Evaluation of the efficacy of part-time versus full-time brace wear in subjects with adolescent idiopathic scoliosis (AIS)

2019 ◽  
Vol 30 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Mohammad Taghi Karimi ◽  
Timon Rabczuk ◽  
Mahsa Kavyani ◽  
Anthony Macgarry
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Full Time ◽  
Part Time

scholarly journals Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986001 ◽  
Author(s):  
Søren Ohrt-Nissen ◽  
Markus Lastikka ◽  
Thomas Borbjerg Andersen ◽  
Ilkka Helenius ◽  
Martin Gehrchen
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Group Versus ◽  
Primary Outcome Measure ◽  
Full Time ◽  
Main Thoracic ◽  
Part Time ◽  
Boston Brace ◽  
Main Curve

Purpose: To compare treatment efficacy between the Boston full-time brace and the Providence part-time brace in main thoracic adolescent idiopathic scoliosis (AIS). Methods: Patients were treated with either the Boston brace ( n = 37) or the Providence brace ( n = 40). Inclusion criteria were Risser grade ≤2, major curve between 25° and 40° with the apex of the curve between T7 and T11 vertebrae. Two-year follow-up was available in all patients unless brace treatment had reached endpoint. The primary outcome measure was main curve progression to ≥45°. Results: Median age was 12.6 years and median treatment length at follow-up was 25 months (interquartile range (IQR): 18–32)) with no difference between the groups ( p ≥ 0.116). Initial median main Cobb angle was 29° (IQR: 27–33) and 36° (IQR: 33–38) in the Boston and Providence groups, respectively ( p < 0.001). At follow-up, 13 patients (35%) had progressed to ≥45° in the Boston group versus 16 patients (40%) in the Providence group ( p = 0.838). Twenty-three patients (62%) had progressed by more than 5° in the Boston group versus 22 patients (55%) in the Providence group ( p = 0.685). The secondary thoracolumbar/lumbar curve progressed by more than 5° in 14 (38%) and 18 (45%) in the Boston and Providence groups, respectively ( p = 0.548). Conclusions: Despite a larger initial curve size in the Providence group, progression of more than 5° or to surgical indication area was similar in the Boston group. Our results indicate that nighttime bracing is a viable alternative to full-time bracing also in main thoracic AIS.

scholarly journals The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (10) ◽  
pp. 2145
Author(s):  
Lorenzo Costa ◽  
Tom P. C. Schlosser ◽  
Hanad Jimale ◽  
Jelle F. Homans ◽  
Moyo C. Kruyt ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Success Rate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Full Time ◽  
Brace Treatment ◽  
Night Time ◽  
Significant Difference ◽  
Part Time

Brace treatment is the most common noninvasive treatment in adolescent idiopathic scoliosis (AIS); however it is currently not fully known whether there is a difference in effectiveness between brace types/concepts. All studies on brace treatment for AIS were searched for in PubMed and EMBASE up to January 2021. Articles that did not report on maturity of the study population were excluded. Critical appraisal was performed using the Methodological Index for Non-Randomized Studies tool (MINORS). Brace concepts were distinguished in prescribed wearing time and rigidity of the brace: full-time, part-time, and night-time, rigid braces and soft braces. In the meta-analysis, success was defined as ≤5° curve progression during follow-up. Of the 33 selected studies, 11 papers showed high risk of bias. The rigid full-time brace had on average a success rate of 73.2% (95% CI 61–86%), night-time of 78.7% (72–85%), soft braces of 62.4% (55–70%), observation only of 50% (44–56%). There was insufficient evidence on part-time wear for the meta-analysis. The majority of brace studies have significant risk of bias. No significant difference in outcome between the night-time or full-time concepts could be identified. Soft braces have a lower success rate compared to rigid braces. Bracing for scoliosis in Risser 0–2 and 0–3 stage of maturation appeared most effective.

scholarly journals Lack of In-Brace X-Rays in Compliant AIS Patients Wearing Full-Time TLSO Braces Associates with Failure

