Significance of recumbent curvature in prediction of in-orthosis correction for adolescent idiopathic scoliosis

He, Chen; To, Michael; Chan, Chi-kwan; Wong, Man Sang

doi:10.1177/0309364618798172

Cited by 3 publications

(10 citation statements)

References 11 publications

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“…The patient's age at the beginning of brace treatment, Cobb angle, curve location, Risser stage, and in-brace correction are important factors for predicting treatment effectiveness in AIS. [26][27][28] In our study, although the mean of age was noticeably different between the progressed and nonprogressed groups at the beginning of brace treatment, there was no significant relationship between the prebrace age and brace effectiveness. This is consistent with the findings of Zhu et al 13 We found out that the prebrace Cobb angle in the nonprogressed group was significantly lower than the progressed group.…”

Section: Discussioncontrasting

confidence: 69%

The Effect of Brace Treatment on Large Curves of 40° to 55° in Adolescents With Idiopathic Scoliosis Who Have Avoided Surgery: A Retrospective Cohort Study

et al. 2021

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Objective: To evaluate the effect of Milwaukee brace treatment on adolescents with idiopathic scoliosis (AIS) with large curves (40° to 55°) who refuse to do surgery.Methods: In this retrospective cohort study, we gathered the clinical records of all adolescents with AIS with an initial curve of 40° to 55°. They had been referred to our center from December 1990 to January 2017. Although they had been advised to do surgery, they had all refused to do it. Their clinical data were recorded, such as sex, age, Risser sign, scoliosis, and kyphosis curve magnitude (at the beginning of brace treatment, weaning time, brace discontinuation, and minimum of 2 years after the treatment). Based on treatment success, the patients were divided into 2 groups: progressed and nonprogressed.Results: Sixty patients with an average initial Cobb angle of 44.93° ± 4.86° were included. The curve progressed in 57%, stabilized in 25%, and improved in 18% of the patients. In the progressed group (34 patients), 31 patients had undergone surgery. There was no significant association between the age of beginning the brace treatment and the final Cobb angle of nonprogressed group (p > 0.05). However, in-brace correction and initial Risser sign had a significant correlation with curve magnitude at the final follow-up (p < 0.05).Conclusion: Brace treatment seems to be effective in controlling the further curve progression in AIS with 40° and 55° curves. Our results can help physicians make sound decisions about the patients with larger curves who refuse to do surgery.

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Section: Discussioncontrasting

confidence: 69%

The Effect of Brace Treatment on Large Curves of 40° to 55° in Adolescents With Idiopathic Scoliosis Who Have Avoided Surgery: A Retrospective Cohort Study

et al. 2021

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“…Table 2 shows the results of the QUIPS appraisal. Of the 14 articles included, five (59.4%) had a low risk of bias [ 6 , 14 , 15 , 28 , 29 ], three (21.4%) had a moderate risk [ 30 – 32 ], and the remaining six studies (42.9%) had a high risk of bias [ 16 , 17 , 33 – 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…For six studies conducted by three research teams, AIS patients were prescribed an underarm thoraco-lumbo-sacral orthosis (TLSO) [ 6 , 14 , 16 , 29 , 30 , 36 ]. In another two studies from one team, a Hong Kong orthosis was prescribed [ 15 , 33 ]. The Providence nighttime brace was used in two other studies [ 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…In these studies, the bracing outcomes were defined with four indicators, including the initial in-brace Cobb angle [ 14 , 32 , 33 , 35 ], initial in-brace correction rate [ 15 , 16 ], curve progression [ 17 , 28 – 31 , 34 , 36 ], and curve regression [ 6 ]. For the initial in-brace correction rate, six studies calculated with major curve magnitudes [ 6 , 28 , 30 – 32 , 36 ], four studies considered both major and minor curves [ 14 , 15 , 17 , 33 ], and the remaining four studies had no clarification [ 16 , 29 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

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Associations between spinal flexibility and bracing outcomes in adolescent idiopathic scoliosis: a literature review

