Scoliosis Brace Research Articles

Assessment of Adolescent and Parent Willingness to Participate in a Comparative Study of Scoliosis Braces.

Adolescents with idiopathic scoliosis (IS) are often prescribed an orthosis to prevent curve progression and avoid surgery. Standard-of-care scoliosis orthoses are designed for full-time (FT) wear, which can be burdensome for some patients. Nighttime (NT) hypercorrective scoliosis orthoses are another option that has a lower impact on daily life, however, additional research is needed to guide the prescription of NT orthoses. The aim of this study was to assess the willingness of patients with IS and their parents/guardians to enroll in a randomized controlled study on bracing in scoliosis. A cross-sectional study was conducted to survey adolescents with IS and their parents/guardians. Eligibility criteria for adolescent participants included: (1) diagnosis of IS, (2) no previous orthosis use, (3) currently seeing a provider for their scoliosis, and (4) able to communicate in English. Parent/guardian participants were the parent or guardian of an adolescent participant and were able to communicate in English. Separate online surveys were designed for adolescents and their parents/guardians. Surveys provided information about a hypothetical study and queried respondents about whether they would participate in the study, their willingness to randomize brace treatment, and their preferences for NT or FT bracing. Descriptive statistics were used to summarize survey data. One hundred four adolescent/parent dyads completed the survey (104 adolescents and 103 parents). Most participants (adolescents: 55.8%, parents: 55.3%) indicated an interest in study participation, and approximately one-third of participants (adolescents: 31.8%, parents: 30.1%) reported that they would be willing to randomize to brace type. Most participants (adolescent: 77.0%, parent: 81.6%) preferred the NT brace if they needed brace treatment. High-quality evidence is needed to inform the use of FT and NT scoliosis orthoses. Approximately a third of respondents would enroll in a randomized trial, indicating that multiple collaborative sites will be needed to recruit a sufficient sample into a randomized study on scoliosis bracing. Study findings also demonstrate support from adolescents and their parents/guardians for research on scoliosis bracing.

An All-in-One Array of Pressure Sensors and sEMG Electrodes for Scoliosis Monitoring.

Scoliosis often occurs in adolescents and seriously affects physical development and health. Traditionally, medical imaging is the most common means of evaluating the corrective effect of bracing during treatment. However, the imaging approach falls short in providing real-time feedback, and the optimal corrective force remains unclear, potentially slowing the patient's recovery progress. To tackle these challenges, an all-in-one integrated array of pressure sensors and sEMG electrodes based on hierarchical MXene/chitosan/polydimethylsiloxane (PDMS)/polyurethane sponge and MXene/polyimide (PI) is developed. Benefiting from the microstructured electrodes and the modulus enhancement of PDMS, the sensor demonstrates a high sensitivity of 444.3 kPa-1 and a broad linear detection range (up to 81.6kPa). With the help of electrostatic attraction of chitosan and interface locking of PDMS, the pressure sensor achieves remarkable stability of over 100000 cycles. Simultaneously, the sEMG electrodes offer exceptional stretchability and flexibility, functioning effectively at 60% strain, which ensures precise signal capture for various human motions. After integrating the developed all-in-one arrays into a commercial scoliosis brace, the system can accurately categorize human motion and predict Cobb angles aided by deep learning. This study provides real-time insights into brace effectiveness and patient progress, offering new ideas for improving the efficiency of scoliosis treatment.

The diagnostic accuracy of community spine radiology for adolescent idiopathic scoliosis brace candidates.

The study aims to establish the diagnostic accuracy of community spine x-rays for brace candidates. A review of adolescent idiopathic scoliosis patients seen for initial visit at a tertiary care pediatric hospital was conducted (n = 170). The index test was the pre-referral community spine x-ray interpreted by a community radiologist. Measures of diagnostic accuracy for the index test were determined against the reference standard if images were obtained within 90 days (n = 111). The reference standard was the 3-foot standing EOS spine x-ray evaluated by spine specialists. Diagnostic criterion for a brace candidate was dichotomized by Cobb angle range (25-40°) according to Scoliosis Research Society criteria. Risser stage was not included given significant missing data in index reports. To mitigate the uncertainty around true progression, sensitivity analyses were conducted on a sub-sample of data when index test was within 60 days of the reference standard (n = 67). Accuracy of the community spine x-ray to detect a brace candidate was 65.8% (95% CI 56.2-74.5). Sensitivity of the index test was 65.4% with a false negative rate of 34.6%. Specificity was 66.1% with a false positive rate of 33.9%. Positive and negative predictive values were 63.0% and 68.4%, respectively. Of the total number of brace candidates (n = 52), 32.7% were missed because of underestimation in Cobb angle (95% CI 21.5-46.2). The proportion of missed brace candidates because of underestimation was unchanged with 60-day data (p = 0.37). Inaccuracies in community spine radiology may lead to missed opportunities for non-operative treatment.

