BASRaT Student Conference 2020

The British Association of Sport Rehabilitators and Trainers (BASRaT) is the UK regulator and professional association for sport rehabilitators. On Friday 14th February, the University of Nottingham hosted its third student BASRaT conference.

What is the student BaSRat conference?

The student BASRaT conference allows sports injury and rehabilitation students from all over the UK to participate in a day of continued professional development via workshops and talks from keynote speakers.

How were Scoliosis SOS involved?

This year, our Birmingham satellite therapist Sian - a University of Nottingham graduate - delivered an educational talk to conference attendees.

Sian's speech covered:

  • Scoliosis education
  • Screening tools that can be used to detect scoliosis
  • Current treatment options provided by the NHS
  • Our in-house ScolioGold method

Here's what Sian had to say about the 2020 BASRaT conference...

"This was a great opportunity to go back to my own university and raise awareness to future sport rehabilitators who are sure to come across patients with scoliosis at some point during their practice. It is a subject that is often overlooked and certainly not explored in depth as part of undergraduate courses, so providing these talks regarding the anatomy changes and screening tools for scoliosis is so important!"

Sian has received some great feedback from the students, some of whom have already expressed further interest in gaining work experience with the Scoliosis SOS Clinic!

About Scoliosis SOS   Our Birmingham Clinic

Highlights of 2019

Happy new year! 2019 was a truly momentous time for the Scoliosis SOS Clinic, so before we dive into the new decade, we thought we'd take a moment to look back at some of the highlights of the past 12 months:

  • New clinics in Birmingham and Bristol! In November 2019, we opened two new scoliosis treatment centres in Birmingham and Bristol, UK. This means that, counting our flagship clinic in London, we now have 3 locations in total - and we're planning to open more in the near future!

  • Scoliosis SOS on BBC One! Back in August, the Scoliosis SOS Clinic was featured on BBC One's A Matter of Life and Debt. The programme told the story of our founder, Erika Maude, and how she was able to set up the clinic with the financial assistance of responsible lenders Foundation East. If you missed A Matter of Life and Debt, don't worry - here's the clip:

  • SOSORT Annual Meeting in San Francisco! In April 2019, several members of the Scoliosis SOS team crossed the Atlantic to attend the 14th annual SOSORT conference in San Francisco, USA. The event included a number of enlightening talks, including a presentation from our own Erika Maude on the cost-effectiveness of scoliosis-specific exercise programmes. Watch Erika's presentation here.

Darren Lui with Scoliosis SOS team

  • A visit from an orthopaedic spinal surgeon! In February 2019, orthopaedic specialist Mr Darren Lui (pictured above centre) came to our London clinic to talk to our therapists and discuss the value of physiotherapy in treating scoliosis patients. Read more about his visit here.

And if you think that's impressive, just wait! We've got lots of big things in store for 2020 - be sure to follow us on Facebook and Twitter to make sure you don't miss any news.

Scoliosis SOS on Facebook   Scoliosis SOS on Twitter

Scoliosis SOS Clinic Principal Erika Maude with Katy Ford

Did you see the Scoliosis SOS team on TV earlier this week?

A Matter of Life and Debt is a BBC One documentary series that focuses on credit unions, responsible moneylenders, and the people whose lives have been transformed by ethical loans.

The third episode of A Matter of Life and Debt's current series aired on Wednesday (21 August 2019), and it featured a segment about our Clinic Principal Erika Maude and the loan that helped her to set up the Scoliosis SOS Clinic back in 2006.

Having been let down by a high-street bank, Erika instead sought assistance from Foundation East, a responsible lender that provides finance and support for businesses. They approved Scoliosis SOS for a loan of £50,000 - a sum that, thanks to the clinic's instant success, was repaid within just nine months!

If you missed our appearance on A Matter of Life and Debt, don't worry - you can watch it below!

More Media Coverage   About Scoliosis SOS

Erika Maude, our Clinic Principal, delivered a scientific presentation to the 2019 SOSORT conference in San Francisco last week.

