Corrective Brace Research Articles

Stress level in adolescents wearing corrective brace for idiopathic scoliosis: study with BSSQ questionnaires

Material and methods The study involved 80 adolescents (71 girls and 9 boys), fulfilling the inclusion criteria: age range between 11.0 and 16.0 years, Cobb angle range between 20 and 45 degrees, wearing Cheneau orthosis for more than 3 months, at least 12 hours per day. The group was analyzed in subgroups according to (1) age: 11.0-13.0 years (n=40) versus 14.016.0 years (n=40), (2) brace wearing time: less than 20h (n=45) versus more than 20h per day (n=35), (3) place of residence: village (n= 34), town (n= 20) or city (n= 26). Maximal angle of trunk rotation (ATR max) was measured using Bunnell scoliometer. Bad Sobernheim Stress Questionnaires (BSSQ), both the Brace and the Deformity versions were used, the former estimates the stress the patients have whilst wearing brace, the latter estimates the stress induced with body deformation.

Prospective study and new concepts based on scoliosis detorsion of the first 225 early in-brace radiological results with the new Lyon brace: ARTbrace.

BackgroundThe symmetrical Lyon brace is a brace, usually used to maintain correction after a plaster cast reduction in the Cotrel’s EDF (Elongation-Derotation-Flexion) frame. The new Lyon brace or ARTbrace is an immediate corrective brace based on some of the principles of the plaster cast which are improved due to advances in CAD/CAM technology. The aim of this paper is to describe concepts of this new brace to be not only a replacement of the plaster cast, but also a definitive brace.MethodsInstead of a plaster cast, three segmental CAD/CAM moulds are made with the instantaneous full 3D raster stereography digitizer (Orten):In self axial elongationIn shift and lumbar lordosisIn shift and thoracic kyphosisA specific software (OrtenShape) makes up the overlay of the three moulds. Mould 1 is used for the pelvis and the shoulders mould 2 for the lumbar segment and mould 3 for the thoracic segment.The mathematical basis of the ARTbrace is the torso column which is a circled helicoid with horizontal circle generator. A torso column is reproduced in the opposite direction of the scoliosis.Like the plaster cast, the ARTbrace is worn for a “total time” of 24 hours 7 days a week without modifying the standard protocol of the Lyon brace reduction.The prospective controlled cohort observational study of the 225 first patients treated since May 2013 is reported below.ResultsThe in-brace immediate reduction is: 0.7, i.e. 40% better with the ARTbrace than with a plaster cast. The correction of flat back is 9° (from 18°.4 to 28°.5 kyphosis Cobb angle). The improved aesthetic appearance is equal for rib hump and ATR.ConclusionThis first paper is an introduction with very short results and does not prejudge the final outcome. The ARTbrace can be used not only to replace the plaster cast, but also as a definitive brace. The new segmental moulding with final detorsion is even more efficient and to this day the ARTbrace is the most effective to reduce the Cobb angle of scoliosis.Electronic supplementary materialThe online version of this article (doi:10.1186/1748-7161-9-19) contains supplementary material, which is available to authorized users.

Optimal management of idiopathic scoliosis in adolescence.

Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical. Optimal management of idiopathic scoliosis requires cooperation within a professional team which includes the entire therapeutic spectrum, extending from simple watchful observation of nonprogressive mild deformities through to early surgery for rapidly deteriorating curvature. Probably most demanding is adequate management with regard to the individual course of the disease in a given patient, while avoiding overtreatment or undertreatment.

Self image, stress level and quality of life in adolescents patients with idiopathic scoliosis

Methods It involved 59 adolescents, (50 girls, 9 boys), ages ranging between 10.0 and 17.0 years, all with Adolescent Idiopathic Scoliosis (AIS) with Cobb angle between 20-58 degrees. The adolescents were wearing the same kind of brace (Cheneau orthosis) for more than 6 months, for at least 16h per day. Three questionnaires were used: Trunk Appearance Perception Scale (TAPS), Bad Sobernheim Stress Questionnaire (BSSQ Brace, BSSQ Deformity), and Brace Questionnaire (BrQ).The TAPS is a tool to evaluate subjective impression of trunk deformity, which includes 3 sets of figures that depict the trunk, from 3 viewpoints: looking toward the back, looking toward the head with the patient bending over, and looking toward the front. BSSQ is the questionnaire that estimates the stress scoliosis patients have, whilst wearing their brace. The BrQ is an instrument for measuring quality of life of scoliotic adolescents, who are being treated conservatively, with wearing of a corrective brace. The analysis considered the type of treatment, curve location, correlation of the total scores with age, Cobb angle and Bunnell rotation angle. Results The age was 14.1 ± 1.7 years. Cobb angle was 33.2 ± 9.5 degrees. The TAPS median for the total score was 4. Adolescents revealed higher score with BSSQ Deformity (median = 14) comparing to BSSQ Brace (median = 11). The mean score for BrQ was 76.6 ± 12.1.

