The Biomechanical Effectiveness of the Boston Brace in the Management of Adolescent Idiopathic Scoliosis

Chase, Andrew P.; Bader, Dan L.; Houghton, G. R.

doi:10.1097/00007632-198906000-00018

Cited by 58 publications

(42 citation statements)

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“…When considering the global statistics, the results concurred with most of the previous clinical studies [2,7,18]. A significant diminution of the Cobb angle was observed, which is the expected effect of brace treatment and the direct application of a force close to the apex of the curve.…”

Section: Discussionsupporting

confidence: 88%

3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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Purpose We have evaluated the effect of bracing in scoliosis on coronal alignment in a cohort of patients. Current literature has not described the specific effect of bracing on the 3D shape of the scoliotic curves. The purpose of this study was to analyze the variability of the 3D effect of bracing on idiopathic scoliosis. Materials and methods The spines of 30 patients with adolescent idiopathic scoliosis were reconstructed using biplanar stereoradiography with and without the brace. The Cobb angle, sagittal and pelvic parameters and transverse plane parameters were calculated. The variability and the mean values of each parameter, with and without a brace, were analyzed and compared using a student t test. Results The Cobb angle improved in 50 % of patients but remained unchanged in 50 % cases. In 90 % of the cases lordosis was decreased. The thoracic kyphosis was decreased in 26 % cases, unchanged in 57 % of cases and increased in 17 % cases. The AVR was improved ([5°) in 26 % cases, worsened in 23 % and unchanged in 50 %. Only the differences of Cobb angle and the lordosis were statistically significant.Conclusions Global statistics of this study concur with the literature. The Cobb angle was significantly improved. It also showed a significant hypolordotic effect. However, the results showed a high variability of the brace treatment effect in almost every parameter. Analysis of this variability by means of 3D reconstructions instead of global statistics should help characterize the mechanisms of correction of brace treatment.

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Section: Discussionsupporting

confidence: 88%

3D analysis of brace treatment in idiopathic scoliosis

et al. 2013

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“…Our results are comparable to those of Wong and Evans (1998), who found that increasing the thoracic strap tension of a Milwaukee brace resulted in an increase in thoracic pad pressure. Likewise, Chase et al (1989) showed that a 50% increase in strap tension resulted in a 20% increase in the mean force exerted through the Boston brace's compression pads. It would have been interesting to quantify the strap tensions of our braces.…”

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 forces calculated from the optimisation method were a little higher than the equivalent brace forces calculated in the literature from pressure measurements at the brace-torso interface (AUBIN et al, 1999;MULCAHY et al, 1973;CHASE et al, 1989). The orthoses analysed in the literature were the Boston brace with forces up to l13N (AUBIN et al, 1999;CHASE et al, 1989) and the Milwaukee brace with forces of 17N (MULCAHY et al, 1973).…”

Section: Discussionmentioning

confidence: 85%

“…Some measurements of contact pressure at the brace-think interface (CHASE et al, 1989;COCHRAN and NACHEMSON, 1985;JIANG et al, 1992;MULCAHY et al, 1973) and tensions in the straps (AUBIN et al, 1999) Boston and Milwaukee braces, but the way in which such forces modified the 3D spinal deformities was not quantified. Threedimensional finite element (FE) models of the spine and thorax have been developed to simulate the brace effect on typical scoliotic spines (ANDRIACCHI et al, 1976;PATWARDAN et al, 1990;WYNARSKY and SCHULTZ, 1991;GIGNAC et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of Cheneau-Toulouse-Munster brace in the treatment of scoliosis using optimisation approach and finite element method

Périé

Gauzy

Hobatho

2002

Med. Biol. Eng. Comput.

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The aim of the study was to investigate the mechanisms of the Cheneau-Toulouse-Munster (CTM) brace in the correction of scoliotic curves, at night in the supine position. Magnetic resonance imaging (MRI) and Computer tomography (CT) acquisitions were performed in vivo on eight girls having an idiopathic scoliosis and being treated for the first time using a personalized CTM brace. Personalized 3D finite element models of the spine were developed for each patient, and an optimisation approach was used to quantify the forces generated by each brace on each scoliotic spine. A sensitivity study was undertaken to test the assumptions about intervertebral behaviour and load transmission from the brace to the spine. The computed CTM brace forces were 9-216N in the coronal plane and 2-72N in the sagittal plane. Personalized spinal stiffness properties should be included in spine models because, in this study, partial correction resulted from the application of higher estimated forces than for total correction. Partially reduced spines should be stiffer than totally reduced spines. The sensitivity study showed that the computed brace forces were proportional to the intervertebral Young's modulus and should be analysed as estimated data. Better knowledge of brace forces should be helpful in brace design to achieve the best correction of first scoliotic deformities.

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The Biomechanical Effectiveness of the Boston Brace in the Management of Adolescent Idiopathic Scoliosis

Cited by 58 publications

References 0 publications

3D analysis of brace treatment in idiopathic scoliosis

3D analysis of brace treatment in idiopathic scoliosis

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

Biomechanical evaluation of Cheneau-Toulouse-Munster brace in the treatment of scoliosis using optimisation approach and finite element method

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