The Objective Measurement of Spinal Orthosis Use for the Treatment of Adolescent Idiopathic Scoliosis

Nicholson, Gregory P.; Ferguson-Pell, Martin; Smith, K; Edgar, Michael; Morley, Timothy

doi:10.1097/01.brs.0000085098.69522.52

Cited by 99 publications

(113 citation statements)

References 28 publications

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“…The rationale for surgery is based on evidence supporting morbidity unrelated to the musculoskeletal system as curve magnitude increases [33,36,37,56]. Moderate and severe thoracic curves are associated with reduced vital capacity and total lung capacity [20,21,27,48].…”

Section: Natural Historymentioning

confidence: 99%

“…Currently, the literature supports initiating nighttime bracing for curves measuring less than 35°with an apex below T9, although centers with experience with these braces may choose to expand the indications [14,19,27,[33][34][35]. Hence, future studies, like the Level 1 BrAIST study [53], will be needed to compare full-time versus part-time bracing using SRS guidelines to determine efficacy of each bracing model to prevent progression of curvature and improve function.…”

Section: Bracing Efficacymentioning

confidence: 99%

“…Although casts are not easily removable, braces are easily removed, not surprising given the negative cosmetic appearance, which fosters poor self-esteem and body image, as well as functional discomfort resulting from pressure points, irritation in hot weather, and restriction of movement [5,33]. The discomfort caused by the external biomechanical forces applied by a brace, in an effort to alter spine growth, is determined by brace characteristics such as size, location, and thickness of the pads; tension of the straps; molding; and stiffness of the brace.…”

Section: Bracing Difficultiesmentioning

confidence: 99%

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Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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Skeletally immature patients with adolescent idiopathic scoliosis are at risk for curve progression. Although numerous nonoperative methods have been attempted, including physical therapy, exercise, massage, manipulation, and electrical stimulation, only bracing is effective in preventing curve progression and the subsequent need for surgery. Brace treatment is initiated as either full-time (TLSO, Boston) or nighttime (Charleston, Providence) wear, although patient compliance with either mode of bracing has been a documented problem. We review the natural history of adolescent idiopathic scoliosis, identify the risks for curve progression, describe the types of braces available for treatment, and review the indications for and efficacy of brace treatment.

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Section: Natural Historymentioning

confidence: 99%

Section: Bracing Efficacymentioning

confidence: 99%

Section: Bracing Difficultiesmentioning

confidence: 99%

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Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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“…The number of wear hours reported in these studies was subjective and difficult to verify due to reliance on patient recall, with the possibility of false reporting. Others have looked at developing objective ways of measuring brace wear compliance by using pressure monitoring [5][6][7] or temperature sensing [8][9][10][11][12]. These sensors worked; however, they were bulky.…”

Section: Introductionmentioning

confidence: 99%

Electronic monitoring of scoliosis brace wear compliance

Rahman

Borkhuu

Littleton³

et al. 2010

Journal of Children's Orthopaedics

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Purpose Accurate evaluation of patient compliance with scoliosis brace usage has been a challenge for physicians treating patients with adolescent idiopathic scoliosis. This inability to accurately measure compliance has resulted in difficulty in determining brace treatment efficacy. This prospective study was performed to demonstrate the efficacy of using a new electronic brace compliance monitor, the Cricket. Methods The Cricket is a small encased circuit that can be attached to the brace and, by means of a temperature sensor, can record brace wear times. This study included ten subjects with adolescent idiopathic scoliosis who were prescribed the Wilmington scoliosis brace (thoraco-lumbosacral orthosis) into which the Cricket sensor was incorporated. Subjects kept a diary of brace wear times. Results Comparisons of data for the Cricket, subject diaries, and prescribed brace wear were evaluated. The mean error between the diary times and Cricket recording was 2%. Patient compliance was 78%. Conclusions The Cricket is a reliable, accurate, and sensitive device to determine patient compliance with scoliosis brace usage.

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“…At least 50% in-brace Cobb angle correction and adherence to a 20-23 h per day wear regimen are mandatory for success [36][37][38][39]. However, the use of bracing is controversial: compliance (hours in brace/prescribed brace regimen) has been found to be as low as 62-67.5% in rigid braces [6,40,41] and pooled data in meta-analysis on observation, exercises and bracing did not provide evidence to recommend one approach over the other [42,43]. This may reflect the physical and psychosocial impacts of a rigid, visible and warm orthosis.…”

Section: Discussionmentioning

confidence: 99%

No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis

Hasler¹,

Schmid²,

Enggist³

et al. 2010

Journal of Children's Orthopaedics

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Introduction Brace treatment is the gold standard for patients with mild adolescent idiopathic scoliosis (Cobb angle 20°-40°). However, negative psychosocial impacts, physical constraints and incompliance cause many patients and parents to seek for so-called holistic and apparently less harmful approaches within the field of complementary and alternative medicine (CAM). Osteopathy-manual interventions on the viscera and locomotor system-is widely used for scoliosis. There is, however, a complete lack of evidence regarding its efficacy. We, therefore, tested the hypothesis that osteopathy alters trunk morphology, a prerequisite to unload the concave side of the scoliosis, and that it halts curve progression.Methods This was a prospective, controlled trial of 20 post-pubertal young women (20°-40°idiopathic scoliosis) randomly allocated to an observation (group 0) or osteopathic treatment (group 1). The latter comprised three sessions (5 weeks). Trunk morphology (clinical examination, video rasterstereography) and spine flexibility (MediMouse Ò ) were assessed at a pre-and post-intervention with a 3-month interval (blinded examiner). We chose scoliometer measurement (rib hump, lumbar prominence) as the main outcome parameter. Results Two patients in the treatment group refused further treatment and the final examination, as they felt no benefit after two osteopathic treatments. Regression analysis for repeat measurements (independent statistician) revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global spinal flexibility. Conclusions We found no evidence to support osteopathy in the treatment of mild adolescent idiopathic scoliosis. Therefore, we caution against abandoning the conventional standard of care for mild idiopathic scoliosis. As for other CAM therapies, the use of osteopathy as a treatment option for scoliosis still needs to be clearly defined.

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The Objective Measurement of Spinal Orthosis Use for the Treatment of Adolescent Idiopathic Scoliosis

Abstract: Temperature provides a clear signal of the time in brace and can be used for long-term data logging using discrete instrumentation, providing a tool to help identify and understand the reasons behind poor compliance.

Cited by 99 publications

References 28 publications

Brace Management in Adolescent Idiopathic Scoliosis

Brace Management in Adolescent Idiopathic Scoliosis

Electronic monitoring of scoliosis brace wear compliance

No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis

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