Predicting brace holiday eligibility in juvenile idiopathic scoliosis.

The psychological effects of scoliosis bracing can be difficult, and thus clinicians sometimes recommend a brace holiday when the curve corrects to less than 25°. However, the clinical indications for taking a break from the brace before reaching maturity have yet to be described. We hypothesized there would be a relationship between brace holiday eligibility and degree of curve at presentation, change in curve magnitude while bracing, and level of bracing compliance. A retrospective cohort study at a single institution was performed from 2016 to 2022. Objective brace compliance I-button data were collected on patients aged 3-9years old. Patients with other etiologies besides idiopathic scoliosis before the age of 10 were excluded. Binary logistic regression was performed to determine the effect of significant variables on the likelihood of brace holiday. Fifty-six patients met inclusion criteria. Of these, 20 were able to get a brace holiday. Patients with higher brace compliance and larger in-brace curve correction were more likely to get a brace holiday (P = 0.015, 0.004). Patients with higher BMIs and larger curves at initial presentation were less likely to get a brace holiday (P = 0.002, 0.014). Compliant brace wearers with good in-brace correction are most likely to be eligible for a brace holiday. While some elements remain immutable, others are modifiable, such as bracing compliance. Understanding how outcomes differ between patients who do and do not take a brace holiday will be crucial to elucidating if the psychological benefit of taking a break from the brace can be justified.

A 3D German-designed brace used to treat adolescent idiopathic scoliosis

Introduction Adolescent Idiopathic Scoliosis (AIS) is a condition that affects an otherwise healthy child 10 years of age or older and is the high risk of severe deformity and surgery. Different brace applications include the Milwaukee Brace, Boston Scoliosis Brace, TLSO and others, and the success rates of orthoses vary. With little experience in the use of the Chêneau-type corset, the brace provides an effective means for the active correction of scoliotic spinal deformity.The objective was to demonstrate an outcome with a 3D functional corrective German-designed corset used to treat a patient with AIS in the period from the onset of the curve to the onset of skeletal maturity.Material and methods The medical history of patient S. including anamnestic, clinical and radiological findings recorded 2018 and 2023 when she used a 3D German-designed (3D GD) corset. The corset design was defined as 3CL/B2 according to the Lehnert – Schroth scoliotic classification as modified by Rigo.Results The left-sided thoracolumbar curve of a 9-year-old patient with a Risser sign of 0 and a Cobb angle of 25° at baseline decreased to 12° at the age of 16 years (Risser sign — 5) due to bracing.Discussion The AIS was diagnosed in the patient at the age of 5 years and bracing was initiated at the age of 9. The curve correction using 3D GD brace was based on the principles offered by Chêneau. The patient used the corset for 20 hours per day. The initial brace correction was 90 %. The curve decreased from Cobb angle 25° to 12° over a six-year period of brace treatment with no need for surgery. Three cases with identical outcomes were reported with the use of the Boston and Chêneau braces in AIS.Conclusion The clinical case showed effective use of the 3D GD corset as a new exponent of corsets developed on the principles offered by Chêneau to prevent surgical treatment by the time of skeletal maturity.