Quality of life and stress level in adolescents with idiopathic scoliosis subjected to conservative treatment

Methods It involved 45 adolescents, ages ranging between 10.0 and 15.0 years, all with Adolescent Idiopathic Scoliosis (AIS), with Cobb angle between 20-45 degrees. The adolescents were wearing the same kind of brace (Cheneau orthosis) for more than 3 months for at least 12h per day. Two questionnaires were used: the Brace Questionnaire (BrQ) and Bad Sobernheim Stress Questionnaire (BSSQ). The BrQ is an instrument for measuring quality of life of scoliotic adolescents who are being treated conservatively with wearing of a corrective brace. The BrQ consists of 34 Likert-scale items associated with eight domains. The BSSQ (Brace and Deformity) questionnaire estimates the stress scoliosis patients have whilst wearing their brace. The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. Results The age was 13.6 ± 1.3 years. Cobb angle was 31.7 ± 7.6 degrees. The mean score for BrQ was 78.1 ± 11.3 points. Adolescents revealed higher score with BSSQ Deformity (median = 15) comparing to BSSQ Brace (median = 12).

Guided-growth implants in the treatment of early childhood scoliosis – pilot study

The aim of treating children with early onset scoliosis is to guide the growth of the spine until the patients reach skeletal maturity. Regardless of its aetiology, progressive early-onset scoliosis requires multiple-stage surgery, usually at 6 to 12 months' intervals. However, precise coordination of the timing of each consecutive surgical procedure with the child's growth pattern is difficult, and the risk of complications that require additional surgery should be taken into account. The aim of this study is to present a new surgical method of treating early onset scoliosis which consists in a single-stage insertion of special implants that enable three-plane correction of spinal deformities, allows the spine to continue growing, does not require multi-stage surgical distractions, and ends after the growth period with a conventional spinal fusion. The results of this pilot study were obtained in a homogeneous group of patients treated identically by insertion of original implants guiding spinal growth. The study involved 15 females and 2 males aged between 5 and 13 years (mean age: 9.8 years). All children in the study group had single-curve thoracic scoliosis. The duration of follow-up was between 6 and 40 months (mean duration: 18 months). The efficacy of the guided-growth implant treatment was assessed based on standard radiographs by evaluating the angle of the curvature, T1-S1 length, and apical vertebral rotation (AVR) 1. preoperatively, 2. postoperatively, and 3. in long-term follow-up. After surgery the scoliosis improved significantly in the range of 51% to 80% (mean improvement: 65%). The degree of the correction depended directly on the initial angle of curvature, which ranged from 56 to 95° (mean angle of curvature: 67°). During the entire follow-up period, twelve patients did not show any loss of correction, or the loss was within the bounds of measurement error. Because of a growth spurt, two female patients had to have the rods replaced with longer ones, since there was a risk that they might slide out of the farthest lower screws. In three patients further spontaneous improvement occurred during the follow-up period. Apical vertebral derotation was achieved during the surgery in all patients, and it was maintained throughout the follow-up period. All patients showed an increase in spinal length in the range of 7 to 40 mm (mean increase: 1mm/month). 1. The surgical method described by us provides for very good correction in the first stage of treatment. 2. The maintenance of the correction does not require the use of corrective braces or any indirect multi-stage surgical procedures. 3. The probability of complications during the insertion of the implants is not higher than that seen with conventional multi-stage treatment.

