The use of mindfulness-based intervention to improve bracing compliance for AIS patients

Abstract

Introduction Despite good bracing compliance is crucial to prevent curve progression among braced AIS patients, only few interventions were suggested to improve bracing compliance. This study examined the effect of MBI on bracing compliance for AIS patients. Methods 116 eligible AIS patients were randomized and 86 participants were enrolled in intervention. Patients in the MBI group joint weekly sessions, which is an adapted version of mindfulness-based stress reduction (MBSR) program, for 8 weeks. Control group consisted of an 8-week PE intervention that is recommended according to the SOSORT 2011 guideline. The primary outcome is the 6-month post-intervention bracing compliance. The secondary outcomes include quality of life and psychosocial measurements. Primary analysis was ANCOVA with treatment as covariate. Trend analysis was conducted using Linear Mixed effect model. Results At the end of intervention, intention-to-treat analysis improved bracing compliance by1.24h/day and 0.08h/day for MBI and PE respectively. MBI group presented an increase in emotional regulation than baseline (ERQ-CCA) (1.92, p = 0.01), especially in Cognitive reappraisal sub-scale (1.00, p = 0.05). Bracing Specific Quality of Life (SRS-22) reduced significantly in both groups, but MBI group decreased less (MBI: -3.08, p = 0.00, PE -4.47, p = 0.00). Effect at six months for compliance progressed negatively but favoured MBI group (MBI: -1.16, p = 0.13, PE: -1.84, p = 0.06) although there was no significant difference between groups (p = 0.78). The Perception of stress (PSS) decreased significantly in PE group (-3,53, p = 0.01) rather than MBI (1.53, p = 0.22), however the between-group difference isn't significant (p = 0.62). Conclusions It is alarming that patients in both interventions group progressed with poorer compliance and worsen QoL. These progressions were less severe in the MBI group than in the PE group, but the differences did not reach statistical significant. Key messages Both groups decreased in compliance and QoL but MBI group reduced less. MBI wasn't more effective in improving participants’ compliance and other measurements.