Luo,

Ma,

Zou

et al. 2023

J Orthop Surg Res

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Objectives To identify the existing assessment methods used to measure the spinal flexibility of adolescents with idiopathic scoliosis before bracing and to evaluate the predictive effect of spinal flexibility on bracing outcomes. Methods A broad literature search was performed in the PubMed, Web of Science, EMBASE, CINAHL, Scopus, and Cochrane Library databases to obtain relevant information about spinal flexibility and bracing outcomes. All literature was retrieved by October 14, 2023. The inclusion and exclusion criteria were meticulously determined. The quality of each included study and the level of evidence were evaluated by the Quality in Prognosis Studies (QUIPS) method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, respectively. Results After screening 1863 articles retrieved from databases, a total of 14 studies with 2261 subjects were eligible for the final analysis in this review. Overall, nine methods of flexibility assessment were identified, including supine radiographs, supine lateral bending radiographs, lateral bending radiographs but without clear positions, hanging radiographs, fulcrum bending physical method, and ultrasound imaging in the positions of supine, prone, sitting with side bending and prone with side bending. In addition, five studies demonstrated that flexibility had a strong correlation with in-brace correction, and eleven studies illustrated that spinal flexibility was a predictive factor of the bracing outcomes of initial in-brace Cobb angle, initial in-brace correction rate, curve progression, and curve regression. The results of GRADE demonstrated a moderate-evidence rating for the predictive value of spinal flexibility. Conclusion Supine radiography was the most prevalent method for measuring spinal flexibility at the pre-brace stage. Spinal flexibility was strongly correlated with the in-brace Cobb angle or correction rate, and moderate evidence supported that spinal flexibility could predict bracing outcomes.

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“…For E1 (on the fours), the sEMG activity on the concave side increased more than the convex side and reached a symmetric sEMG activity on both sides. E1 may be regarded as a symmetric exercise with reduced longitudinal gravity on the spine, which would simultaneously correct the sagittal lordosis and coronal scoliosis of spinal deformity [ 20 ]. The symmetric sEMG activity of paraspinal muscles during E1 may be related to both the self-correction of the patients and the spontaneous correction by the postural change.…”

Section: Discussionmentioning

confidence: 99%

How do Paraspinal Muscles Contract during the Schroth Exercise Treatment in Patients with Adolescent Idiopathic Scoliosis (AIS)?

Yang

Zheng

et al. 2022

Bioengineering

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The Schroth exercise can train the paraspinal muscles of patients with adolescent idiopathic scoliosis (AIS), however, muscle performance during the training remains unknown. This study applied surface electromyography (sEMG) to investigate the paraspinal muscle activities before, during and after Schroth exercise in nine AIS patients. This study found that after the Schroth exercise, the paraspinal muscle symmetry index (PMSI) was significantly reduced (PMSI = 1.3), while symmetry exercise significantly lowered the PMSI (PMSI = 0.93 and 0.75), and asymmetric exercise significantly increased the PMSI (PMSI = 2.56 and 1.52) compared to relax standing (PMSI = 1.36) in participants (p < 0.05). Among the four exercises, the PMSI of on all fours (exercise 1) and kneeling on one side (exercise 3) was the most and the least close to 1, respectively. The highest root mean square (RMS) of sEMG at the concave and convex side was observed in squatting on the bar (exercise 2) and sitting with side bending (exercise 4), respectively. This study observed that the asymmetric and symmetric exercise induced more sEMG activity on the convex and concave side, respectively, and weight bearing exercise activated more paraspinal muscle contractions on both sides of the scoliotic curve in the included AIS patients. A larger patient sample size needs to be investigated in the future to validate the current observations.

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Significance of recumbent curvature in prediction of in-orthosis correction for adolescent idiopathic scoliosis

Cited by 3 publications

References 11 publications

The Effect of Brace Treatment on Large Curves of 40° to 55° in Adolescents With Idiopathic Scoliosis Who Have Avoided Surgery: A Retrospective Cohort Study

The Effect of Brace Treatment on Large Curves of 40° to 55° in Adolescents With Idiopathic Scoliosis Who Have Avoided Surgery: A Retrospective Cohort Study

Associations between spinal flexibility and bracing outcomes in adolescent idiopathic scoliosis: a literature review

How do Paraspinal Muscles Contract during the Schroth Exercise Treatment in Patients with Adolescent Idiopathic Scoliosis (AIS)?

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