Polish validation of Brace Questionnaire

PurposeThe aim of the study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into Polish.MethodsThe BrQ is an instrument for measuring the quality of life of scoliotic adolescents who are being treated conservatively with wearing a corrective brace. The BrQ consists of 34 Likert-scale items related to eight domains. The translation from the original Greek into Polish was performed. The process of cultural adaptation of the questionnaire was in accordance with the guidelines of the International Quality of Life Assessment Project. It involved 35 adolescents, aged between 10.0 and 16.0 years, all with adolescent idiopathic scoliosis with mean Cobb angle of 35.1 ± 10.6 degrees, and all wearing the same kind of brace (Chêneau orthosis) for more than 3 months. Statistical analysis calculated the reliability (internal consistency), floor and ceiling effects of the BrQ.ResultsThe internal consistency was satisfactory; Cronbach’s alpha coefficient was 0.94. There was no floor or ceiling effects.ConclusionsPolish version of the BrQ is reliable and can be used in adolescents with idiopathic scoliosis wearing the brace to assess their quality of life.

Polish validation of brace questionnaire

The aim of the study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into Polish. The BrQ is an instrument for measuring quality of life of scoliotic adolescents who are being treated conservatively with wearing of a corrective brace [1]. The BrQ consists of 34 Likert-scale items associated with eight domains. Material and methods The translation from the original Greek into Polish was performed. The process of cultural adaptation of the questionnaire was compliant with the guidelines of the International Quality of Life Assessment (IQOLA) Project. It involved 30 adolescents, ages ranging between 10.0 and 17.0 years, all with Adolescent Idiopathic Scoliosis (AIS) and all wearing the same kind of brace (Cheneau). The statistical analysis calculated the reliability (internal consistency), floor and ceiling effects of the BrQ [2-5]. Results The age was 14.0 +/- 1.6 years. The adolescents were wearing the brace for more than 3 months. Cobb angle was 33.6 +/- 11.6 degrees. The internal consistency was satisfactory: Cronbach’s alpha coefficient was 0.82, p<0.001. There was no floor or celing effect.

Infantile idiopathic scoliosis: surgical treatment in rapidly progressive cases

Materilas and methods Age of onset was in between 4th and 36th month of life. Initial treatment consisted of physiotherapy and Chenau corrective bracing in all patients. Duration of conservative treatment was from 4 to 5.5 years. The age at surgery was: from 7 to 12 years (table 1). Finally patients underwent surgical treatment: anterior and posterior fusion in 2 patients (3 curves), posterior instrumentation (2 growing rods) in one patient, and VEPTR device in one case. All have led to clinical improvement.

Corrective Bracing for Severe Idiopathic Scoliosis in Adolescence: Influence of Brace on Trunk Morphology

Aim. The aim of the work was to study whether wearing a corrective brace by adolescent girls with severe idiopathic scoliosis can influence external shape of the trunk. Methods. Comparison of clinical deformity of two groups of girls matched for age and Cobb angle: group (1) of 23 girls, aged 14.9 ± 1.3 years, Cobb angle 55.0° ± 6.8°, who refused surgical treatment and have been wearing Chêneau brace for more than 6 months, compared with group (2) of 22 girls, aged 14.1 ± 1.8 years, Cobb angle 59.7° ± 14.6° never treated with corrective bracing. Clinical deformity was assessed with the Bunnell scoliometer (angle of trunk rotation ATR) and surface topography (posterior trunk symmetry index POTSI and Hump Sum HS). Results. The ATR in the primary curvature was 11.9° ± 3.4° (5°–18°) in group 1 versus 15.1° ± 5.6° (6°–25°) in group 2 (P = 0.027). The HS was 16.8° ± 3.8 versus 19.2° ± 4.6, respectively, P = 0.07. The POTSI value did not differ between groups. Conclusion. Girls with Cobb angle above 45 degrees, who have been subjected to brace treatment, revealed smaller clinical deformity of their back comparing to nontreated girls having similar radiological curvatures.

Evaluation of the Stress Level of Children with Idiopathic Scoliosis in relation to the Method of Treatment and Parameters of the Deformity

Stress level due to existing body deformity as well as to the treatment with a corrective brace is one of factors influencing the quality of life of children with idiopathic scoliosis undergoing non-surgical management. The purpose of the study was to evaluate the stress level among children suffering from idiopathic scoliosis in relation to the method of treatment and the parameters of the deformity. Seventy-three patients with idiopathic scoliosis participated in the study. Fifty-two children were treated by means of physiotherapy, while 21 patients were treated with both Cheneau corrective brace and physiotherapy. To assess the stress level related to the deformity itself and to the method of treatment with corrective brace, the two Bad Sobernheim Stress Questionnaires (BSSQs) were applied, the BSSQ Deformity and the BSSQ Brace, respectively.

Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

BackgroundConservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients.MethodsThe analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line.ResultsIn the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed.ConclusionBest results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish.

Clinical Results of Short Leg Corrective Bracing for Bowlegs due to Blount's Disease or Rickets

Clinical Results of Short Leg Corrective Bracing for Bowlegs due to Blount's Disease or Rickets

"Brace Technology" Thematic Series - The ScoliOlogiC® Chêneau light™ brace in the treatment of scoliosis.

BackgroundBracing concepts in use today for the treatment of scoliosis include symmetric and asymmetric hard braces usually made of polyethylene (PE) and soft braces. The plaster cast method worldwide seems to be the most practiced technique for the construction of hard braces at the moment. CAD (Computer Aided Design) systems are available which allow brace adjustments without plaster. Another possibility is the use of the ScoliOlogiC™ off the shelf system enabling the Certified Prosthetist and Orthotist (CPO) to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This Chêneau light™ brace, developed according to the Chêneau principles, promises a reduced impediment of quality of life in the brace. The correction effects of the first 81 patients (main diagnosis Adolescent Idiopathic Scoliosis (AIS) [n = 64] or Early Onset Scoliosis (EOS) [n = 15]), treated according to the principles of the Chêneau light™ brace have shown a satisfactory in-brace correction exceeding 50% of the initial Cobb angle.Brace descriptionThe ScoliOlogiC® off the shelf bracing system enables the CPO to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This brace, when finally adjusted is called Chêneau light™ brace. The advantage of this new bracing system is that the brace is available immediately, is easily adjustable and that it can also be easily modified. This avoids construction periods of sometimes more than 6 weeks, where the curve may drastically increase during periods of fast growth. The disadvantage of this bracing system is that there is a wide variability of possibilities to arrange the different shells during adjustment.ResultsThe Cobb angle in the whole group was reduced by an average of 16,4°, which corresponds to a correction effect of 51%. The differences were highly significant in the T-test (T = 17,4; p < 0,001). The best correction effects achieved with Chêneau braces reported in literature so far are about 40% in two different studies. The correction effect was highest in lumbar and thoracolumbar curve patterns (62%; n = 18). In thoracic scoliosis the correction effect was 36% (n = 41) and in double major curve patterns 50% (n = 22). The correction effect was affected in a slightly negative way due to age (r = -0,24; p = 0,014), negatively with the Risser stage (-0,29; p = 0,0096) and correlated negatively with the Cobb angle measured before treatment (r = -0,43; p < 0,0001).ConclusionsThe use of the Chêneau light™ brace leads to correction effects above average when compared to correction effects of other braces described in literature. The reduction of material seems to increase patient's comfort and reduces the stress patients may suffer from whilst in the brace.80% of the adolescent population of scoliosis patients can be braced with the Chêneau light™ brace. In certain patterns of curvature and in the younger population with an age of less than 11 years, other approaches have to be used, such as plaster based bracing or the application of CAD/CAM based orthoses.

The treatment of adult scoliosis utilizing the SpineCor Dynamic Corrective Brace

Scoliosis and spinal deformities offer little hope for rehabilitation in the adult population. Pain and viscero-somatic dysfunction are frequently encountered, and conventional medical care uses rigid bracing, medication and surgery in the most serious cases. The treatment of adult scoliosis with The SpineCor® Dynamic Corrective Brace deserves more attention. It offers a great variety of combinations to improve spinal alignment and posture, and depending on the curve type, its severity and rigidity. The main therapeutic goal is to reduce pain and the strain on the neuromusculoskeletal system. The brace acts as a dynamic support against compressive loading on the inter-vertebral joints, while creating a corrective movement in the spine which produces neuromuscular integration.

The treatment of Hyperkyphosis utilizing the SpineCor® Dynamic Corrective Brace: some preliminary results

Hyperkyphosis has long been reported to be associated with many health disorders, both psychological and patho-mechanical. Very few options for the management of this condition are available in medicine, while conservative treatment like chiropractic and physiotherapy can only offer limited structural rehabilitation. Although originally designed for the treatment of AIS, The SpineCor® Dynamic Brace offers a great variety of options for the treatment of Hyperkyphosis. According to our morphologic classification of hyperkyphotic thoracic curves: Upper Thoracic (UT) (often associated with an anterior thoracic translation relative to pelvis), mid-thoracic (MT) (often associated with hyperlordosis and no significant ribcage translation), and lower thoracic (LT) (often associated with posterior translation of ribcage). Many combinations of brace fittings have been designed for the creation of vectors that create a specific corrective movement for the patient's spine and posture.

