Immediate Effects of Sforzesco® Bracing on Respiratory Function in Adolescents with Idiopathic Scoliosis.

Fabrizio Di Maria,Vito Pavone,Alessia Caldaci,Gianluca Testa,Marco Sapienza,Ada Vancheri,Andrea Vescio,Chiara Di Maria

doi:10.3390/healthcare9101372

Fabrizio Di Maria, Vito Pavone + Show 6 more

Open Access

https://doi.org/10.3390/healthcare9101372

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Journal: Healthcare	Publication Date: Oct 14, 2021
Citations: 12	License type: CC BY 4.0

Affiliation: University of Catania

Abstract

The thoraco-lumbar bracing is an effective management of adolescent idiopathic scoliosis (AIS). Studies have shown that brace wearing reduces lung volume. Whether or not the Sforzesco brace, frequently used in Italy, affects lung volume has not been investigated. We studied the immediate effect of Sforzesco bracing on lung volumes in 11 AIS patients (10 F, 1 M; aged 13.6 ± 1.6 yrs) mean Cobb angle 26 ± 4.49 degrees. Lung function variables and the perceived respiratory effort were recorded twice, before and 5 min after bracing. The one-way analysis of variance repeated measures, and multiple comparison tests, showed that means of unbraced variables were not significantly different from the corresponding means of predicted values, whereas means under brace were significantly lower (p < 0.05) compared to both predicted and baseline values of respiratory variables. In addition, a significant correlation (p < 0.0001) was found between unbraced and braced values, and linear regression equations were calculated. A significant but clinically unimportant increase in perceived effort was observed under the brace. In conclusion, data indicate that lung function is not impaired in moderate AIS and that wearing the Sforzesco brace causes an immediate, predictable reduction of lung volumes. Data also suggest that the respiratory discomfort during brace wearing could not be due to respiratory function defects.

Highlights

Idiopathic scoliosis is characterized by a lateral curvature of the spine, with a Cobb angle of more than 10 degrees and rotation of the vertebral column along its longitudinal axis [1]
The aim of this study is to determine whether baseline respiratory function parameters, compared to their predicted values, were altered, and whether static and dynamic lung volume and perceived respiratory effort are affected by the Sforzesco brace in a group of adolescents with moderate idiopathic scoliosis
The study demonstrates that the application of the Sforzesco brace causes a significant decrease in lung function, which in some patients is associated with increased perception of respiratory effort

Summary

Introduction

Idiopathic scoliosis is characterized by a lateral curvature of the spine, with a Cobb angle of more than 10 degrees and rotation of the vertebral column along its longitudinal axis [1]. Adolescent patients are at risk of curvature progression through adulthood, causing chest deformity and movement abnormalities of the rib cage, thereby reducing chest compliance and lung volume [2]. During the past few decades, several studies have confirmed that adolescent idiopathic scoliosis (AIS) can be positively affected by wearing a rigid thoracolumbar brace [3]. Similar to chest wall strapping that reduces thoracic distensibility and restricts lung volumes in normal subjects [4], brace wearing impairs respiratory mechanics [5,6] and results in a reduction of pulmonary function [7,8] and increased dyspnea perception [8].

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