"Back You Up" Protocol: Individualized empowerment programme for adolescent idiopathic scoliosis (AIS)

Abstract

<b>Background</b> – Adolescent idiopathic scoliosis (AIS) is characterized by curvature of the spine and uneven shoulders and hips, with a prevalence of 2-3% in the adolescent population. At present, adolescents with mild scoliosis (Cobb angle between 10° and 20°) are only observed every 6 to 12 months, with no active interventions, while bracing remains the most effective non-operative treatment modality for moderate cases (Cobb angle between 20° and 40°) to prevent the progression of spinal curvature. Arguably, the clinical management of AIS focuses primarily on medical treatment currently, in which adolescents are assumed a relatively passive role.

<b>Purpose</b> – Through interdisciplinary collaboration that includes expertise in social work, clinical psychology, orthopaedics, fashion design and textile technology, this study aims to investigate the effectiveness of the “Back You Up” Protocol, an individualized empowerment programme, for adolescents with AIS in promoting their psychological well-being and empowering them to be more proactive in the management of their spinal deformities.

<b>Design/methodology/approach</b> – The individualized empowerment programme includes two service modules targeting AIS with different severity of spine deformity: (1) 30-session surface electromyographic (sEMG) biofeedback posture training for adolescents with mild scoliosis; and, (2) personalized appearance style management for adolescents with moderate scoliosis. A total of 17 adolescents with scoliosis have joined the programme. In-depth interviews were conducted with 13 adolescents who have completed the service module (1) to understand their perspectives on the programme and thematic analysis was used to explore the protocol’s effectiveness in improving the adolescents’ psychological well-being and active participation in minimizing curve progression.

<b>Findings</b> – The results showed that the programme facilitated the active participation of adolescents with scoliosis in improving their psychological well-being and reducing/controlling their spinal curvature.

<b>Research limitations</b> – The sample size is limited, and the two service modules were conducted separately with a 4-year gap in between, making it difficult to confirm the effectiveness of the overall protocol and generalize its results.

<b>Originality/value</b> – The individualized empowerment programme effectively improves the psychological well-being of adolescents with scoliosis, by encouraging them to take an active role in minimizing the progression of spinal curvature. Increased patient participation in future treatment planning is suggested.