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

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.

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The Turkish version of the Brace Questionnaire in brace-treated adolescents with idiopathic scoliosis

Prosthetics and Orthotics International ◽

10.1177/0309364617690393 ◽

2017 ◽

Vol 42 (2) ◽

pp. 129-135 ◽

Cited By ~ 3

Author(s):

Gözde Gür ◽

Yavuz Yakut ◽

Theo Grivas

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Correlation Coefficient ◽

Research Society ◽

Brace Treatment ◽

Turkish Version ◽

Scoliosis Research Society ◽

Brace Questionnaire

Background: Evaluation of the effects of brace treatment on quality of life in adolescent idiopathic scoliosis is important. Objectives: To analyze the validity and reliability of the Turkish version of the Brace Questionnaire. Study design: Cohort study, evaluation of reliability and validity of the Turkish version of the Brace Questionnaire. Methods: Twenty-eight patients undergoing brace treatment for adolescent idiopathic scoliosis (median age: 14.6 years) were included in the study. The Brace Questionnaire was translated into Turkish and administered to the patients twice at an interval of 5 days. Reliability was assessed using the test–retest method (Pearson’s correlation coefficient); internal consistency was analyzed using Cronbach’s alpha. Validity was assessed by correlating the Brace Questionnaire with the Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 questionnaire. Results: The mean Cobb angles were 31.1° ± 8.3° and 29.7° ± 9° for thoracic and lumbar regions, respectively. Cronbach’s alpha was 0.94. Intraclass correlation coefficient was 0.95 in test–retest reliability analysis. The correlations between Brace Questionnaire and Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 were r = 0.67 and r = 0.64, respectively. Conclusion: The Turkish version of the Brace Questionnaire to measure the effects of brace treatment on quality of life in adolescent idiopathic scoliosis was found to have good validity, excellent reliability, and high internal consistency. Clinical relevance We recommend routine use of the Brace Questionnaire in scoliosis patients to evaluate brace-related quality of life and relevant factors and to support the individual when necessary during such treatment.

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

Klinische Pädiatrie ◽

10.1055/a-0963-8996 ◽

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.

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The effect of time on qualitative compliance in brace treatment for AIS

Prosthetics and Orthotics International ◽

10.1080/03093640802015839 ◽

2008 ◽

Vol 32 (2) ◽

pp. 136-144 ◽

Cited By ~ 8

Author(s):

Ian Mak ◽

Edmond Lou ◽

James V. Raso ◽

Doug L. Hill ◽

Eric Parent ◽

...

Keyword(s):

Idiopathic Scoliosis ◽

Cobb Angle ◽

Treatment Method ◽

Monitor System ◽

Brace Treatment ◽

Time Analysis ◽

Night Time ◽

Angle Measurements ◽

Non Surgical Treatment ◽

Over Time

Brace treatment is the most commonly used non-surgical treatment method for adolescent idiopathic scoliosis (AIS). This study is to determine the force changes exerted by a brace over time during both day and night-time wear and to explore correlations between force changes to bracing outcomes. Twenty subjects (three male, 17 female) diagnosed with idiopathic scoliosis who had worn their braces for six months participated into this study. However, due to non-continuous brace wear and exclusion of subjects with large curves (Cobb angle >40°), only nine subjects were included into the day-time analysis and 11 subjects were included into night-time analysis. All subjects used a load monitor system from four days up to 14 days with Boston braces. Cobb angle measurements were taken at initiation of brace treatment as well as after weaning upon completion of the treatment. After the monitoring period, the data was extracted and analyzed. Forces were compared between hours 1, 2, and 5 for the day and night groups, and the correlation of force changes to bracing outcomes were analyzed. In daytime wear, a significant decrease in force over time was found. Most of the decrease occurred within hours 1 and 2 of brace wear. There was no significant decrease during night wear. There were no significant correlations between force decline and outcome.

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

Journal of Clinical Medicine ◽

10.3390/jcm10102145 ◽

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.

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What Is the Effect of Surgery on the Quality of Life of the Adolescent With Adolescent Idiopathic Scoliosis?

