[Show abstract][Hide abstract] ABSTRACT: In the presented study we aimed to investigate the influence of bracing time on perception of mental health by both parents and children with Adolescent Idiopathic Scoliosis (AIS) longitudinally, in relation to socio-demographic and scoliosis-related data. The study design was comprised of three questionnaire assessments, with the second and the third evaluation taking place 6 and 12 months after the beginning of the study, respectively. Thirty-six AIS females treated conservatively and their parents completed the Polish versions of The Strengths and Difficulties Questionnaire-25 (SDQ-25). The results indicated psychiatric disorder was unlikely, but concern all SDQ-25 parent and patient domains and general results. Patient results do not differ significantly in regards to the total score and the particular domains of the SDQ-25. Parents SDQ-25 results differ significantly in regards to the emotional symptoms domain only (p = .023, after Bonferroni correction, the difference is insignificant). The study groups differ significantly within the 2nd evaluation in regards to hyperactivity/inattention domain (p = .026) and within the last evaluation in regards to emotional symptoms domain (p = .009). After Bonferroni correction the differences are insignificant. In general, parents and their children with AIS perceived patients' mental health in a similar way. Patient and parent assessment of mental health was unchanged after a 12-month brace treatment period. Poor psychological outcome was associated with more severe spinal deformity, brace-wearing duration and age of patient.
Journal of Developmental and Physical Disabilities 06/2013; 25(3):325-342. · 0.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to make a prospective analysis of changes in anxiety levels and determining their associations with a longitudinal subjective assessment of trunk deformity in adolescent females with scoliosis, in relation to clinical, radiological and brace-related data. The study design was comprised of three questionnaire assessments, with the second and third evaluations taking place 6 and 12 months after the beginning of the study, respectively. 36 AIS females treated conservatively were asked to fill in the Polish versions of the Spinal Appearance Questionnaire (SAQ-pl) and the trait version of the Spielberger's Anxiety Inventory for Children (STAIC-trait). High anxiety was indicated in 16.6, 8.3 and 8.3% during the 1st, 2nd and 3rd evaluations. Patients' results differ in regards to the Curve domain; the discrepancies concern the 2nd and 3rd and the 1st and 3rd evaluations (p = 0.028 and p = 0.003, respectively). The only association between STAIC-trait and SAQ-pl regards Trunk shift in the 1st evaluation (rs = 0.48). The logistic regression revealed that the duration of brace-wearing in months has a statistically significant (p = 0.021) influence on the probability of diagnosing patients' low anxiety levels in the 2nd assessment. Special attention should be paid to patients' emotional reactions later on as brace-wearing continues as well as to the results which support the point that patients' perceptions of spinal deformity do not deteriorate with treatment time. Clinicians need to be aware how patients' appearance-specific cognitions might be associated with levels of emotional distress and relate to clinical and radiological, scoliosis-related data.
Journal of Developmental and Physical Disabilities 04/2013; 25(2):203-220. · 0.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: PURPOSE: In the presented study, we aimed to assess changes over time in the perception of trunk deformity, body function, stress level and mental health in females with adolescent idiopathic scoliosis (AIS) who were treated conservatively with a Cheneau brace, taking the Trunk Appearance Perception Scale (TAPS), Scoliosis Research Society-22 (SRS-22) and Bad Sobberheim Stress Questionnaires (BSSQ) criteria of evaluation into consideration. METHODS: The study design was comprised of three questionnaire assessments, with the second and the third evaluation taking place 6 and 12 months after the beginning of the study, respectively. Thirty-six females treated conservatively were asked to fill in the TAPS, SRS-22 and BSSQ forms. RESULTS: In regards to TAPS, the results differed between the 1st and the 2nd assessment in Figure 2 only (p = 0.013). The difference between the 1st and the 3rd evaluation concerned Figure 3 and the total score (p = 0.011 and p = 0.005, respectively). The SRS-22 and BSSQ results of study participants did not differ significantly between the 1st and the 2nd, between the 2nd and the 3rd and between the 1st and the 3rd evaluations. CONCLUSIONS: The study indicated that the assessment of girls with AIS concerning body function and mental health did not deteriorate in the course of orthosis treatment. Furthermore, they showed improvement in perceptions particularly in regards to trunk shape. We pointed out that the negative perceptions of mental health, self-image and low level of activity held by females with AIS coexisted with severe emotional distress. Moreover, factors that improved functioning or subjective physical appearance ratings in particular, such as level of activity, were indicated.