Correlation between clinical and epidemiological characteristics of adolescents with idiopathic scoliosis and their quality of life

Introduction:Bracing and physiotherapy in Adolescent idiopathic scoliosis, are closely linked to heightened levels of psychological distress.Objective:The objective of this study is to investigate the relationship between the clinical and epidemiological characteristics of AIS patients and their quality of life.Subjects and Methods: This study encompassed 60 patients aged 13.85 ± 1.87 years,exhibiting mild to severe AIS. All subjects adhered to a Schroth exercise program for a minimum of three months, with 26 of them additionally undergoing conservative treatment with braces. Each participant completed the ISYQOL questionnaire and an individual form detailing clinical and epidemiological characteristics. Results:A notable correlation was observed concerning the use of braces.Patients utilizing a brace demonstrated higher ISYQOL scores,indicating a lower HRQoL,compared to those exclusively following Schroth exercise programs. HRQoL exhibited positive correlations with the age at diagnosis,height,age at menstruation onset, and duration of Schroth exercise treatment. HRQoL displayed negative correlations with age,weight,duration of brace treatment, maximum angle trunk rotation , and maximum Cobb angle. The study indicated that lumbar curves were associated with a higher QoL.Conclusions:The use of a brace was found to have a negative impact on HRQoL.

Association between Adverse Psychological Emotions and Postoperative Brace for Adolescent Idiopathic Scoliosis: A Prospective Cohort Study with Propensity Score Matching.

Although the advantages of postoperative braces have been verified in many fields, it is not clear whether postoperative braces can help reduce patients' adverse psychological emotions such as kinesiophobia, anxiety, and depression. This study aims to analyze whether the use of a postoperative brace helps reduce adverse psychological emotions in adolescent idiopathic scoliosis (AIS) patients undergoing spinal deformity surgeries. All consecutive patients who underwent spinal corrective surgeries at our institution between April 2023 and July 2023 formed the prospective cohort. Outcome measures were collected in the preoperative period, 3 months after surgery, and 6 months after surgery. All patients were assessed using the Tampa scale for kinesiophobia (TSK), the hospital anxiety and depression scale (HADS), and the numerical rating scale (NRS). A statistical model of propensity score matching was used to eliminate potential selection bias and maintain comparability. Multivariate linear regression models were used to determine the relationship between postoperative brace and adverse psychological emotions. After propensity score matching, this study ultimately enrolled 150 patients. There were no significant differences between the two groups in terms of demographic and perioperative variables. The fully adjusted model showed that the TSK scores of the non-brace group at the 3-month (ꞵ = 2.50, 95% CI 0.80-4.20, p = 0.005) and 6-month follow-up (ꞵ = 2.75, 95% CI 0.75-4.74, p = 0.007) were significantly higher than those of the brace group. The HADS score of the non-brace group at the 3-month follow-up was significantly higher than that of the brace group (ꞵ = 1.75, 95% CI 0.28-3.22, p = 0.019). The NRS score of the non-brace group at the 3-month follow-up was significantly higher than that of the brace group (ꞵ = 0.69, 95% CI 0.05-1.33, p = 0.034). At the 6-month follow-up, there were no significant difference for HADS score or NRS score between the two groups. In the early postoperative period, the postoperative brace could provide AIS patients with psychological supports and help them reduce the frequency of adverse psychological emotions. The postoperative brace could continuously improve the fear of movement within 6 months after surgery, and help reduce anxiety, depression, and pain within 3 months after surgery.

Outcomes for nighttime bracing in adolescent idiopathic scoliosis based on brace wear adherence.

This study determined brace wear adherence for patients treated with nighttime braces and evaluated the effect of brace adherence on curve progression. One hundred twenty-two patients with AIS ages 10-16years, Risser stages 0-2, major curves 20°-40° treated with Providence nighttime braces prescribed to be worn at least 8h per night were prospectively enrolled and followed until skeletal maturity or surgery. Brace adherence was measured using iButton temperature sensors after 3months of brace initiation and at brace discharge. Curve types were single thoracolumbar/lumbar (62%, n = 76), double (36%, n = 44), and single thoracic (2%, n = 2). Brace adherence averaged 7.8 ± 2.3h after 3months (98% adherence) and 6.7 ± 2.6h at brace discharge (84% adherence). Curves that progressed ≥ 6° had decreased brace adherence than non-progressive curves after 3months (7.0h vs. 8.1h, p = 0.010) and at brace discharge (5.9h vs. 7.1h, p = 0.017). Multivariate logistic regression analysis showed that increased hours of brace wear [odds ratio (OR) 1.23, 95% confidence interval (CI) 1.06-1.46], single curves (OR 3.11, 95% CI 1.35-7.53), and curves < 25° (OR 2.61, 95% CI 1.12-6.44) were associated with non-progression at brace discharge. Patients treated with nighttime bracing have a high rate of brace adherence. Lack of curve progression is associated with increased brace wear. Nighttime bracing is effective at limiting curve progression in AIS single thoracolumbar/lumbar and double curves. Prognostic Level 2.