Spine ◽

10.1097/brs.0b013e3182837c95 ◽

2013 ◽

Vol 38 (9) ◽

pp. 786-794 ◽

Cited By ~ 21

Author(s):

Paul R. P. Rushton ◽

Michael P. Grevitt

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis

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Initial Correction Rate Can be Predictive of the Outcome of Brace Treatment in Patients With Adolescent Idiopathic Scoliosis

Clinical Spine Surgery ◽

10.1097/bsd.0000000000000343 ◽

2017 ◽

Vol 30 (4) ◽

pp. E475-E479 ◽

Cited By ~ 9

Author(s):

Leilei Xu ◽

Xiaodong Qin ◽

Yong Qiu ◽

Zezhang Zhu

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Brace Treatment ◽

Correction Rate ◽

Initial Correction

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The impact of immediate in-brace 3D corrections on curve evolution after two years of treatment: preliminary results

Studies in Health Technology and Informatics - Research into Spinal Deformities 9 ◽

10.3233/shti210459 ◽

2021 ◽

Author(s):

A Guy ◽

H Labelle ◽

S Barchi ◽

CÉ Aubin

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Treatment Outcomes ◽

Lumbar Lordosis ◽

Treatment Success ◽

Curve Evolution ◽

Preliminary Results ◽

Coronal Correction ◽

The Impact

For the brace treatment of adolescent idiopathic scoliosis (AIS), in-brace correction and brace-wear compliance are well-documented parameters associated with a greater chance of treatment success. However, the number of studies on the impact of sagittal and transverse correction on curve evolution in the context of bracing is limited. The objective of this work was to evaluate how immediate inbrace correction in the three anatomical planes is related to long-term curve evolution after two years of bracing. We performed a retrospective analysis on 94 AIS patients followed for a minimum of two years. We analyzed correlations between in-brace correction and two-year out-of-brace evolution for Cobb and apical axial rotations (ARs) in the medial thoracic and thoraco-lumbar/lumbar regions (MT & TL/L). We also studied the association between the braces’ kyphosing and lordosing effect and the evolution of thoracic kyphosis (TK) and lumbar lordosis (LL) after two years. Finally, we separated the patients into three groups based on their curve progression results after two years (corrected, stable and progressed) and compared the 3D in-brace corrections and compliance for each group. Coefficients were statistically significant for all correlations. They were weak for Cobb angles (MT: -0.242; TL/L: -0.275), low for ARs (MT: -0.423; TL/L: -0.417) and moderate for sagittal curves (TK: 0.549; LL: 0.482). In-brace coronal correction was significantly higher in corrected vs stable patients (p=0.004) while compliance was significantly higher in stable vs progressed patients (p=0.026). This study highlights the importance of initial in-brace correction in all three planes for successful treatment outcomes.

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Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?

Global Spine Journal ◽

10.1177/2192568220910712 ◽

2020 ◽

pp. 219256822091071

Author(s):

Bhavuk Garg ◽

Nishank Mehta ◽

Rudra Narayan Mukherjee

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Treatment Outcomes ◽

Outcome Measures ◽

Deformity Correction ◽

Sagittal Vertical Axis ◽

Scoliosis Research Society ◽

Lenke Classification ◽

Selective Fusion ◽

Significant Difference

Study Design: Retrospective cohort. Objective: ( a) To compare the recommendations of Lenke and Peking Union Medical College (PUMC) classifications in choosing distal fusion levels in Lenke 1 adolescent idiopathic scoliosis (AIS) curves and ( b) to analyze whether the variability in distal fusion levels influences treatment outcomes. Methods: Hospital records of Lenke 1 AIS patients operated for single stage, posterior-only deformity correction were analyzed. Distal fusion levels recommended by Lenke and PUMC classifications were calculated and were compared with the actual distal fusion levels. The study population was divided based on whether the actual distal fusion levels were in agreement, shorter or longer than those recommended by Lenke classification. Subgroup analysis of Lenke 1C curves was done. The groups were compared with regard to the following outcome measures: Cobb angle correction, postoperative sagittal vertical axis, postoperative C7 offset, and Scoliosis Research Society–22r (SRS-22r) score at 24 months. Results: The distal fusion levels recommended by the 2 classifications were in agreement in 92 of 104 cases. In all the cases with disparity, Lenke classification recommended shorter fusions than the PUMC classification. No statistically significant difference was observed in the outcome measures—whether the actual distal fusion levels were in agreement, shorter, or longer than those recommended by the Lenke classification or whether or not the recommendations for selective fusion of any of these classifications were adhered to. Conclusion: Lenke classification can save fusion levels without compromising on treatment outcomes when compared with PUMC classification. Variability in choice of distal fusion levels is not clinically significant at 24-month follow-up.

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Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment

Prosthetics and Orthotics International ◽

10.1177/0309364618820144 ◽

2019 ◽

Vol 43 (3) ◽

pp. 301-308 ◽

Cited By ~ 7

Author(s):

Gozde Yagci ◽

Yavuz Yakut

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Exercise Therapy ◽

Trunk Rotation ◽

Stabilization Exercise ◽

Core Stabilization ◽

Trunk Deformity ◽

Core Stabilization Exercise

Background: There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis. Objectives: Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis. Methods: Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°–45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life. Results: Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only. Conclusion: Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis. Clinical relevance This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

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