P80. The effect of scoliosis support orthosis bracing on adult spinal deformity patients: Evaluation of gait and dynamic balance

Abstract

<h3>BACKGROUND CONTEXT</h3> Non-operative treatment is regarded as the first-line of therapy for patients with adult spinal deformity (ASD) without neurologic deficits or significant impairment. While there is high-level evidence supporting the use of rigid bracing in adolescent idiopathic scoliosis, there is a paucity of literature pertaining to the use of scoliosis support orthosis (SSO) in ASD patients. <h3>PURPOSE</h3> To investigate the impact of an SSO on pain, gait parameters, and functional balance measures in symptomatic ASD patients. <h3>STUDY DESIGN/SETTING</h3> Prospective cohort study. <h3>PATIENT SAMPLE</h3> Thirty ASD patients (26 Females, Age: 72.7, Cobb Angle: 47.1°) <h3>OUTCOME MEASURES</h3> Six-minute walk test, Time Up and Go test, 3D Gait analysis, Cone of Economy analysis, VAS, ODI, SRS22r, Fear Avoidance Beliefs Questionnaire (FABQ) [32], and Tampa Scale for Kinesiophobia (TSK). <h3>METHODS</h3> Thirty ASD patients were evaluated on 3 different occasions: first day of bracing: baseline (Pre), and 45-min post fitting (Post45m), and after 8-weeks of bracing for 4 hours a day (Post8w). Each patient performed a 6-minute walk (over-ground gait), a dynamic balance test, and completed VAS, ODI, and SRS22r. <h3>RESULTS</h3> Significant short- and long-term improvements using SSO were found in the 6-minute walk (Pre: 278.6; Post45m: 322.2; Post8w: 338.8 m, p<0.001), walking speed (Pre: 0.88; Post45m: 0.97; Post8w: 0.97 m/s, p<0.001), head total sway distance during the balance test (Pre: 81.33; Post45m: 68.63; Post8w: 60.72 cm, p=0.048), low-back pain (VAS: Pre: 5.5; Post45m: 3.5; Post8w: 3.3, p<0.001), and for the ODI (Pre: 41.9; Post45m: 32.9; Post8w: 30.1, p=0.005). <h3>CONCLUSIONS</h3> This study demonstrated clinically significant improvements in PROMs, spatiotemporal gait parameters and functional balance measures with the use of a SSO for patients with ASD. Some improvements were established immediately following brace fitting and many improvements were observed after wearing SSO for 8 weeks. In addition, this is the first SSO study for ASD to examine gait parameters and functional balance measures in order to understand the benefits of non-operative treatment from a functional and activity of daily living perspective. Based on the results of this study, it is reasonable to consider custom fitted SSO as a treatment option to provide a measurable degree of pain relief and improvement of function for patients with ASD, if the goals of treatment match the measured benefits demonstrated in our paper. Future studies are warranted to investigate if the observed benefits can be maintained over longer periods, possibly with reduced wear times for patients with ASD. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.