Use of DXA in Scoliosis
Research type
Research Study
Full title
A Pilot Study of the Use of Dual-Energy X-ray Absorptiometry (DXA) in Scoliosis
IRAS ID
335664
Contact name
Ashley Cole
Contact email
Sponsor organisation
Sheffield Children's Hospital
Duration of Study in the UK
0 years, 9 months, 6 days
Research summary
DXA scans are like x-rays but are taken lying down on a flat surface over 1-2 minutes. There is no ‘tube’ like a CT or MRI scanner and they are acquired over 1-2 minutes so patients need to lie reasonably still. They are usually used to assess bone mineral density. However, they have been used to assess spinal fractures in children with weak bones and a study has shown that children prefer them to normal x-rays. The radiation dose is about half of the dose from a UK to America flight and about 1/6th of the dose of a normal x-ray. iDXA is the latest version of DXA.
Scoliosis is a curvature of the spine which occurs in children and will often get worse as the child grows. We use x-rays to look for worsening of the spinal curves. If we can use iDXA images instead of normal x-rays for checking if the curve is getting worse or to make better braces to treat scoliosis then this will reduce the radiation dose these children are exposed to.
This is a pilot study to look at image quality of iDXA AP supine spinal images to see if we can accurately measure the size of the curve from iDXA images and to see how patients feel about iDXA imaging compared to normal x-rays. With normal x-rays being taken standing (or sitting if patients are in a wheelchair), it is important that we understand how the lying down images compare to the standing images. Where there may be some clinical benefit, images will be taken standing (normal x-rays) and lying down (iDXA images). We will see if the additional of iDXA images can help in brace design and brace monitoring.
Results Summary:
: When a baby is born seriously unwell this is a very stressful time for parents. They are faced with an uncertain future and often experience symptoms of post-traumatic stress. Additionally, because the baby must have specialist medical care to keep them alive, parents can experience a delay in feeling like a parent. Music therapy is increasingly being considered to support parents, babies and staff globally. However, the acceptability of this intervention when a baby is seriously unwell is unknown.
The aim of this study was to firstly better understand the challenges and areas of support for parents with babies with uncertain futures and healthcare professionals on neonatal units before collaboratively designing a music therapy intervention to improve experiences. Through collaborating with parents and staff with lived experience it aimed to create a culturally sensitive intervention that was accessible and acceptable to parents and staff on neonatal units.This study was carried out by Music Therapist and researcher Kirsty Jane as part of her PhD thesis supervised by Professor Glenn Robert at King’s College London. It was funded by the NIHR as part of Kirsty’s Doctoral Clinical Academic Fellowship Award (NIHR30374). Initially, seven parents with lived experience and 2 family support charities advised Kirsty on the appropriateness of the study. Charities and children’s hospices then supported with reaching families who met the criteria of the study.
Parents with lived experience supported Kirsty with running 4 focus groups for parents with lived experience of having a seriously unwell baby on the neonatal unit in Manchester and London. Parents could choose to have an interview at a place of their choice if they preferred. These were held between July and September 2024 and listened to parents’ experiences of the neonatal unit with their baby and their use of music through sharing keepsakes and jointly listening to song or sound of their choice. Additionally, two focus groups were held online for healthcare professionals to share their experiences as well as their feelings about the potential of music therapy.All data from focus groups and interviews was then taken to a co-design group made up of parents and professionals with lived experience. In the first meeting the parents and professionals separately highlighted areas that stood out to them and were felt to be key moments. Kirsty and another researcher then did the same and brought all the highlighted excerpts to the next co-design meeting. At the second meeting the co-design team grouped the highlighted areas into larger categories which were then used to create a map of parent and staff experiences from beginning to end of the neonatal unit experience both positively and negatively. Parents and staff use of music was then added to this to visualise where music may be able to support. This map was used by Kirsty to create themes that would inform the development of the intervention in the next meeting.
At the third meeting the co-design group was asked to reflect on the themes of trauma, identity and parent-staff relationship before individually developing ideas which would aim to reconnect staff and parents with previous strengths they had found in music to support them to feel capable to manage the neonatal experience with their infant. The group then shared their ideas and identified areas of similarity. These areas were then further developed by professional designers to create digital concepts of the ideas to present at the final meeting.
In the final meeting the co-design team reviewed the intervention which had 5 parts: a) a musical gift created by external family or friends with the support of the unit music therapist b) a blog of parent and staff use of music on the neonatal unit c) a diary for parent self-reflection d) a staff shared playlist e) staff ‘ask me’ badges. On review the co-design team felt that a parent blog would not be engaged with but parents liked the possibility of listening to what other parents had listened to. It was suggested that instead of a diary and a blog, a journal could be provided that would act as a guide for using music with links to playlists made by parents with lived experience. The journal was also considered as a helpful space for self-reflection.
The researchers plan to test the acceptability of the intervention later in 2025. It is hoped that the intervention will support social connection and increase staff’s capacity to support parents and parents’ capacity to engage with support and their baby on the neonatal unit. It is a culturally sensitive intervention which has the potential to provide accessible psychological support.
Each stage of the study will hopefully be published in open access journals as well as findings and updates being shared on the study social media page @soundorigins.mt.REC name
London - Bromley Research Ethics Committee
REC reference
24/PR/0220
Date of REC Opinion
19 Apr 2024
REC opinion
Further Information Favourable Opinion