Automated design of nighttime braces for adolescent idiopathic scoliosis with global shape optimization using a patient-specific finite element model

Adolescent idiopathic scoliosis is a complex three-dimensional deformity of the spine, the moderate forms of which require treatment with an orthopedic brace. Existing brace design approaches rely mainly on empirical manual processes, vary considerably depending on the training and expertise of the orthotist, and do not always guarantee biomechanical effectiveness. To address these issues, we propose a new automated design method for creating bespoke nighttime braces requiring virtually no user input in the process. From standard biplanar radiographs and a surface topography torso scan, a personalized finite element model of the patient is created to simulate bracing and the resulting spine growth over the treatment period. Then, the topography of an automatically generated brace is modified and simulated over hundreds of iterations by a clinically driven optimization algorithm aiming to improve brace immediate and long-term effectiveness while respecting safety thresholds. This method was clinically tested on 17 patients prospectively recruited. The optimized braces showed a highly effective immediate correction of the thoracic and lumbar curves (70% and 90% respectively), with no modifications needed to fit the braces onto the patients. In addition, the simulated lumbar lordosis and thoracic apical rotation were improved by 5° ± 3° and 2° ± 3° respectively. Our approach distinguishes from traditional brace design as it relies solely on biomechanically validated models of the patient’s digital twin and a design strategy that is entirely abstracted from empirical knowledge. It provides clinicians with an efficient way to create effective braces without relying on lengthy manual processes and variable orthotist expertise to ensure a proper correction of scoliosis.

Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis

Moderate-grade adolescent idiopathic scoliosis (AIS) may be treated with full-time bracing. For patients who reject full-time bracing, the effects of alternative, conservative interventions are unknown. To determine whether self-mediated physical activity combined with either nighttime bracing (NB) or scoliosis-specific exercise (SSE) is superior to a control of physical activity alone (PA) in preventing Cobb angle progression in moderate-grade AIS. The Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS) randomized clinical trial was conducted from January 10, 2013, through October 23, 2018, in 6 public hospitals across Sweden. Male and female children and adolescents aged 9 to 17 years with an AIS primary curve Cobb angle of 25° to 40°, apex T7 or caudal, and skeletal immaturity based on estimated remaining growth of at least 1 year were included in the study. Dates of analysis were from October 25, 2021, to January 28, 2023. Interventions included self-mediated physical activity in combination with either NB or SSE or PA (control). Patients with treatment failure were given the option to transition to a full-time brace until skeletal maturity. The primary outcome was curve progression of 6° or less (treatment success) or curve progression of more than 6° (treatment failure) seen on 2 consecutive posteroanterior standing radiographs compared with the inclusion radiograph before skeletal maturity. A secondary outcome of curve progression was the number of patients undergoing surgery up until 2 years after the primary outcome. The CONTRAIS study included 135 patients (45 in each of the 3 groups) with a mean (SD) age of 12.7 (1.4) years; 111 (82%) were female. Treatment success was seen in 34 of 45 patients (76%) in the NB group and in 24 of 45 patients (53%) in the PA group (odds ratio [OR], 2.7; 95% CI, 1.1-6.6). The number needed to treat to prevent curve progression with NB was 4.5 (95% CI, 2.4-33.5). Treatment success occurred in 26 of 45 patients (58%) in the SSE group (OR for SE vs PA, 1.2; 95% CI, 0.5-2.8). Up to 2 years after the primary outcome time point, 9 patients in each of the 3 groups underwent surgery. In this randomized clinical trial, treatment with NB prevented curve progression of more than 6° to a significantly higher extent than did PA, while SSE did not; in addition, allowing transition to full-time bracing after treatment failure resulted in similar surgical frequencies independent of initial treatment. These results suggest that NB may be an effective alternative intervention in patients rejecting full-time bracing. ClinicalTrials.gov Identifier: NCT01761305.