Quality of Life Research 11/2012; · 2.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A cross-sectional analysis of parents' and patients' perceptions of deformity- and brace-related stress regarding conservative treatment of adolescent idiopathic scoliosis.
The purpose of this study was to determine the agreement between patients' and parents' assessments of emotional stress and to compare these assessments with radiographical measurements of spinal deformity.
Conservative treatment in patients with scoliosis may cause emotional stress. To our knowledge, no group has ever reported patient and parental estimation of stress related to wearing a brace and spinal deformity in girls with adolescent idiopathic scoliosis.
Sixty-three pairs of parents and girls with adolescent idiopathic scoliosis treated with a Cheneau brace were separately asked to complete the Bad Sobberheim Stress Questionnaire-Deformity and the Bad Sobberheim Stress Questionnaire-Brace. The age range of the patients was from 10 to 17 years. Patients were assessed at a mean of 14.12 (SD, 10.99) months after the start of the conservative treatment.
Patients thought that a moderate level of stress was connected with conservative treatment; however, the stress level, related to perceived trunk deformation, was low. From the parents' perspective, patients experienced a moderate level of stress during conservative treatment and related to spinal deformity. The study groups differ in their perception of stress levels due to body disfigurement but not during the conservative treatment. Parent-patient stress-level disparities were not related to body mass index, age of the patient, brace application, and radiographical measurements of spinal deformity.
Patients and parents perceive the emotional stress related to brace treatment in the same way; however, parents overestimate the assessment of stress levels related to body deformity. From the perspective of patients and parents, brace wearing increased the level of stress induced by the deformity alone. Complete assessment of conservative treatment should include evaluation of emotional stress from the perspective of patients and parents.
[Show abstract][Hide abstract] ABSTRACT: Evaluation and comparison of translated and culturally adapted self-reported measurements.
The aim of this prospective study was to cross-culturally adapt the Polish versions of Revised Oswestry Disability Index (RODI-PL), Quebec Back Pain Disability Scale (QDS-PL), and the Low Back Outcome Score (LBOS-PL).
The application of instruments in English, which have undergone translation must be subjected to validation studies. Such studies are necessary above all for instruments that have been adapted to establish their value and usefulness in studies of patient populations where English is not the native language.
The translation was carried out according to International Quality of Life Association (IQOLA) Project and consisted of the following stages: translation, synthesis of the translations, back translation, expert committee, and testing of the prefinal versions of questionnaires. Eighty-five consecutive patients with low back pain due to spinal disc herniation and degenerative changes completed the QDS-PL, RODI-PL, LBOS-PL, and a Visual Analogue Scale twice within 2-day intervals. Mean duration of LBP was 45.9 months SD 55.5. The evaluation of degenerative changes in the lumbar region was carried out according to the Modic scale. Twenty-nine patients were categorized at type I, 4 patients were registered as type II, and 52 patients were type III.
Cronbach α values for the LBOS-PL equaled 0.77, for the RODI-PL 0.85, and 0.95 for the QDS-PL. Item-total correlation confirmed that all scales are internally consistent. Test-retest reliability was excellent for RODI-PL and QDS-PL, but poor for LBOS-PL (0.88, 0.93, and 0.34, respectively). All questionnaires were significantly intercorrelated. We identified the strongest correlation between QDS-PL and RODI-PL (0.823, P < 0.001). The statistically significant correlation was identified between the QDS-PL and Modic Classification (rS = 0.226 P = 0.038).
QBPDS-PL and RODI-PL are reliable and valid. Furthermore, investigation of the psychometric properties of the LBOS-PL in different spinal conditions is required. There is a relation between the results of the QDS-PL, and different levels of advancement in degenerative disease of the lumbar spine, according to the Modic Classification.
[Show abstract][Hide abstract] ABSTRACT: The aim of this paper is to evaluate the frequency of limb shortening in the course of solitary bone cyst treatment. The correlation between the mode of treatment as well as the occurrence of pathological fracture, cyst location, volume, and locularity were examined.
A retrospective analysis was carried out on 135 patients where 80 underwent curettage and bone grafting and 55 were administered methylprednisolone injection with a mean time to follow-up of 12 years.
