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The Gensingen Brace (GBW) for the same curve pattern (Double Major) as the ART Brace on Fig. (2). This brace is considerably smaller than the braces on Figs. (1 and 2). (With kind permission by Nico Tournavitis, SBPRS, Thessaloniki, Athens, Nicosia).
Source publication
Introduction
Physiotherapeutic Scoliosis-Specific Exercises (PSSE) and bracing have been found to be effective in the stabilization of curves in patients with Adolescent Idiopathic Scoliosis (AIS). Yet, the difference among the many PSSEs and braces has not been studied. The present review attempts to investigate the role of curve correction in the...
Citations
... На современном этапе наиболее перспективными являются научные разработки по медицинской реабилитации больных сколиозом, включающие в себя технологии электростимуляции в составе комплексных методик лечения таких больных [40][41][42][43]. ...
Introduction. Scoliosis is one of the most common orthopedic diseases of childhood and adolescence, leading to disability and reducing the child’s quality of life. The prevalence of scoliosis in the structure of pediatric orthopedic pathology reaches 30 %. In 50 % of cases, the disease is characterized by a severe progressive course, especially during puberty. Aim. Studying the effectiveness of electrical stimulation methods for scoliosis in children to develop recommendations for their practical use based on the analysis of systematic reviews and randomized controlled trials. Materials and methods. The search was carried out using the database of evidence-based physiotherapy PubMed, Cyberleninka and eLIBRARY using the keywords: «electrical stimulation», «pulse currents», «scoliosis», «children» for the period from 2008–2024.Exclusion criteria: articles published on this topic before 2008. Main content. The main methods of physiotherapy used in the treatment of scoliosis in children are electrotherapy methods, among which electrical stimulation plays a leading role. The advantage of electrical stimulation for scoliosis in children is to provide training in the strength and tone of the back muscles on the side of the deformity. Electrical stimulation is indicated for scoliosis of I and II degrees. The greatest effect in the correction of scoliotic spinal deformity in children is observed with the combined use of electrical stimulation and exercise therapy. This review provides data on the relevance of medical rehabilitation of scoliosis in children, the mechanism of action of electrical stimulation, data on the effectiveness of using electrical stimulation methods for scoliosis in children: sinusoidal modulated currents, diadynamic therapy, transcutaneous electrical neurostimulation, interference therapy, fluctuarization and functional programmable electrical stimulation. Conclusion. Currently, a wide range of electrical stimulation technologies has been developed for the medical rehabilitation of children with scoliosis, among which sinusoidally modulated currents and diadynamic currents are most often used. Transcutaneous electrical neurostimulation, having a predominantly antinociceptive effect, also has an effect on muscle contractions. Functional programmable electrical stimulation of muscles is a promising technology for medical rehabilitation of children with scoliosis, requiring further study and scientific justification.
... Several studies have suggested that braces must correct the curve by at least 30-50% to prevent significant curve progression [16][17][18] . Ng et al. found that an in-brace correction lower than 10% was associated with an increased rate of failure of brace treatment, whereas an in-brace correction higher than 40-50% was associated with an increased rate of brace treatment success 35 . ...
The aim of the study is to identify the effects of in-brace correction on coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis (IS). The coronal spinal parameters [Cobb angle, apical vertebral rotation (AVR), lateral trunk shift, coronal alignment, biacromial slope and pelvic asymmetry] and the thoracic cage parameters [T1- 12 height, T1-S1 height, thoracic transverse diameter, and apical vertebral body-rib ratio (AVB-R)] of 89 child and adolescent patients were measured on posterior-anterior full-spine radiographs at pre-brace and in-brace conditions using Surgimap software. The initial in-brace correction (IBC) was calculated as a percentage decrease in the Cobb angle on the in-brace radiographs. The mean IBC rate for the primary curve was 37% (range = 10-100%). In the in- brace condition, the Cobb angle (p<0.001), AVR (p<0.001) and lateral trunk shift (p<0.001) decreased significantly; no statistically significant difference was found in the biacromial slope (p=0.713) and the coronal alignment (p=0.074). The T1-12 height and the T1-S1 height increased significantly (p<0.001) whereas the thoracic transverse diameter and the AVB-R decreased significantly (p<0.001). Unlike IBC rate was below 30% as IBC rate was above 30%, the T1-12 height (p<0.001) increased and the AVB-R decreased (p<0.001). The bracing improved the lateral trunk shift, the AVB-R, the thoracic and spine heights, but decreased the thoracic transverse diameter. The thoracic cage parameters may be better when the IBC rate is above 30%.
... For a clearer analysis, the mean and standard deviation values of the in-brace correction rate of the brace treatment are recommended to be recorded and reported in future studies. The in-brace correction rate has been considered as an assessment standard to evaluate the quality of braces [2], since the larger magnitudes of the in-brace correction rate is associated with a better final treatment outcome [16,32,[51][52][53]. However, the value of the in-brace correction rate was unable to be quantitatively extracted in the included trials and analyzed in this meta-analysis. ...