The Improvement of Trunk Muscle Endurance in Adolescents with Idiopathic Scoliosis Treated with ScoliBrace® and the ScoliBalance® Exercise Approach

The impact of scoliosis bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE) on trunk muscle endurance in adolescents with idiopathic scoliosis is unknown. ScoliBrace®, a rigid, three-dimensional, over-corrective thoraco-lumbar-sacral orthosis (TLSO), and ScoliBalance®, a PSSE program, were used to treat adolescent idiopathic scoliosis (AIS) patients. A retrospective study of the trunk muscle endurance of 33 AIS patients who received ScoliBrace® and ScoliBalance® was conducted. The patients were treated with ScoliBrace® and an individualized ScoliBalance® program. Trunk extensor muscle endurance (TE) and abdominal muscle endurance (AE) tests were performed at initial assessment and then at averages of 6.6 and 24.4 weeks of treatment. The data were analyzed using the Wilcoxon signed-rank test, Stata version 15.1. The participants were aged 13.24 years (SD = 1.64) with a mean Cobb angle of 38.97° (SD = 9.49°). TE improved significantly (p &lt; 0.001) at both short- and medium-term intervals using ScoliBalance® and ScoliBrace® in the AIS patients. AE also showed significant improvement between baseline and short-term follow-up, with non-significant improvement at medium-term follow-up. Overall, trunk muscle endurance showed improvement in the AIS patients using ScoliBrace® and ScoliBalance®. Future research is required to determine the individual and combined effects of each treatment. However, it seems likely that trunk muscle endurance will not deteriorate in AIS patients with this combined treatment.

Pressure Monitoring for Scoliosis Braces using Textile-based Pressure Sensor Arrays

Scoliosis is a type of spine deformity that commonly arises during adolescence. The usage of a brace is an effective method in the conservative treatment of scoliosis. The aim of this study is to examine the pressure applied to the brace that is used in the treatment of scoliosis by integrating a textile-based capacitive pressure sensor array. By considering the sensitivity, durability, recovery/response time, and working range, appropriate sensor cells were chosen. The characterization of the selected pressure sensor cell and its coherence with other cells were examined in the experiments. It is observed that the overall average relative error for the proposed pressure estimation process is 0.18.

The acute effects of brace use on lower extremity performance in individuals with adolescent idiopathic scoliosis.

Braces have been a popular treatment option for scoliosis among healthcare professionals for many years. However, the effect of braces on scoliosis treatment remains a subject of ongoing debate and research. Our study aimed to evaluate the effects of wearing a spinal brace on vertical jump, postural control, reach distance, and fall risk in patients with Adolescent Idiopathic Scoliosis (AIS). We included 33 patients with AIS aged between 10 to 18years old in our cross-sectional study. Patients were randomly subjected to vertical jump test, standing long jump test, timed up and go test, postural control, and forward reach test, while wearing and not wearing the scoliosis brace, respectively. Our findings revealed that patients wearing scoliosis braces had significantly lower vertical jumps (p = .001), standing long jumps (p < .001), and forward reach distances with their dominant (p = .002) and non-dominant limbs (p = .007) compared to those who did not wear the brace. However, there was no significant difference in postural control and timed up and go test between the two groups (p > .05). Our study suggests that wearing a scoliosis brace may negatively affect an individual's vertical and standing long jumps, and forward reach distances. However, wearing or not wearing the brace had no significant effect on postural control and timed stand-up test. Long-term follow-up studies are needed to evaluate the overall effectiveness of scoliosis braces in treating AIS.

Finite Element Model of Scoliosis Brace with Increased Utility Characteristics

Orthoses are of critical importance in the field of medical biomechanics, particularly in the correction of spinal deformities. The objective of the current research was to improve the utility characteristics of the scoliosis brace without compromising its corrective capabilities. The orthotic shell of the Boston brace was used as the basis for this investigation. The finite element method (FEM) was used to evaluate the distribution of corrective forces through the device. The flow of force lines within the orthotic shell was determined by mapping the paths of maximum principal stresses. Areas of the device that had a negligible effect on overall stiffness were identified and material from these areas was eliminated. Minor modifications were then made to the redesigned shell to maintain its corrective stiffness. As a result of these changes, the weight of the braces was reduced without compromising its corrective stiffness. When subjected to corrective forces, the shell’s displacement patterns in the transverse plane showed minimal changes from the original model, confirming that its corrective capacity remained largely intact. This research presents an innovative methodology for orthotic design and demonstrates that structural optimization based on the mapping of maximum principal stress pathways can significantly improve device functionality. The approach outlined here holds promise for future advances in the design of various orthotic devices, thereby contributing to the advancement of the field.