2021 ◽  
Author(s):  
Isabel Alvarez ◽  
Kiley Poppino ◽  
Lori Karol ◽  
Amy L McIntosh
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Successful Treatment ◽  
Univariate Analysis ◽  
Full Time ◽  
X Rays ◽  
Skeletally Immature ◽  
X Ray ◽  
Total Treatment ◽  
Registration Date

Abstract BackgroundIn-brace correction and brace compliance with Thoraco-Lumbo-Sacral Orthotic (TLSO) braces are associated with successful treatment of Adolescent Idiopathic Scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not.MethodsAll skeletally immature (Risser 0–2) patients were treated for AIS (25°-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 hours a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation.Results90 patients (F:82, M:8) with an average age of 12.1(10.1–15.0) years, Risser grade 0(0–2), BMI percentile 48.5(0.0-98.8), and daily brace wear of 16.5(12.1–21.6) hrs/day were treated for 24.3(8.0-66.6) months. Patients went through 1.7(1–4) braces on average. 42/90(46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5–100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014).ConclusionsPatients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1(95% CI 1.2–7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays.Trial Registration:ClinicalTrials.gov - NCT02412137, Initial Registration Date April 2015

scholarly journals Correlation between quantity and quality of orthosis wear and treatment outcomes in adolescent idiopathic scoliosis

2004 ◽  
Vol 28 (1) ◽  
pp. 49-54 ◽  
Author(s):  
E. Lou ◽  
J. V. Raso ◽  
D. L. Hill ◽  
J. K. Mahood ◽  
M. J. Moreau
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Treatment Outcomes ◽  
Treatment Method ◽  
Load Level ◽  
Full Time ◽  
Brace Treatment ◽  
Non Surgical Treatment ◽  
Orthotic Treatment

Orthotic treatment is the most commonly used non-surgical treatment method for adolescent idiopathic scoliosis (AIS). This study determined whether treatment outcome correlates with how often and how well children with AIS wear their orthoses. Eighteen (18) subjects (3M, 15F) who were diagnosed with idiopathic scoliosis and had wom their orthoses from 6 months up to 1 year participated in this study. All subjects were prescribed Boston braces to be wom full time (23hrs/day). Twelve (12) subjects who completed their brace treatment were included in the data analysis. Three (3) treatment outcomes were classified as improvement, no change and deterioration. The quality of the brace wear was assessed by how often the brace was wom with zero force, below 80%, between 80 to 120%, and above 120% of the load level prescribed in the clinic. The quantity of brace wear was determined by how many hours per day they wore their brace. Subjects who wear their braces tighter and for more hours per day seem to have better outcomes.

scholarly journals Lack of in-brace x-rays in compliant AIS patients wearing full-time TLSO braces associates with failure

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Isabel Alvarez ◽  
Kiley Poppino ◽  
Lori Karol ◽  
Amy L. McIntosh
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Univariate Analysis ◽  
Full Time ◽  
X Rays ◽  
Skeletally Immature ◽  
Level Of Evidence ◽  
X Ray ◽  
Total Treatment ◽  
Registration Date

Abstract Background In-brace correction and brace compliance with thoraco-lumbo-sacral orthotic (TLSO) braces are associated with successful treatment of adolescent idiopathic scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not. Methods All skeletally immature (Risser 0-2) patients were treated for AIS (25-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 h a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation. Results Ninety patients (F 82, M 8) with an average age of 12.1 (10.1-15.0) years, Risser grade 0 (0-2), BMI percentile 48.5 (0.0-98.8), and daily brace wear of 16.5 (12.1-21.6) h/day were treated for 24.3 (8.0-66.6) months. Patients went through 1.7 (1-4) braces on average. Forty-two out of 90 (46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5-100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014). Conclusions Patients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1 (95% CI 1.2-7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays. Trial registration ClinicalTrials.gov—NCT02412137, initial registration date April 2015 Level of evidence III

