Braces for idiopathic scoliosis in adolescents

Négrini, Stefano; Minozzi, Silvia; Bettany‐Saltikov, Josette; Zaina, Fabio; Chockalingam, Nachiappan; Grivas, Theodoros B; Kotwicki, Tomasz; Maruyama, Toru; Romano, Michele; Vasiliadis, Elias

doi:10.1002/14651858.cd006850.pub2

Cited by 65 publications

(41 citation statements)

References 138 publications

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“…23 girls and 7 boys were included. The mean age at radiological examination was 11 [range [8][9][10][11][12][13][14]. 10 were classified Risser 0 or 1, 7 were Risser 2, 8 were Risser 3 and 5 were Risser 4.…”

Section: Imaging Protocol and 3d Modelingmentioning

confidence: 99%

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3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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Purpose We have evaluated the effect of bracing in scoliosis on coronal alignment in a cohort of patients. Current literature has not described the specific effect of bracing on the 3D shape of the scoliotic curves. The purpose of this study was to analyze the variability of the 3D effect of bracing on idiopathic scoliosis. Materials and methods The spines of 30 patients with adolescent idiopathic scoliosis were reconstructed using biplanar stereoradiography with and without the brace. The Cobb angle, sagittal and pelvic parameters and transverse plane parameters were calculated. The variability and the mean values of each parameter, with and without a brace, were analyzed and compared using a student t test. Results The Cobb angle improved in 50 % of patients but remained unchanged in 50 % cases. In 90 % of the cases lordosis was decreased. The thoracic kyphosis was decreased in 26 % cases, unchanged in 57 % of cases and increased in 17 % cases. The AVR was improved ([5°) in 26 % cases, worsened in 23 % and unchanged in 50 %. Only the differences of Cobb angle and the lordosis were statistically significant.Conclusions Global statistics of this study concur with the literature. The Cobb angle was significantly improved. It also showed a significant hypolordotic effect. However, the results showed a high variability of the brace treatment effect in almost every parameter. Analysis of this variability by means of 3D reconstructions instead of global statistics should help characterize the mechanisms of correction of brace treatment.

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Section: Imaging Protocol and 3d Modelingmentioning

confidence: 99%

“…The effect of bracing in idiopathic scoliosis has been evaluated in our series and essentially in the AP plane by means of global statistics [2][3][4][5][6][7][8]. However, the different curve topology and severity, different brace concepts and designs should not be analyzed together as this could lead to controversial conclusions.…”

Section: Introductionmentioning

confidence: 99%

3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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“…Although research is still being conducted on the effects of physiotherapy 2 for scoliosis, bracing is recognized to stop progression 3 during the pubertal growth spurt. Now, with the newest Chêneau style computer-aided design/ computer-aided manufacturing (CAD/ CAM) bracing under certain circumstances the potential exists to improve curvature radiologically and visually 4 .…”

Section: Introductionmentioning

confidence: 99%

Bracing scoliosis: The evolution to CAD/CAM for improved in-brace corrections

Weiss¹,

Seibel²,

Moramarco³

et al. 2013

Hard Tissue

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“…Two publications reported bracing protocols that lasted up to 4 years and required the brace to be worn for 23 hours per day. 11,12 The effectiveness of bracing protocols is unclear, 13 although a recent trial reported by Weinstein et al 14 suggests that there is promise of efficacy.…”

Section: Rationale For Treatmentsmentioning

confidence: 99%

Active Treatment for Idiopathic Adolescent Scoliosis (ACTIvATeS): a feasibility study

Williams

Heine

Williamson

et al. 2015

Health Technol Assess

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BackgroundThe feasibility of conducting a definitive randomised controlled trial (RCT) evaluating the clinical effectiveness and cost-effectiveness of scoliosis-specific exercises (SSEs) for adolescent idiopathic scoliosis (AIS) is uncertain.ObjectivesThe aim of this study was to assess the feasibility of conducting a large, multicentre trial of SSE treatment for patients with AIS, in comparison with standard care, and to refine elements of the study design. The objectives were to (1) update a systematic review of controlled trials evaluating the efficacy of SSE in AIS; (2) survey UK orthopaedic surgeons and physiotherapists to determine current practice, patient populations and equipoise; (3) randomise 50 adolescents to a feasibility trial of either usual care or SSE interventions across a range of sites; (4) develop, document and assess acceptability and adherence of interventions; (5) assess and describe training requirements of physiotherapists; and (6) gain user input in all relevant stages of treatment and protocol design.DesignMulticomponent feasibility study including UK clinician survey, systematic literature review and a randomised feasibility trial.SettingThe randomised feasibility study involved four secondary care NHS trusts providing specialist care for patients with AIS.ParticipantsThe randomised feasibility study recruited people aged 10–16 years with mild AIS (Cobb angle of < 50°).InterventionsThe randomised study allocated participants to standard practice of advice and education or a physiotherapy SSE programme supported by a home exercise plan. Our choice of intervention was informed by a systematic review of exercise interventions for AIS.Main outcome measuresThe main outcome was feasibility of recruitment to the randomised study. Other elements were to inform choice of outcomes for a definitive trial and included curve severity, quality of life, requirement for surgery/brace, adverse events, psychological symptoms, costs and health utilities.ResultsA UK survey of orthopaedic consultants and physiotherapists indicated a wide variation in current provision of exercise therapy through physiotherapy services. It also found that clinicians from at least 15 centres would be willing to have their patients involved in a full study. A systematic review update found five new studies that were generally of low quality but showed some promise of effectiveness of SSE. The randomised study recruited 58 patients from four NHS trusts over 11 months and exceeded the pre-specified target recruitment rate of 1.4 participants per centre per month, with acceptable 6-month follow-up (currently 73%). Adherence to treatment was variable (56% of participants completed treatment offered). The qualitative study found the exercise programme to be highly acceptable. We learnt important lessons from patient and public involvement during the study in terms of study and intervention presentation, as well as practical elements such as scheduling of intervention sessions.ConclusionsA definitive RCT evaluating clinical effectiveness and cost-effectiveness of SSE for idiopathic scoliosis is warranted and feasible. Such a RCT is a priority for future work in the area. There is a sufficiently large patient base, combined with willingness to be randomised within specialist UK centres. Interventions developed during the feasibility study were acceptable to patients, families and physiotherapists and can be given within the affordability envelope of current levels of physiotherapy commissioning.Trial registrationCurrent Controlled Trials ISRCTN90480705.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 55. See the NIHR Journals Library website for further project information.

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Braces for idiopathic scoliosis in adolescents

Cited by 65 publications

References 138 publications

3D analysis of brace treatment in idiopathic scoliosis

3D analysis of brace treatment in idiopathic scoliosis

Bracing scoliosis: The evolution to CAD/CAM for improved in-brace corrections

Active Treatment for Idiopathic Adolescent Scoliosis (ACTIvATeS): a feasibility study

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