Bracing Adolescent Idiopathic Scoliosis (BASIS) study - night-time versus full-time bracing in adolescent idiopathic scoliosis: study protocol for a multicentre, randomized controlled trial.

Scoliosis is a lateral curvature of the spine with associated rotation, often causing distress due to appearance. For some curves, there is good evidence to support the use of a spinal brace, worn for 20 to 24 hours a day to minimize the curve, making it as straight as possible during growth, preventing progression. Compliance can be poor due to appearance and comfort. A night-time brace, worn for eight to 12 hours, can achieve higher levels of curve correction while patients are supine, and could be preferable for patients, but evidence of efficacy is limited. This is the protocol for a randomized controlled trial of 'full-time bracing' versus 'night-time bracing' in adolescent idiopathic scoliosis (AIS). UK paediatric spine clinics will recruit 780 participants aged ten to 15 years-old with AIS, Risser stage 0, 1, or 2, and curve size (Cobb angle) 20° to 40° with apex at or below T7. Patients are randomly allocated 1:1, to either full-time or night-time bracing. A qualitative sub-study will explore communication and experiences of families in terms of bracing and research. Patient and Public Involvement & Engagement informed study design and will assist with aspects of trial delivery and dissemination. The primary outcome is 'treatment failure' (Cobb angle progression to 50° or more before skeletal maturity); skeletal maturity is at Risser stage 4 in females and 5 in males, or 'treatment success' (Cobb angle less than 50° at skeletal maturity). The comparison is on a non-inferiority basis (non-inferiority margin 11%). Participants are followed up every six months while in brace, and at one and two years after skeletal maturity. Secondary outcomes include the Scoliosis Research Society 22 questionnaire and measures of quality of life, psychological effects of bracing, adherence, anxiety and depression, sleep, satisfaction, and educational attainment. All data will be collected through the British Spine Registry.

Cobb angle decrease with CAEN brace for adolescent idiopathic scoliosis: A case report

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity defined by a lateral curvature of the spine with a Cobb angle of at least 10 degrees. The appropriate treatment is chosen based on the patient's maturity (Risser sign), location, severity, and progression risk of curvature. Skeletally immature patients with a Cobb angle above 25 degrees or less with evidence of progression are usually treated with a brace in order to prevent curve progression, therefore preventing the need for surgical correction. Nighttime bracing was developed to ensure brace compliance without compromising the overall effectiveness of brace treatment. We present the case of an adolescent boy with idiopathic scoliosis and progressive spinal curvature who was treated with a type of nighttime brace (CAEN). The overall result was satisfactory, with not only no increase in the final curvature after brace discontinuance but also a 15° decrease relative to the initial Cobb angle.

Infrared Thermography for Real-Time Assessment of the Effectiveness of Scoliosis Braces.

This work proposes an innovative method, based on the use of low-cost infrared thermography (IRT) instrumentation, to assess in real time the effectiveness of scoliosis braces. Establishing the effectiveness of scoliosis braces means deciding whether the pressure exerted by the brace on the patient's back is adequate for the intended therapeutic purpose. Traditionally, the evaluation of brace effectiveness relies on empirical, qualitative assessments carried out by orthopedists during routine follow-up examinations. Hence, it heavily depends on the expertise of the orthopedists involved. In the state of the art, the only objective methods used to confirm orthopedists' opinions are based on the evaluation of how scoliosis progresses over time, often exposing people to ionizing radiation. To address these limitations, the method proposed in this work aims to provide a real-time, objective assessment of the effectiveness of scoliosis braces in a non-harmful way. This is achieved by exploiting the thermoelastic effect and correlating temperature changes on the patient's back with the mechanical pressure exerted by the braces. A system based on this method is implemented and then validated through an experimental study on 21 patients conducted at an accredited orthopedic center. The experimental results demonstrate a classification accuracy slightly below 70% in discriminating between adequate and inadequate pressure, which is an encouraging result for further advancement in view of the clinical use of such systems in orthopedic centers.