Watch the video below to see her presentation in full.

Video Transcript

Erika Maude: Hello everybody, and thank you for having me along today. This is a continuation of the research that my colleague Jason Black first presented in Lyon two years ago looking at the cost-effectiveness of exercise therapy for adults with scoliosis.

Introduction - Health Economics

Adult patients with idiopathic scoliosis have been shown to present with impaired health-related quality of life. Therefore, in health systems globally, a key objective of treatment is to improve quality of life whilst maintaining cost-effectiveness. The cost-effectiveness of PSSEs [physiotherapeutic scoliosis-specific exercises] has not been researched, and thus conclusions about whether or not they are a viable economic alternative to surgery or bracing for healthcare systems cannot be made.

In the UK, the National Health Service offers spinal fusion surgery as the only treatment for adults with idiopathic scoliosis. They treat about 360 cases per year, each costing £24,853. Under cost-utility analysis, cost-effective analysis estimates the cost of treatment. It is used to inform funding decisions based on the benefit of treatment versus how much it costs. It requires extrapolation of data because it estimates the lifetime benefits of treatment.

Introduction - QALYs

The primary outcome of cost-utility analysis is the cost per quality-adjusted life year, or 'QALY' for short - otherwise known as the incremental cost-effectiveness ratio, which I'll come onto a bit more in a moment. QALYs analyse both the quality and the quantity of life years, where (rather morbidly) 0 equals death and 1 equals perfect health. QALY are accumulative, and thus a 0.2 QALY improvement lasting for 5 years equals 1 QALY for the patient.

The ICER [incremental cost-effectiveness ratio] is calculated as the difference in the expected cost of Intervention A compared to Intervention B divided by the difference in the expected QALYs produced by Intervention A and Intervention B. Generally, it is considered that the interventions costing the UK's National Health Service less than £30,000 per QALY gained are deemed to be cost-effective.

Introduction - EQ-5D

The EQ-5D is the measure preferred by the UK's National Institute of Clinical Excellence [NICE] for comparing cost-effectiveness. It's a descriptive system, and it defines health-related quality of life in terms of five dimensions:

  • Mobility
  • Self-care
  • Usual activities
  • Pain and discomfort
  • Anxiety and depression

Responses to each of these dimensions are divided into three levels (1st, no problems; 2nd, some to moderate problems; and 3rd, severe to extreme problems), thus generating a total of 243 possible health states. On the left is an example EQ-5D form, which can only be used with licensed permission.

Objectives

The aim of this study was to explore the cost-effectiveness of physiotherapeutic scoliosis-specific exercises for adult patients with idiopathic scoliosis using an intensive, group-based therapy approach.

Method

183 consecutively-recruited UK-based adult patients (with an average age of 38.5 years at the start of treatment) attending the Scoliosis SOS Clinic in London for intensive ScolioGold treatment filled out the EQ5D5L questionnaire at 5 different time points:

  1. Before treatment
  2. After treatment
  3. 6 months check-up
  4. 12 months check-up
  5. 18 months check-up

The EQ-5D results were then converted into QALYs using assumptions about the duration of treatment effect. A linear regression model was then used to statistically analyse the results.

Results - Response Rate

Due to the method of data collection, consecutive nature of patient recruitment, and time limitations imposed by the 3-year EQ5D5L licence, 100% of the participants completed the questionnaire pre-treatment, 91% immediately post-treatment, 68% at their 6-month check-up, with 51% at both 12- and 18-month check-ups.

Results - EQ5D5L Scores

Before treatment, the average EQ-5D score was 0.773, and immediately after treatment, this increased to an average of 0.881. At 6 months, the average was 0.862, and at both 12 and 18 months check-up, the average was maintained at 0.863. All of these changes were statistically significant.

