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Purpose Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types. Methods Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies’ officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM. Results The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction—valves (monocot, bivalve, multisegmented), construction—closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups. Conclusion The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.

The objective was to determine the primary correction of the Cobb angles of 147 idiopathic scoliosis subjects wearing the Rigo System Chêneau (RSC) brace. The RSC brace is a scoliosis brace that incorporates expansion and pressure areas to treat all aspects of the 3D scoliotic deformity not only in the frontal plane but also in the sagittal and transverse planes. RSC brace uses specific clinical and radiological classifications to define the most effective principles of correction. The experimental hypothesis predicted that those subjects who are treated with the RSC brace would report a significant primary correction of the major, minor, thoracic, and lumbar Cobb angles for both the main and Society of Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) restrictive criteria groups. The primary correction of main group was 43°, 42°, 48°, and 37°for thoracic, lumbar, major, and minor curve, respectively. The primary correction of SOSORT group was 54°, 59°, 61°, and 52°for thoracic, lumbar, major, and minor curve, respectively. The present experiment focused on the radiographic measurements of idiopathic scoliosis subjects before treatment and the primary correction with the RSC brace. The results are based on a sample size of 147 subjects in the main group and 25 subjects in the SOSORT (restrictive criteria) group. As a result, the RSC brace system had significant primary corrections in both the main and SOSORT groups. Because the initial in-brace radiographs presented with favorable results, it is predicted that the RSC brace prevents curve progression at the end of the treatment. (J Prosthet Orthot. 2011;23:69 -77.) KEY INDEXING TERMS: RSC brace, scoliosis brace, idiopathic scoliosis, conservative treatment for scoliosis DINO GALLO, CPO (GM), AND ROBERT DALLMAYER, CPO (GM), are affiliated with ORTHOLUTIONS

Background: The current increase in types of scoliosis braces defined by a surname or a town makes scientific classification essential. Currently, it is a challenge to compare braces and specify the indications of each brace. A precise definition of the characteristics of current braces is needed. As such, the International Society for Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) mandated the Brace Classification Study Group (BCSG) to address the pertinent terminology and brace classification. As such, the following study represents the first part of the SOSORT consensus in addressing the definitions and providing a visual atlas of bracing. Methods: After a short introduction on the braces, the aim of the BCSG is described and its policies/general consideration are outlined. The BSCG endeavor embraces the very important SOSORT -Scoliosis Research Society cooperation, the history of which is also briefly narrated. This report contains contributions from a multidisciplinary panel of 17 professionals who are part of the BCSG. The BCSG introduced several pertinent domains to characterize bracing systems. The domains are defined to allow for analysis of each brace system.Results: A first approach to brace classification based on some of these proposed domains is presented. The BCSG has reached a consensus on 139 terms related to bracing and has provided over 120 figures to serve as an atlas for educational purposes.Conclusions: This is the first clinical terminology tool for bracing related to scoliosis based on the current scientific evidence and formal multidisciplinary consensus. A visual atlas of various brace types is also provided.

Background and aimThe purpose of this paper is to share with scoliosis professionals the X-rays of different pad placement levels associated with improved curve correction in a case of idiopathic scoliosis (IS). Scoliosis braces of all types and brands utilize common principles of construction that ensure good fit and function. Equally important to the end result is good patient follow-up care and brace quality control by the orthotist.Design and methodsThis report reviewed the case of an 11-year-old girl diagnosed with IS, focusing on the in and out-of-brace x-rays, as well as the fit and function of the braces. The first brace was a TLSO-type, the second a Cheneau-type brace using a B1 model following the Rigo classification of scoliosis.ResultsThe first TLSO-type brace presented an in-brace X-ray that showed a curve increase. The Cheneau-type scoliosis brace reduced the Cobb angles over 50%.ConclusionsThe biomechanical changes consequent to modifications in brace design and pad placements appeared to have improved the scoliosis and reduced the Cobb angles in this case. An orthotist must provide optimal fit and function of the brace which was prescribed by the referring physician. Adherence to certain basic design principles, and close follow up by the orthotist-especially during growth spurts - are critical to its effectiveness. Specifically, a skilled orthotist must be experienced with the particular brace-type, apply these principles, maintain a good working relationship with both physician and patient to ensure timely brace adjustments essential to continued brace comfort and efficacy.