Could trochanteric pelvic stabilization be removed from the adolescent idiopathic scoliosis brace? A prospective pilot study.

Idiopathic scoliosis is the most common musculoskeletal deformity in children. There is a dose-response relationship between compliance and improvement in scoliosis. The literature revealed that esthetic considerations have negative consequences on the quality of life (QOL) of patients and consequently on wearing time of the brace. To minimize esthetic problems and then increase QOL and wearing time, we proposed a new relay brace named "corset Collerette" without a pelvic-trochanteric base. A prospective cohort study was conducted in the rehabilitation department of Bordeaux University Hospital. Patients consulting for adolescent idiopathic scoliosis were registered in a prospective hospital database. The patients expressing unwillingness to wear the usual brace or who had decreased compliance were offered the corset Collerette and were included in a 3-month follow-up. Outcome measures assessed at baseline and at 3 months were Scoliosis Research Society Outcomes Questionnaire (SRS-22) and Brace Questionnaire scales and wearing time. Cobb's angle evolution since the start of bracing was also collected. The primary end point was the QOL assed by the SRS-22 scale at 3 months of follow-up. The first 38 patients agreeing to wear the corset Collerette were included in the study. The QOL assessed by the SRS-22 was significantly improved with the corset Collerette ( p < 0.05). There was no significant increase in wearing time and thoracic Cobb's angles between baseline and follow-up ( p > 0.05). The switch to the corset Collerette allowed an improvement in the QOL of the patients and avoid a decrease in compliance with wearing the brace and maintain the same in-brace Cobb's angles.

Influence of Undergarments on the Comfort Level of Scoliosis Brace Wearers.

Bracing has proven to be an effective method for the conventional treatment of scoliosis in young people. A brace, a therapeutic device, covers the upper body and promotes healing by applying pressure to specific areas. However, wearing a scoliosis brace negatively affects the user's thermo-physiological well-being and often leads to discomfort. In this study, we investigated the influence of T-shirts as an undergarment on the thermo-physiological well-being of the brace wearer. For this purpose, we performed a comparative analysis of six T-shirts made from different special knitted fabrics. We carried out wearing tests in a computer-controlled climate chamber according to a predetermined protocol. The test subject wore the orthopedic brace over the different T-shirts at three different temperatures. The results indicate that the knitted fabrics of undergarments and environmental conditions considerably impact the wearer's thermo-physiological comfort. In the tests, the T-shirts made from the selected functional fabrics performed very well. The T-shirt made from the classic cotton fabric containing elastane yarn also performed well and was the most environmentally friendly. Currently, due to its lower price and easier availability, this cotton T-shirt can be recommended for wearing under a scoliosis brace.

Evaluation of the effectiveness of scoliosis braces designed based on CAD CAM and manual casting. A review of literature

Various methods of conservative treatment have been used to control the progression of scoliosis, including physical therapy and brace. Actually, there are two main approaches for fabrication of scoliotic braces. However, the main question posted here is that whether the braces produced based on CAD/CAM approach is more effective (To reduce the scoliosis curve based on Cobb angle) than the braces fabricated by manual casting or not. Therefore, the aim of this review was to compare the effectiveness of braces produced by CAD/CAM and manual method based on the available literature. Moreover, it was aimed to compare the quality of life of scoliotic subjects treated by the braces produced based on two mentioned approaches. A search was done in some data bases such as Google Scholar, PubMed, ISI Web of Knowledge, Ebsco and Scopus. CAD/CAM key word was used in combination with scoliosis. The quality of the studies was deter-mined by use of Black and Down tool. Actually 9 papers were found on combination of CAD/CAM and scoliosis in which, 5 papers were on comparison of the efficiency of the brace designed based on manual method and CAD/CAM. The other papers were on evaluation of the efficiency of the braces designed based on CAD/CAM with and without finite element analysis. The quality of the papers varied between 9 and 16. It can be concluded from the available studies that the braces designed based on CAD/CAM approach are lighter and more comfortable than the braces de-signed based on traditional method. However, there seems to be no difference between the effectiveness of the braces fabricated by CAD/CAM and manual casting.