Results - Calculation of QALYs

Although patient scores were statistically much improved at 12 and 18 months post-treatment, due to the fewer number of patients who reached the later time points, reliable data was only available up to 6 months following treatment, and therefore an assumption on the persistence of the treatment effect is required for later time points. To look at both extremes: assuming that the treatment benefit ended after just six months, additional QALYs were 0.045, which means that the ICER would be £90,000 per QALY. However, assuming that the treatment effect continued for 43.8 years (the average life expectancy of the patients in this study), then additional QALYs were 3.899, meaning the ICER would fall to just £1,000 per QALY.

Therefore, to meet NICE's requirements for health economics, the effects of treatment would need to persist for 1.5 years.

Conclusion

In conclusion, EQ-5D results improved with PSSE in adult patients with idiopathic scoliosis. If the treatment effect of the PSSEs persists for only 1.5 years, it is expected to be cost-effective in UK-based adults. Further long-term research is required to start planning for PSSE to become available within national healthcare services; with publication of these results, we hope to highlight that the input of physiotherapy in this patient group should warrant funding.

Limitations

We are aware that there are several limitations to this study, namely lack of a control group, limited long-term follow-up, and no data on cost savings from exercise therapy.

Thank you for listening.

More Scoliosis Research >   About Erika and the Team >

The final 2 days of the 2019 SOSORT (Society On Scoliosis Orthopaedic and Rehabilitation Treatment) meeting in San Francisco proved to be just as productive and educational as the start of the conference.

 Erika Maude SOSORT Presentation

Friday 26 April

Friday began with a variety of scientific paper award sessions, including those on the 'Impact of Sports Activities on Adolescent Scoliosis Patients' (from a team at the Italian Scientific Institute) and the 'Effects of Inspiratory Muscle Training on Respiratory Muscle Strength' (from a research group at Bezmiâlem University in Istanbul, Turkey). This was followed by a moving presentation from Dr. Scott Haldeman on the work of World Spine Care, a global charity on a mission to improve lives in under-served communities by aiming to create a world in which everyone has access to the highest possible quality of spine care.

Clinic Principal Erika Maude (pictured above) then presented the Scoliosis SOS Clinic's work: 'Exploring the Cost Effectiveness of an Intensive Physiotherapeutic Scoliosis Specific Exercise (PSSE) Programme in a UK Adult Population'. Many of our patients will recall being asked to complete quality of life questionnaires at various points during their treatment programmes, and we are very grateful to everyone who has helped to contribute to this ground-breaking piece of research and prove that our ScolioGold therapy is a cost-effective alternative to the existing treatments of bracing and surgery that are currently offered by the UK's National Health Service. We will be uploading the full video recording of Erika 's presentation at the San Francisco conference later next week.

The day concluded with a talk from orthopaedic specialist Mr Peter Newton, current president of the SRS (Scoliosis Research Society), on the organisation's work as a networking hub for spinal specialists from all over the world.

 

Georgie Frere SOSORT Presentation

Saturday 27 April

Saturday saw Rachel Mulvaney, Vice President of Curvy Girls, speak on the 'Power of Peer Support' and showcase the amazing work this society does to help girls with scoliosis across the globe.

Our Clinical Manager Georgie Frere (pictured above) also gave an excellent insight into the importance of 'Strategies to Improve Home Exercise Compliance in Patients with Scoliosis', something that we are very passionate about supporting our patients with when they return home after completing a treatment course at our clinic. Every patient receives a personalised exercise schedule, and we have also been trialling the use of paper exercise diaries for some of our patients to see if this improves their motivation at home. Georgie's presentation has also been recorded and will be uploaded to our YouTube channel shortly.

 

Looking ahead to SOSORT 2020

Next year's SOSORT conference will be held in Melbourne, Australia, and the Scoliosis SOS team are already hard at work finalising their scientific abstracts for submission before the deadline in October 2019. The 2020 conference looks set to be bigger than ever, and will be teaming up with SpineWeek to offer a scientific collaboration bringing together clinicians and scientists from around the world and from very different scientific societies.

Learn More About Scoliosis SOS >   Upcoming Treatment Course Dates >

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