My orthopedic brace inventory (MOBI): a new, reliable, and valid questionnaire to identify barriers to brace adherence in adolescent idiopathic scoliosis treatment

PurposeFull-time wearing of an orthopedic brace has demonstrated effectiveness in limiting curve progression in adolescents with idiopathic scoliosis. However, treatment adherence is challenging, with an average wearing time of 13 h/day. Despite this issue, barriers to brace adherence have rarely been studied. The aim of this study was to develop and validate a new instrument tool to evaluate factors influencing brace adherence.MethodsOur study followed the COnsensus-based Standards for the selection of health Measurement INnstruments criteria (COSMIN). A conceptual framework was initially defined, and experts elaborated, reviewed, and selected candidate items. We also investigated the MOBI's factorial structure and its psychometric properties.ResultsThe MOBI initial version included 32 items related to four conceptual barriers to adherence, namely social/emotional, treatment, patient, and health system/professional. The factorial analysis led to an 18-item inventory with an internal consistency of 0.85 with four better-defined barriers (treatment social/emotional support structure, patient's self-image and perception, treatment adverse effects, and treatment acceptability. The MOBI-18f correlates with the SRS-22 domain treatment satisfaction and pain and the SF-12 mental health. Patients with poor brace wear time and more severe scoliosis will score higher on the MOBI-18f questionnaire.ConclusionThe MOBI-18f is a reliable and valid measure of patients' adherence to brace treatment. This questionnaire can be used to develop interprofessional adherence support intervention in AIS patients undergoing brace treatment.