Based on clinical and radiological evaluation, limb shortening was found in ten patients when the data before and after treatment was compared. Limb shortening ranging from 1 to 5 cm during the course of the treatment was observed: six in humerus, two in femur, two in tibia. Those with epiphyseal changes, magnetic resonance imaging to evaluate the degree of growth plate damage was performed. Patients with and without limb shortening did not differ statistically regarding the applied method of treatment. The cyst volume was significantly larger in the group of patients with limb shortening when compared to the group of patients with no limb shortening.
In patients treated with curettage and bone grafting, the mode of treatment does not increase the frequency of occurrence of iatrogenic limb shortening. In patients with limb shortening, a statistically significant larger volume of the cyst was observed.
[Show abstract][Hide abstract] ABSTRACT: Psychopathological symptoms occur more often in chronically ill patients than in healthy populations. The aim of this study was to analyze the associations between different types of treatment and stress levels.
The study group consisted of 69 females, of whom 35 were treated conservatively with a Cheneau brace; the other 34 subjects were treated operatively and, after correction of scoliosis with thoracoplasty, wore a brace for 12 weeks during the postoperative period. Patients completed the Polish versions of the Bad Sobernheim Stress Questionnaire-Deformity and the Bad Sobernheim Stress Questionnaire-Brace.
Patients who were treated surgically felt a moderate level of stress connected with wearing the brace and with body deformation. The group treated conservatively felt moderate stress connected with wearing the brace, but a low level of stress in relation to body deformation. The groups differed significantly statistically in the level of stress felt regarding body deformation (p=0.004). In the group treated conservatively, the correlation between the level of stress, the age at which treatment was initiated, and degree of apical translation proved to be significant.
Patients treated surgically in comparison with patients treated conservatively report higher stress levels connected with body deformation. A higher level of stress depends on the degree of trunk deformation on the frontal plane; stress is also higher in patients who begin conservative treatment at a later age.
Medical science monitor: international medical journal of experimental and clinical research 02/2011; 17(2):CR83-90. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Even though there are several region-specific functional outcome questionnaires measuring neck disorders that have been developed in English-speaking countries, no Polish version has ever been validated. The purpose of our study was to translate, culturally adapt and validate the Neck Disability Index (NDI) and Copenhagen Neck Functional Disability Scale (CDS) for Polish-speaking patients with neck pain.
The translation was carried out according to the International Quality of Life Association (IQOLA) Project. Sixty patients were treated due to degenerative and discopathic disorders in the cervical spine filled out the NDI-PL and the CDS-PL. The pain level was evaluated using the Visual Analog Scale. The mean age of the assessed group was 47.1 years (SD 8.9). We used Cronbach's alpha to assess internal consistency. We assessed the test-retest reliability using the Intraclass Correlation Coefficients (ICCs). The Spearman's rank correlation coefficient (rS) was used to determine dependency between quantitative characteristics. The Mann-Whitney test was applied to determine dependency between quantitative and qualitative characteristics.
The Cronbach's alpha values were excellent for the NDI-PL in the test and in the retest (0.84, 0.85, respectively), and for the CDS-PL (0.90 in the test and in the retest). Intraclass Correlation Coefficients were excellent for the CDS-PL and NDI-PL and equalled 0.93 (95% CI from 0.89 to 0.95) and 0.87 (95% CI from 0.80 to 0.92), respectively The concurrent validity was good in the test and in the retest (rs = 0.42 p < 0.001; rs = 0.40 p = 0.002, respectively) for NDI-PL and for CDS-PL (rs = 0.42 p < 0.001; rs = 0.40 p = 0.001, respectively). The adapted questionnaires showed a strong inter-correlation both in the test (0.87 p < 0.001) and in the retest (0.79 p < 0.001).
The present versions of the NDI-PL and CDS-PL, the first to be published in Polish, have proven to be reliable and valid for patients with degenerative changes in the cervical spine. The NDI-PL and CDS-PL have excellent internal consistency and test-retest reliability, and good concurrent validity. The adapted questionnaires showed a strong inter-correlation both in the test and in the retest. No ceiling or floor effects were detected in the NDI-PL and CDS-PL. The NDI-PL and CDS-PL are comparable with other versions and can be recommended and used in international comparative studies.
