**5. Discussion**

In this study, the treatment group's data showed no significant difference in changes over the duration of the trial for all questionnaires. This contrasts with research [53, 54] which found a significant difference between the effectiveness of a surgical approach and a non-operative method of treatment. Research from Grubb et al. (1994) [53] examined the effectiveness of a surgery on 28 adults with idiopathic scoliosis and 25 adults with degenerative scoliosis. In comparison to the 10.6% change in scores over the 6-month treatment period for the present study [53], Grubb et al. found that patients who had degenerative scoliosis and were treated operatively reported a decrease in their pain scores of 70% whilst patients with adult adolescent scoliosis reported an 80% reduction. Furthermore, both sets of patients reported improvements in their healthrelated quality of life in addition to improvements in standing and walking over the 2–7 year follow-up period.

Li et al. [54] compared self-reported outcome scores from patients treated operatively to those treated non-operatively. They found that patients who received operative treatment reported significantly better self-outcome scores in the EQ5D VAS and SRS-22, but not in the ODI or the SF-12. Although the results from our quantitative work showed no significant difference over time for braced patients, discussions between patients and clinicians gave insight into the benefits of the brace. Patients spoke about how the brace reduced their pain, allowing their participation in new activities or longer participation in activities that they could already carry out. Some participants discussed how for the previous few weeks their pain levels were low, but when the time came to complete the questionnaires, they were having a 'bad week', due to their scoliosis pain or pain from other underlying health conditions. With a small sample size, the effect of 'bad weeks' would have a substantial effect on the results obtained, with potentially a Type 2 error where actual differences between groups may not have been detected. Furthermore, from the questionnaire results, it would appear that the questionnaires may not have been sensitive enough to assess small changes for patients who received the brace.
