Study of the pressures applied by a Chêneau brace for correction of adolescent idiopathic scoliosis

Abstract

We performed a study on 32 idiopathic scoliotic patients (30 females, 2 males) treated with a Chêneau brace. Eighteen patients had a single right thoracic curve and 14 had a single right thoracolumbar curve. We used the TekScan 1 system (ClinSeat Type 5315 Sensor, TekScan, Boston MA, USA) to measure pressures at the skin-brace interface, assess the effect of strap tension and analyze the variation of these pressures with position and activity. The TekScan 1 device enabled identification of the pressure areas corresponding to the brace's three loading points. The pressure under the main pad had a greater mean value than the pressure under the two counter-pads. Tightening the straps led to a significant increase in the pressures, whatever the position studied or the curve pattern. Compared with the standing (reference) position, we observed significantly higher pressures during maximal inspiration ( p 5 0.001) and lower pressures during maximal expiration, in the prone position and after having risen from a lying position, for both thoracic curves ( p 5 0.001) and thoracolumbar curves ( p 5 0.01). The pressures for thoracolumbar curves were lower than those for thoracic curves, whatever the position studied and both before and after strap adjustment. For lying positions, lying on the right side produced the greatest increase pressure. Even though the TekScan 1 system does not provide direct information on the correction of spinal curvature, it appears to be a useful tool in the treatment of scoliotic patients. Strap adjustment clearly influences the applied pressures -particularly those on the rib cage. During activity, there is a natural tendency to decrease the pressure; this justifies efforts to maintain strap tensions in general and during day wear in particular.

Analysis of the corrective forces exerted by a dynamic derotation brace (DDB)

“…14 We did not find any significant change for the force value between standing and maximum expiration. On the contrary, Pham et al 4 and Coté 12 evidenced significant reduction of the pressure whatever the brace strap tension and the curve pattern was.…”

“…Van den Hout et al 3 measured the exerted forces using the electronic PEDAR measuring device (Novel, Germany) and Pham et al 4 the pressures using the Tekscan ClinSeat Type 5315 Sensor. Dynamic analyses of the exerted forces or the distribution of the pressure for a variety of body postures have been performed by Aubin et al 2 , Van den Hout et al, 3 Pham et al, 4 Cochran and Waugh 5 and Wong and Evans. 6 However, there were great disparities between the published data, which can probably be explained by the diversity of brace types studied, the different curve patterns and the various measurement methods and instruments.…”

First end-result of a prospective cohort with AIS treated with a CAD Chêneau style brace

“…This form is then wrapped with a heated polyethylene sheet which is vacuumed to the form and finally cut from the mould 32) . Some studies exist to support cast based Chêneau style bracing [33][34][35][36][37][38] including one prospective controlled paper 23) .…”

Remodelling of trunk and backshape deformities in patients with scoliosis using standardized asymmetric computer-aided design/computer-aided manufacturing braces

“…Seventy-nine papers were displayed when using the keyword search for 'scoliosis', 'orthosis' and 'improvement'. Nine papers from the list were of interest for our research and are discussed in the next section of this paper [31][32][33][34][35][36][37][38][39] . There is a limited body of evidence demonstrating clinical improvements 33,35,37 via bracing, and even less research showing trunk-shape improvements.…”