[Show abstract][Hide abstract] ABSTRACT: DTDST mutations cause a spectrum of diastrophic dysplasia disorders characterized by defects of proteoglycans sulfation. Reduction of sulfate/chloride antiporter activity is manifested by lower sulfate uptake and depends on a combination of mutations in DTDST. We analyzed a family with an autosomal recessive form of bone dysplasia. Three affected brothers from this family are compound heterozygotes for C653S/A715V mutations. We classified their phenotype as a new intermediate form between diastrophic dysplasia and multiple epiphyseal dysplasia, manifested by shortening of stature, metatarsus adductus/club foot, mild brachydactyly, proximally placed thumbs and clinodactyly of the fifth fingers. Radiographs document platyspondyly most marked in the lower thoracic and upper lumbar spine, epiphyseal dysplasia affecting predominantly the femoral heads, widening of the metaphyses, narrow growth cartilage and multilayered patellae. Exaggerated lesser trochanters of femur, that is, "monkey wrench" sign, elevated greater trochanters, thin upper pubic rami, grossly normal carpal/tarsal bones and severe, early onset osteoarthritis were other notable features.
American Journal of Medical Genetics Part A 11/2010; 152A(12):3036-42. · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The goal of this research was to determine whether short-term differences exist in psychopathological symptoms between adolescents with scoliosis treated operatively or conservatively. We analyzed the personality characteristics of scoliosis patients compared with controls.
The study group consisted of 35 scoliosis patients treated conservatively; 35 patients treated surgically with posterior (27 cases) or anterior (7 cases) correction and fusion combined with thoracoplasty who then, after surgery, went on to use a brace; and a group of 35 healthy controls. Psychopathological symptoms were assessed with the Erich Mittenecker and Walter Toman Personality Test.
In comparison with healthy individuals, the entire group of patients, including patients treated conservatively, expressed more self-criticism, whereas the patients treated surgically expressed more self-criticism, neurotism, and depressiveness. The daily length of brace use and age of patients in conservatively treated patients had a significant effect on the outcomes, in patients treated operatively degree of apical translation after surgery played a similarly significant role.
Patients with scoliosis fell in the range average for the personality test. The prevalence of self-reported psychopathological symptoms is higher in patients with scoliosis in the short-term after brace or surgical treatment compared with healthy controls. There are differences in personality characteristics between adolescents with scoliosis after conservative or surgical treatment. Patients treated conservatively show more symptoms of maniacality, and the longer the brace was applied during the day, the higher the level of depression reported by the patients themselves. Patients treated operatively manifest more symptoms of neurotism.
Medical science monitor: international medical journal of experimental and clinical research 11/2010; 16(12):CR606-15. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Organ transplantation is a treatment method that is very sensitive to public opinion. Information regarding misconduct in the recovery and transplant of organs very often leads to a definite decrease in the numbers of operations. In 2007 in Poland, the national media reported numerous controversial transplantation incidents. Directly after these occurrences, the number of transplantations fell sharply. Public opinion worsened as did the level of trust placed in doctors. Social psychology explains the mechanisms responsible for this phenomenon through the notion of cognitive schemata. Their permanence is explained through selective perception, memory and the effect of persistence.
Medical science monitor: international medical journal of experimental and clinical research 08/2010; 16(8):RA171-6. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Polish adaptation of the original version of Scoliosis Research Society (SRS) instrument.
The transcultural adaptation of SRS-22 and evaluation of its internal consistency.
High psychometric value of the SRS-22 Questionnaire has made it an effective evaluation instrument in clinically assessing the functional status of patients with adolescent idiopathic scoliosis.
First, 2 translators translated the original version into Polish. Afterwards, the translators identified differences between the translations and produced a consensus version. In the third stage, 2 native English speakers produced back translations. Finally, a team of 2 orthopedic surgeons, translators, a statistician and a psychologist reviewed all the translations to produce a prefinal version. The questionnaire was administered to 60 girls at the age of 16.6, SD 2.0 with adolescent idiopathic scoliosis treated with the Cotrel-Dubousset method in Pediatric Orthopaedics and Traumatology Clinic in Poznań.
The internal consistency in the Polish version equaled 0.89 for the overall result and 0.81 for function, 0.81 for pain, 0.80 for mental health, 0.77 for self-image, and 0.69 for treatment satisfaction domains, respectively.
