Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner

Aulisa, Angelo Gabriele; Giordano, Marco; Falciglia, Francesco; Marzetti, Emanuele; Poscia, Andrea; Guzzanti, Vincenzo

doi:10.1186/1748-7161-9-6

Cited by 54 publications

(70 citation statements)

References 30 publications

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“…Another limitation of the study is the lack of a control group (i.e., untreated patients), but no ethics committee would allow not to treat structured and progressive scoliosis ranging from 25 to 40° Cobb at 10–12 years of age. Nevertheless, in another our study, it was demonstrated that in all our cases in which the brace is not worn correctly the evolutionary process of scoliosis, confirming its evolutivity, is resumed [ 27 ] and recently the efficacy of the brace against the control group was confirmed also in other paper [ 18 ].…”

Section: Discussionsupporting

confidence: 67%

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Lyon bracing in adolescent females with thoracic idiopathic scoliosis: a prospective study based on SRS and SOSORT criteria

Aulisa

Guzzanti

Falciglia

et al. 2015

BMC Musculoskelet Disord

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BackgroundThe Lyon brace is commonly prescribed in many European countries to patients with thoracic curves and is based on the three-point pressure system.The purpose of this study was to evaluate the efficacy of Lyon bracing for the conservative treatment of adolescent females with idiopathic thoracic curves in a case series selected on the basis of the Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management Standardization Criteria and followed the guidelines on management of idiopathic scoliosis with corrective braces, proposed by the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT).MethodsProspective study based on an ongoing database.From 1297 patients treated for idiopathic scoliosis between 1995 and 2014 fulfill the inclusion criteria 102 patients treated with Lyon brace. Of these, 69 patients had a definite outcome, 17 have abandoned treatment e 16 are still in treatment. The 104 patients were adolescent females with curvatures in the thoracic spine and a pre-treatment Risser score ranging from 0 to 2. All patients were prescribed with full-time Lyon bracing. The minimum duration of follow-up was 24 months after the end of weaning (mean: 41.64 ± 31.45 months). Anteroposterior radiographs were used to estimate the curve magnitude (CM) at 5 time points: beginning of treatment (t1), one year after the beginning of treatment (t2), intermediate time between t1 and t4 (t3), end of weaning (t4), 2-year minimum follow-up from t4 (t5). Three outcomes were distinguished: curve correction, curve stabilization and curve progression.ResultsThe results from our study showed that of the 69 patients with a definite outcome the CM mean value was 31.51° ± 4.34 SD at t1 and 20° ± 7.6 SD at t5. Curve correction was accomplished in 85.5 % of patients, curve stabilization was obtained in 13 % of patients and curve progression was evident in only 1.5 %. None of the patients were recommended surgery post-bracing. Of 17 patients who abandoned the treatment, at the time of abandonment (14.4 age) have achieved curve correction in 13 cases (77 %), stabilization in 53 cases (18 %) and progression in 1 case (5 %).ConclusionThe Lyon brace, through its biomechanical action on vertebral modeling, is highly effective in correcting thoracic curves in particularly when the SOSORT guidelines were adopted in addition to the SRS criteria.

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Section: Discussionsupporting

confidence: 67%

“…In particular, bracing discontinuation up to 1 month does not impact on the treatment outcome. Conversely, wearing the brace only overnight is associated with a high rate of curve progression [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Lyon bracing in adolescent females with thoracic idiopathic scoliosis: a prospective study based on SRS and SOSORT criteria

Aulisa

Guzzanti

Falciglia

et al. 2015

BMC Musculoskelet Disord

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“…Blount et al [ 37 ] originally described full-time brace wear as 23 hours a day and Rowe et al [ 5 ] found that bracing for 23 hours a day was the most successful means in their meta-analysis. Aulisa et al [ 38 ] also stated that wearing the brace only overnight was associated with a high rate of curve progression. Indeed, the guidelines released by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) indicate adherence as a key element in determining the efficacy of bracing [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria

et al. 2015

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BackgroundThe efficacy of brace treatment for patients with adolescent idiopathic scoliosis (AIS) remains controversial. To make comparisons among studies more valid and reliable, the Scoliosis Research Society (SRS) has standardized criteria for brace studies in patients with AIS. The purpose of this study was to evaluate the efficacy of the Osaka Medical College (OMC) brace for AIS in accordance with the modified standardized criteria proposed by the SRS committee on bracing and non-operative management.MethodsFrom 1999 through 2010, 31 consecutive patients with AIS who were newly prescribed the OMC brace and met the modified SRS criteria were studied. The study included 2 boys and 29 girls with a mean age of 12 years and 0 month. Patients were instructed to wear the brace for a minimum of 20 hours per day at the beginning of brace treatment. The mean duration of brace treatment was 4 years and 8 months. We examined the initial brace correction rate and the clinical outcomes of main curves evaluated by curve progression and surgical rate, and the compliance evaluated by the instruction adherence rate for all cases. The clinical course of the brace treatment was considered progression if ≥6° curvature increase occurred and improvement if ≥6° curvature decrease occurred according to SRS judgment criteria.ResultsThe average initial brace correction rate was 46.8%. In 10 cases the curve progressed, 6 cases the curve improved, and 15 cases the curve remained unchanged (success rate: 67.7%). The mean instruction adherence rate, that was defined the percentage of the visits that patients declared they mostly followed our instruction to total visits, was 53.7%. The success rate was statistically higher in the patient group whose instruction adherence rate was greater than 50% (88.2%) as compared with in those 50% or less (42.8%).ConclusionsOMC brace treatment for AIS patients could alter the natural history and significantly decreased the progression of curves to the threshold for surgical intervention. Better instruction adherence of brace wear associated with greater success.

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“…1 However, compliance with the prescribed regimen is an issue and reduced compliance has consistently been shown to affect treatment outcome. [1][2][3][4] Because of these issues, a part-time brace design was developed. This brace was designed to provide a higher level of curve correction allowing for nighttime use only.…”

Section: Introductionmentioning

confidence: 99%

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

Ohrt-Nissen

Lastikka

Andersen

et al. 2019

J Orthop Surg (Hong Kong)

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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.

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Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner

Cited by 54 publications

References 30 publications

Lyon bracing in adolescent females with thoracic idiopathic scoliosis: a prospective study based on SRS and SOSORT criteria

Lyon bracing in adolescent females with thoracic idiopathic scoliosis: a prospective study based on SRS and SOSORT criteria

Efficacy of the Osaka Medical College (OMC) brace in the treatment of adolescent idiopathic scoliosis following Scoliosis Research Society brace studies criteria

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

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