Long-term Results of Conservative Therapy of Adolescent Idiopathic Scoliosis Using the Cheneau Brace

2019 ◽  
Vol 231 (05) ◽  
pp. 248-254
Author(s):  
Carmen Dorothea Weniger ◽  
Albert Fujak ◽  
Benjamin Hofner ◽  
Markus Fuchs ◽  
Raimund Forst ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Research Society ◽  
Long Term Results ◽  
Correct Identification ◽  
Scoliosis Surgery ◽  
Full Time ◽  
Brace Treatment ◽  
Scoliosis Research Society ◽  
Increased Risk

AbstractAdolescent idiopathic scoliosis is a disease of the growing skeleton. The goal in therapy is to decelerate or to prevent progression of the spinal curve. As part of a retrospective study the patient group of the scoliosis surgery from 1995–2016 was analysed according to the inclusion criteria of the Scoliosis research Society (SRS). 159 of 643 of the patients fullfilled the specific criteria. The assessment of effectiveness was based on the progression of the angle of curvature. If it was ≤5° it was judged positively. The therapy in accordance to Cheneau is a full-time bracing orthosis. Data from 159 patients – 136 fem. (85.5%), 23 male (14.5%) was analysed. The average age at the beginning of treatment was 13.3±1.7 years. The average duration was 3.47±1.2 years. The average Cobb-angle before treatment was 28.39°±9.44°. At the completion is was 27.7°±12.34°. Stabilisation of scoliosis (≤5°) was achieved for 136 of the patients (85.5%). The final follow-up showed a progression of the Cobb angel>5° in 23 cases, of which 19 had to undergo secondary surgery. The length of therapy had a positive influence (p=0.057) on the result. Brace treatment constitutes an effective method of therapy at curvatures between 20–40°. Short duration of therapy correlates with a expressively increased risk towards progression (p=0.057). The Cheneau brace treatment constitutes an effective treatment at curvature angles between 20–40°. The risk of progression can be reduced by a timely and correct identification.

Exploring Barriers to Doctoral Education in Communication Sciences and Disorders: Insights From Practicing Professionals

2020 ◽  
Vol 5 (6) ◽  
pp. 1552-1563
Author(s):  
Denise A. Tucker ◽  
Mary V. Compton ◽  
Sarah J. Allen ◽  
Robert Mayo ◽  
Celia Hooper ◽  
...  
Keyword(s):  
Doctoral Students ◽  
Online Survey ◽  
Academic Research ◽  
Doctoral Degree ◽  
Full Time ◽  
Doctoral Study ◽  
Doctoral Research ◽  
Part Time ◽  
Advance Research ◽  
Doctor Of Philosophy

Purpose The intended purpose of this research note is to share the findings of a needs assessment online survey of speech and hearing professionals practicing in North Carolina to explore their interest in pursuing a research-focused PhD in Communication Sciences and Disorders (CSD) and to document their perceptions of barriers to pursing a PhD in CSD. In view of the well-documented shortage of doctor of philosophy (PhD) faculty to attract, retain, and mentor doctoral students to advance research and to prepare future speech and hearing professionals, CSD faculty must assess the needs, perceptions, and barriers prospective students encounter when considering pursuing a doctoral research degree in CSD. Method The article describes the results of a survey of 242 speech and hearing professionals to investigate their interest in obtaining an academic research-focused PhD in CSD and to solicit their perceived barriers to pursuing a research doctoral degree in CSD. Results Two thirds of the respondents (63.6%) reported that they had considered pursuing a PhD in CSD. Desire for knowledge, desire to teach, and work advancement were the top reasons given for pursuing a PhD in CSD. Eighty-two percent of respondents had no interest in traditional full-time study. Forty-two percent of respondents indicated that they would be interested in part-time and distance doctoral study. The barriers of time, distance, and money emerged as those most frequently identified barriers by respondents. Conclusion The implications inform higher education faculty on how they can best address the needs of an untapped pool of prospective doctoral students in CSD.

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