The Polish version of SRS-22 is characterized by high internal consistency for all domains and for the overall score, which makes it an evaluation tool after surgical treatment compatible with the original SRS-22.
[Show abstract][Hide abstract] ABSTRACT: To evaluate cyst remodeling, including complete healing and recurrence, and its relation to the cyst volume in two groups of patients, using curettage and bone grafting or methylprednisolone injection.
A retrospective analysis was carried out on data from 132 patients with solitary bone cyst, where 79 (59.9%) had undergone curettage and bone grafting and 53 (40.1%) had been administered methylprednisolone injection, with a mean time to follow up of 12 years. The cyst volume was evaluated from conventional radiographs and the method originally reported by Göbel et al. to evaluate the volume of Ewing's sarcoma. The results were analyzed using the criteria of Neer et al. and Capanna et al.
The mean cyst volume was 36.8 cm(3). Recurrence was noted in 16 (20.2%) patients treated with curettage and in nine (17.0%) treated with methylprednisolone. Cyst volume in patients treated with curettage and bone grafting ranged from 8.3 cm(3) to 100.0 cm(3) and with methylprednisolone from 14.0 cm(3) to 50.6 cm(3) . In neither group was the cyst volume related to recurrence. Volumes from 1.3 cm(3) to 81.9 cm(3) were stated for patients treated with curettage and bone grafting, when complete healing was observed; they were significantly lower than for those of the total group of patients who underwent curettage and bone grafting.
1. An association between solitary cyst volume and recurrence in patients treated with either bone curettage and grafting or methylprednisolone was not found. 2. The frequency of complete healing in patients treated with bone curettage and grafting decreased with an increase in the cyst volume.
[Show abstract][Hide abstract] ABSTRACT: Fourty-eight patients were treated operatively for idiopathic scoliosis by means of Cotrel Dubousset technique heaving pre-operative angle values of 50°_70°. Exercise test was performed using cycle ergometer both in pre- and postoperative period. Cardiorespiratory parameters were constantly measured throughout the test to estimate ventilation threshold. Following parameters were included: heart rate, oxygen intake, lung ventilation per minute, rate and volume of ventilation, as well as power and work performed. Test was terminated when ventilation threshold was achieved. This is considered noninvasive method to calculate threshold of anaerobic metabolism. Maximal oxygen intake was indicated by means of Astrand-Ryhming nomogram. Body weight and height were also measured. Operative treatment of scoliosis using Cotrel-Dubousset method enhances physical efficiency moderately most probably due to improvement of respiratory mechanics, increase in ventilation per minute during exercise test through deepening of breaths rather than increase in ventilation rate.
[Show abstract][Hide abstract] ABSTRACT: The perspective of trunk deformity is a matter of special concern for adolescent idiopathic scoliosis (AIS) patients. No research group has ever reported interviewing patients and their parents regarding differences in perception of body appearance in the course of Cheneau brace treatment. We aimed to investigate the level of agreement in the field of concerns and perceptions of spinal appearance in relation to brace- and scoliosis-related data between parents and female patients with AIS, treated with a Cheneau brace, by means of the Spinal Appearance Questionnaire-pl (SAQ-pl). In this cross-sectional study forty-one pairs of parents and female patients with AIS were asked to separately complete the Polish versions of the Spinal Appearance Questionnaire-pl patient form (SAQ-pl patient form) and the SAQ-pl parent form. Age of patients was 13.60 years SD 1.60 (range 10–17). Patients scored 2.70 (SD 0.60) and parents scored 2.70 SD 0.60 in the total score of the SAQ-pl. The study groups do not differ significantly in regards to the SAQ-pl results. The percentage of consistent answers on SAQ-pl items ranges from 34.10 % (item 20) to 78 % (item 8). Height, age and brace-wearing time per day, were significantly related to the differences in the patient-parent General perception of body shape (rs
= −0.51, rs
= −0.34, rs
= 0.36, respectively). Parents and female patients with AIS have similar concerns and perceptions of spinal appearance. The discrepancies in General perception of spinal appearance between parents and AIS females decrease with age of patient. Parental emotional support may contribute to minimizing the risk factors of psychological impairment, especially in late adolescents with AIS.
Journal of Child and Family Studies · 1.42 Impact Factor