Effectiveness of Orthotic Treatment on Clinical Outcomes of the Patients with Adolescent Idiopathic Scoliosis Under Different Wearing Compliance Levels

Liu, Shan; Ho, Lok Yi; Hassan Beygi, Babak; Wong, Man Sang

doi:10.2106/jbjs.rvw.23.00110

Cited by 3 publications

(1 citation statement)

References 47 publications

(257 reference statements)

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“…Brace efficacy is strongly related to dosage [12,13], but brace-wearing hours are also considered inversely correlated to demand on patients [1,4,14]. Materials, production methods, and personalization of the brace have all evolved in the last decades to improve efficacy and patient comfort [7,[15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort

Negrini,

Febbo,

Tessadri

et al. 2024

JCM

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Background: The Sforzesco brace is a very rigid push-up brace effective in adolescent idiopathic scoliosis (AIS). We recently developed a new Sforzesco brace based on modularity (the Modular Italian brace—MI brace) that could allow standardization, facilitating global expertise diffusion, increased modifiability and adaptability, and cost savings due to longer brace life. We aimed to compare the short-term results of the two braces. Methods: The retrospective study included 231 consecutive AIS treated with a MI brace (N = 53) or Sforzesco brace (N = 178). The main outcome was the first 6-month follow-up out-of-brace radiograph Cobb angle change. Secondary outcomes included the in-brace Cobb degrees and aesthetics (TRACE), prominence (angle of trunk rotation and mm), kyphosis, and lordosis changes. Results: The two groups were similar at baseline, apart from more immature patients in MI brace. Both braces reduced the Cobb angle (−6° out-of-brace; −16° in-brace) without differences between groups. All secondary outcomes improved, apart from a statistically and clinically insignificant 3° kyphosis reduction. The MI brace participants were 4.9 times more likely to improve the Cobb angle than the Sforzesco brace (OR = 4.92; 95%CI 1.91–12.64; p = 0.001). Conclusions: These findings suggest that the MI-brace can be safely used instead of the classical Sforzesco brace. However, further studies of different designs and longer follow-ups are needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort

Negrini,

Febbo,

Tessadri

et al. 2024

JCM

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Results of bracing adolescent idiopathic scoliosis in the context of clinical practice and the Scoliosis Research Society’s criteria: 5-year observational study from a German orthopaedic university hospital

Delbrück,

Karl,

Hildebrand

et al. 2024

Eur J Med Res

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Background Brace therapy’s influence on adolescent idiopathic scoliosis’s (AIS) natural course is inconclusive. Methods Brace-treated AIS patients from 2016 to 2020 were examined regarding four endpoints at brace weaning: surgery need, curve progress ≥ 6° and > 45°, and curve improvement ≥ 6°. Prediction variables’ influence was computed for the all-patients group and three subgroups (Subgroup 1: fulfilling the Scoliosis Research Society’s [SRS] criteria, Subgroup 2: initial Cobb angle < 25°, Subgroup 3: initial Cobb angle > 40°). According to the data characteristics, parametric and non-parametric tests and binary logistic regression were performed. Results The research included 69 patients. Overall, after brace weaning surgery was recommended for 20.3% of them, curve progression was ≥ 6° in 23.2%, the Cobb angle was beyond 45° in 11.6%, and the Cobb angle improved by ≥ 6° in 20.3%. Patients needing surgery had a significantly higher initial Cobb angle (38.8° ± 9.8° vs 27.8° ± 7.6°, p < 0.001), lower Risser stages (p = 0.010), and higher Nash and Moe degrees (p = 0.030). Patients with curve progress ≥ 6° were younger at first curve notification (12.4 ± 1.5 vs 13.7 ± 1.7 years, p = 0.011) and older at menarche (13.4 ± 1.1 vs 12.6 ± 1.2 years, p = 0.037). Furthermore, 21.6% of all Risser 3 and 4 patients had still curve progress ≥ 6°. In-brace correction was significantly higher in patients with curve improvement ≥ 6° vs < 6° (54.0% ± 31.2% vs 31.9% ± 30.7%; p = 0.019). Nine patients fulfilled the SRS criteria, 22 had initial Cobb angles < 25°, and 11 had > 40°. Real brace wear (RBW) in all groups had no significant effect on outcome. Two significant subgroup differences were found: Surgery recommendation and curve progression beyond 45° were significantly more frequent in the initial Cobb angle > 40° subgroup. Conclusions Brace effectiveness can be assumed because curve improvement was achieved in nearly one-fifth with sufficient in-brace correction. However, no significant influence of RBW on the outcome endpoints was demonstrated. To clarify conflicting results, big data management, including untreated patients, must be employed to further research AIS’s multifactorial influenced aetiology and course. Meanwhile, it is worth starting bracing in AIS in practice also beyond the SRS’s criteria.

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Digitalized 3D Spinal Decompression and Correction Device Improved Initial Brace Corrections and Patients’ Comfort Among Adolescents with Idiopathic Scoliosis: A Single-Centre, Single-Blinded Randomized Controlled Trial

Jie,

Li,

Dong

et al. 2024

Bioengineering

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This study aimed to evaluate the efficacy of a novel three-dimensional (3D) spinal decompression and correction device in improving the in-brace correction and patient comfort level for adolescents with idiopathic scoliosis (AIS), and to assess the impact of the number of vertebrae involved in the scoliotic curve on the correction’s effectiveness. A single-centre, single-blinded randomized controlled trial (RCT) was conducted in 110 AIS patients aged 10–18 years who were randomly allocated into four groups receiving 0–3 days of device intervention. Each session lasted for 30 min and was conducted twice daily. Significant improvements were observed in both the in-brace correction ratio and patient comfort level, particularly in the 2- and 3-day intervention groups (p < 0.001). The number of involved vertebrae for a scoliotic curve was positively correlated with the in-brace correction ratio in the no intervention (or 0-day) and 1-day intervention groups, while this correlation varied in the 2- and 3-day intervention groups. These findings suggested that the prolonged use of the 3D device could improve the correction ratios and patient comfort, while the role of vertebrae involvement in predicting the initial correction may require further exploration to optimize personalized treatment strategies in future clinical practice.

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Effectiveness of Orthotic Treatment on Clinical Outcomes of the Patients with Adolescent Idiopathic Scoliosis Under Different Wearing Compliance Levels

Cited by 3 publications

References 47 publications

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort

Results of bracing adolescent idiopathic scoliosis in the context of clinical practice and the Scoliosis Research Society’s criteria: 5-year observational study from a German orthopaedic university hospital

Digitalized 3D Spinal Decompression and Correction Device Improved Initial Brace Corrections and Patients’ Comfort Among Adolescents with Idiopathic Scoliosis: A Single-Centre, Single-Blinded Randomized Controlled Trial

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