comparative observational multicenter study, nested in a prospective database of outpatient tertiary referral clinics, including 327 consecutive patients. Inclusion criteria were AIS, age≥10 years old at first evaluation, Risser sign 0–2, and 11–20°Cobbangle. Exclusion criteria were consultations only and brace prescription at baseline. Groups performed PSSE according to the SEAS (Scientific Exercise Approach to Scoliosis) School, usual physiotherapy (UP) and no therapy (controls [CON]). End of treatment was medical discharge, Risser sign 3, or failure (defined by the need for bracing before the end of growth or Cobb angle>29°). The probability of failure was estimated by the risk ratio (RR) and 95% confidence interval (CI). The number needed to treat was estimated. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. Propensity scores were used to reduce the potential effects of confounders related to the observational design. Results We included 293 eligible subjects after propensity score matching (SEAS, n=145; UP, n=95; controls, n=53). The risk of success was increased 1.7-fold (P=0.007) and 1.5-fold (P=0.006) with SEAS versus controls in the efficacy and intent-to-treat analyses, respectively, and the number needed to treat for testing SEAS versus controls was 3.5 (95% CI 3.2–3.7) and 1.8 (95% CI 1.5–2.0), respectively. The success rate was higher with SEAS than UP in the efficacy analysis. Conclusions SEAS reduced the bracing rate in AIS and was more effective than UP. PSSEs are additional tools that can be included in the therapeutic toolbox for AIS treatment. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314416 Permalink : ./index.php?lvl=notice_display&id=82643 [article] Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial [texte imprimé] / Stefano Negrini ; Sabrina Donzelli ; Alessandra Negrini ; et al. . - 2019 . - p. 69-76. Doi : 10.1016/j.rehab.2018.07.010 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°2 (Mars 2019) . - p. 69-76 Mots-clés : Scoliosis  Adolescents  Exercise Résumé : Background In an ideal experimental setting, 2 randomized controlled trials recently showed the efficacy of physiotherapeutic scoliosis-specific exercises (PSSEs) for adolescents with idiopathic scoliosis (AIS). Now large observational studies are needed to check the generalizability of these results to everyday clinical life. Objective To explore the effectiveness of PSSEs for avoiding bracing or progression of AIS in everyday clinics. Methods This was a longitudinal comparative observational multicenter study, nested in a prospective database of outpatient tertiary referral clinics, including 327 consecutive patients. Inclusion criteria were AIS, age≥10 years old at first evaluation, Risser sign 0–2, and 11–20°Cobbangle. Exclusion criteria were consultations only and brace prescription at baseline. Groups performed PSSE according to the SEAS (Scientific Exercise Approach to Scoliosis) School, usual physiotherapy (UP) and no therapy (controls [CON]). End of treatment was medical discharge, Risser sign 3, or failure (defined by the need for bracing before the end of growth or Cobb angle>29°). The probability of failure was estimated by the risk ratio (RR) and 95% confidence interval (CI). The number needed to treat was estimated. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. Propensity scores were used to reduce the potential effects of confounders related to the observational design. Results We included 293 eligible subjects after propensity score matching (SEAS, n=145; UP, n=95; controls, n=53). The risk of success was increased 1.7-fold (P=0.007) and 1.5-fold (P=0.006) with SEAS versus controls in the efficacy and intent-to-treat analyses, respectively, and the number needed to treat for testing SEAS versus controls was 3.5 (95% CI 3.2–3.7) and 1.8 (95% CI 1.5–2.0), respectively. The success rate was higher with SEAS than UP in the efficacy analysis. Conclusions SEAS reduced the bracing rate in AIS and was more effective than UP. PSSEs are additional tools that can be included in the therapeutic toolbox for AIS treatment. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314416 Permalink : ./index.php?lvl=notice_display&id=82643

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