Effectiveness and biomechanics of spinal orthoses in the treatment of adolescent idiopathic scoliosis (AIS)

Wong, Man Sang; Mak, Arthur F. T.; Luk, K.D.K.; Evans, John H.; Brown, B.

doi:10.1080/03093640008726538

Cited by 62 publications

(50 citation statements)

References 26 publications

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“…As such, they play a role in curvature change. Wong et al [35] investigated the effectiveness and biomechanical factors of spinal orthoses in a prospective study. In the study, he found that the Cobb angle while wearing a brace strongly correlated with the pad pressure and strap tension.…”

Section: Discussionmentioning

confidence: 99%

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

et al. 2012

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Summary of background data The curve pattern of idiopathic scoliosis is important for making decisions concerning bracing. However, whether the curve pattern changes during brace treatment have not been fully documented. The aim of this study was to investigate the changes of curve pattern during brace treatment in skeletally immature patients with adolescent idiopathic scoliosis (AIS). MethodsFrom January 2002 to January 2011, AIS patients treated with a Boston or Milwaukee brace were recruited after meeting the following inclusion criteria: older than 10 years of age at initiation of bracing; having a Cobb angle of 25°-40°; with a Risser sign 0-2; being regularly followed until the weaning of brace or the necessity of surgical treatment; and without history of previous treatment. A total of 130 female and 11 male AIS patients were included. The mean age was 12.9 years at initiation of bracing, and the female patients were, on average, 2.7 months past menarche. The mean follow-up period was 2.6 years (range 1.0-5.5 years). The definitions of changes in curve patterns were divided into four categories as follows: (1) shift of the apex of the main curve; (2) change in the curve span of more than two vertebrae; (3) change in the main curve type with regard to the apex location; and (4) change of curve direction. The patients were divided into two groups. Group A was comprised of patients who had experienced one or more categories of curve pattern changes, and Group B was comprised of those who had not. Results Of these 39 patients, 14 had apex shifting, 2 underwent curve span changes, 22 experienced changes in the main curve type, and one female had both changes in the apex and curve span. At the initiation of bracing, patients in Group A demonstrated significantly lower menarchal status (P = 0.018) and lower Risser grade (P = 0.025) than those in Group B. The difference in the percentage of patients who underwent Boston bracing between the two groups was statistically significant (41.5 % for Group A vs. 24.0 % for Group B, P = 0.023). Conclusion Changes in curve pattern can occur during brace treatment. Patients with less skeletal maturity and those treated with a Boston brace are more susceptible to this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

et al. 2012

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“…We observed a significant increase in pad pressures at the moment of maximum inspiration (p 5 0.001). Wong et al (2000) measured the pressures exerted by the TLSO brace's pads by using a dynamic pressure monitor sensor (DPM 2000C 1 ) and also found higher mean pressures during deep inspiration in patients with thoracic curves. We also evidenced a significant reduction in pressure during maximum expiration ( p 5 0.01), whatever the brace strap tension and the curve pattern.…”

Section: Discussionmentioning

confidence: 99%

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

Pham¹,

Houilliez²,

Schill³

et al. 2008

Prosthetics &Amp; Orthotics International

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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 1 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 1 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 5 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 5 0.001) and thoracolumbar curves ( p 5 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 1 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.

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“…The MR examination was carried out after a mean duration of orthotic treatment of 18 months; therefore the orthotic effect of the primary correction on spinal curvature may be different from the findings obtained immediately after bracing. Wong et al (2000) found that the maximum reduction of the coronal, sagittal and axial Cobb's angle occurred in the first 12 months after bracing. The timing of examination in the present study's patients might not reflect the maximum corrective effect of bracing.…”

Section: Discussionmentioning

confidence: 99%

“…Orthoses have been demonstrated to be effective for a significant proportion of patients with mild to moderate adolescent idiopathic scoliosis (AIS), provided that treatment is started early enough and the orthosis worn with good compliance (Wong and Evans 1998;Wong et al 2000;Wright 1997;Lonstein and Winter 1994;Willers et al 1993;Rudicel and Renshaw 1983;Blount and Moe 1980;Edmonson and Morris 1977;Keiser Shufflebarger 1976).…”

Section: Introductionmentioning

confidence: 99%

Curve Correction Effect of Rigid Spinal Orthosis in Different Recumbent Positions in Adolescent Idiopathic Scoliosis (AIS)

Chu¹,

Wong²,

Chau³

et al. 2006

Prosthetics &Amp; Orthotics International

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In this pilot cross-sectional study, the effectiveness of rigid spinal orthoses in the correction of spinal curvature of 14 patients with moderate adolescent idiopathic scoliosis (AIS) at different recumbent positions (supine, prone, right and left decubitus) was investigated. Using magnetic resonance (MR) imaging and multi-planar reconstruction technique, evaluation of the scoliotic spine in the coronal, sagittal and axial planes and the effect of spinal orthosis on AIS at different recumbent positions was studied. There was significant reduction of coronal Cobb's angle (p 5 0.05) with bracing at all four recumbent positions and the maximal reduction was found in the prone position (18% reduction). The sagittal Cobb's angle was only significantly reduced at the supine position while the axial rotation did not change significantly in all positions.

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Effectiveness and biomechanics of spinal orthoses in the treatment of adolescent idiopathic scoliosis (AIS)

Cited by 62 publications

References 26 publications

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

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

Curve Correction Effect of Rigid Spinal Orthosis in Different Recumbent Positions in Adolescent Idiopathic Scoliosis (AIS)

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