Adolescents’ experience of bracing for idiopathic scoliosis: a systematic review and meta-analysis

BACKGROUND: Brace treatment is the most common conservative approach for adolescents with idiopathic scoliosis (AIS). However, lived experiences with the brace may influence adherence and the achievement of successful outcomes. AIM: To synthesize qualitative studies on the lived experiences, perceptions, and challenges faced by AIS during brace treatment, and strategies they use to enhance or ensure adherence. DESIGN: A systematic review of qualitative studies, followed by a meta-synthesis. METHODS: MEDLINE, CINAHL, Web of Science, Cochrane Library, Scopus, Physiotherapy Evidence Database, and PsycINFO were searched (from inception to September 1, 2025). References included in these studies and studies included in the ISICO (Italian Scientific Spine Institute) website were also reviewed. We selected primary qualitative or mixed methods studies with identifiable qualitative data, focused on the lived experiences of adolescents with AIS aged 10-18 years, and published in English or Italian. The methodological quality of the studies was assessed with the Joanna Briggs Institute and the Mixed Methods Appraisal tools. Extracted data in the form of texts and quotes were thematically synthesized. FINDINGS: Ten studies involving 135 adolescents, mainly female (78.5%), aged 10-18 years, with a Cobb angle of 25.8° to 37.2° and an overall duration of bracing from 7.7 months to 2.9 years. Three analytical themes emerged: 1) "Losing and reconstructing selfhood through and beyond brace treatment," 2) "Redefining self and social roles," and 3) "Regaining agency." CONCLUSION: Bracing involves a dynamic process of developmental and relational transitions. Adolescents' experiences shift from an initial disruption characterized by psychological shock, physical discomfort, and social stigma, to gradual adaptation and self-regulation, during which they reconstruct their sense of self, identity, and autonomy. Support from parents, peers, teachers, and healthcare professionals is crucial. At the same time, active involvement in treatment planning enhances adolescents' sense of agency, helping them overcome resistance and burden and integrate the brace into daily life.