Guidelines on "Standards of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research": SOSORT Consensus 2008

BackgroundReported failure rates,(defined based on percentage of cases progressing to surgery) of corrective bracing for idiopathic scoliosis are highly variable. This may be due to the quality of the brace itself, but also of the patient care during treatment. The latter is sometimes neglected, even though it is considered a main determinant of good results among conservative experts of SOSORT. The aim of this paper was to develop and verify the Consensus on management of scoliosis patients treated with bracesMethodsWe followed a Delphi process in four steps, distributing and gradually changing according to the results a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ), and during a Consensus Session at the SOSORT Athens Meeting with a Meeting Questionnaire (MQ). We set a 90% agreement as the minimum to be reached.ResultsWe had a 71% response rate to PMQ, and 66.7% to MQ. Since the PMQ we had a good agreement (no answers below 72% – 70.2% over 90%). With the MQ the agreement consistently increased for all the answers previously below 90% (no answers below 83%, 75% over 90%). With increasing experience in bracing all numerical criteria tended to become more strict. We finally produced a set of 14 recommendations, grouped in 6 Domains (Experience/competence, Behaviours, Prescription, Construction, Brace Check, Follow-up).ConclusionThe Consensus permits establishment of recommendations concerning the standards of management of idiopathic scoliosis with bracing, with the aim to increase efficacy and compliance to treatment. The SOSORT recommends to professionals engaged in patient care to follow the guidelines of this Consensus in their clinical practice. The SOSORT criteria should also be followed in clinical research studies to achieve a minimum quality of care. If the aim is to verify the efficacy of bracing these criteria should be companions of the methodological research criteria for bracing proposed by other societies.

The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study

BackgroundCorrective bracing for adolescent idiopathic scoliosis (AIS) has favourable outcomes when patients are compliant. However, bracing may be a stressful and traumatic experience and compliance with a bracing protocol is likely to be dependent upon patients' physical, emotional and social wellbeing. The Brace Questionnaire (BrQ), a recently-developed, condition-specific tool to measure quality of life (QOL) has enabled clinicians to study relationships between QOL and compliance.MethodsThe BrQ was administered to 31 AIS patients after a minimum of 1 year of wearing a brace. Subjects were 13–16 year old South African girls with Cobb angles of 25–40 degrees. Participants were divided into two groups according to their level of compliance with the bracing protocol. Brace Questionnaire sub- and total scores were compared between the two groups using the t-test for comparison of means.ResultsTwenty participants were classified as compliant and 11 as non-compliant. Mean total BrQ scores (expressed as a percentage) were 83.7 for the compliant group and 64.4 for the non-compliant group (p < 0.001), and on analysis of the 8 domains that make up the BrQ, the compliant group scored significantly higher in the 6 domains that measured vitality and social, emotional and physical functioning.ConclusionPoor compliance with a brace protocol is associated with poorer QOL, with non-compliant patients lacking vitality and functioning poorly physically, emotionally and socially. Quality of life for adolescents with idiopathic scoliosis may relate more to psychosocial coping mechanisms than to physical deformity and its consequences. It is important to establish whether remedial programmes are capable of addressing personal, group and family issues, improving QOL and promoting compliance.

The use of the SpineCor Dynamic Corrective Brace in Greece: a preliminary report

Methods From 2003–2007, 109 patients were treated. 82 patients met the inclusion criteria proposed by the SpineCorporation [2]. 26 patients met the criteria for inclusion proposed by the SRS [1]. There were no patients with an outcome. Assessment of the brace effectiveness included (1) percentage of patients who had an initial Cobb angle reduction of 5° or greater; (2) percentage of patients who had an initial Cobb angle increase or decrease of less than 5° (3) percentage of patients who had an initial Cobb increase of 5° or greater and (4) the number of cases progressing to require surgery or undergone surgery.

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

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 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 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 < 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 < 0.001) and thoracolumbar curves (p < 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 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.