The CAD/CAM technology has been increasingly popular in manufacturing spinal braces for patients with adolescent idiopathic scoliosis (AIS) in clinics. However, whether the CAD/CAM-manufactured braces or the CAD/CAM-manufactured braces integrating with biomechanical simulation could improve the in-brace correction angle of spinal braces in AIS patients, compared to the manually manufactured braces, has remained unclear. The purpose of this systematic review and meta-analysis was to compare the in-brace correction angle of (1) computer-aided design and computer-aided manufacturing (CAD/CAM)-manufactured braces or (2) the CAD/CAM-manufactured braces integrating with biomechanical simulation with that of (3) manually manufactured braces. The Web of Science, OVID, EBSCO, PUBMED, and Cochrane Library databases were searched for relevant studies published up to March 2023. Five randomized controlled trials (RCTs) or randomized controlled crossover trials were included for qualitative synthesis, and four of them were included for meta-analysis. The meta-analysis effect sizes of the in-brace correction angle for CAD/CAM versus manual method, and CAD/CAM integrating with biomechanical simulation versus the manual method in the thoracic curve group and the thoracolumbar/lumbar curve group were 0.6° (mean difference [MD], 95% confidence intervals [CI]: −1.06° to 2.25°), 1.12° (MD, 95% CI: −8.43° to 10.67°), and 3.96° (MD, 95% CI: 1.16° to 6.76°), respectively. This review identified that the braces manufactured by CAD/CAM integrating with biomechanical simulation did not show sufficient advantages over the manually manufactured braces, and the CAD/CAM-manufactured braces may not be considered as more worthwhile than the manually manufactured braces, based on the in-brace correction angle. More high-quality clinical studies that strictly follow the Scoliosis Research Society (SRS) guidelines with long-term follow-ups are still needed to draw more solid conclusions and recommendations for clinical practice in the future.
... However, nonsurgical interventions for AIS are controversial (Day et al., 2019;Fan et al., 2020). Previous studies have suggested that nonsurgical therapy is an effective treatment for scoliosis, particularly AIS (Dufvenberg et al., 2021;Ng et al., 2017). However, the prevalence of scoliosis is increasing, and many researchers argue that current treatments for AIS are insufficient Płaszewski and Bettany-Saltikov, 2014). ...
Scoliosis is defined as a deviation from the normal vertical line of the spine and consists of a lateral curvature in which the spine rotates within the curvature. Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and the cause is unknown. In this study, it was investigated whether conservative treatment for adolescent idiopathic scoliosis (CONTRAIS) reduced the patient’s Cobb angle, and the effect of CONTRAIS according to the severity of idiopathic scoliosis and the efficacy of CONTRAIS by spinal region were also verified. Idiopathic scoliosis patients with a Cobb angle of 10° or more were recruited and classified into mild, moderate, and severe groups according to the Cobb angle (°). Cobb angle was measured radiographically before and after 10 weeks of treatment. A combination of CONTRAIS, including physical therapy, exercise therapy, manual therapy, and home exercise was prescribed for all patients. The patients visited the hospital 3 times a week for 10 weeks for treatment, and exercised at home for 20 min every day. In this study, the effect of reducing Cobb angle of CONTRAIS did not differ according to the spinal region. Also, the Cobb angle reduction effect of CONTRAIS was more effective in severe group. This study may suggest that early detection and treatment through CONTRAIS enables successful correction of AIS.
... Moderate scoliotic curves are currently treated with a brace-an effective and non-invasive method to decrease curve progression [1][2][3][4][5][6]7]. Some of the widely accepted risk factors for curve progression in AIS include female sex, skeletal immaturity determined by Risser/ tri-radiate cartilage staging and female menarche status, extreme body mass index (BMI), a greater curve magnitude, and specific curve types such as main thoracic curves [1][2][3][4][5][6][8][9][10][11][12]. ...
... For example, in-brace correction is a value measuring the percent decrease in curve magnitude while the patient wears his or her brace compared to the curve magnitude without the brace. Braces that correct the scoliotic curve by at least 40-50% have been shown to stabilize or improve curves while braces that lead to less than 10% correction have been associated with an increased risk of brace failure [6,10]. ...
Background
In-brace correction and brace compliance with thoraco-lumbo-sacral orthotic (TLSO) braces are associated with successful treatment of adolescent idiopathic scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not.
Methods
All skeletally immature (Risser 0-2) patients were treated for AIS (25-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 h a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation.
Results
Ninety patients (F 82, M 8) with an average age of 12.1 (10.1-15.0) years, Risser grade 0 (0-2), BMI percentile 48.5 (0.0-98.8), and daily brace wear of 16.5 (12.1-21.6) h/day were treated for 24.3 (8.0-66.6) months. Patients went through 1.7 (1-4) braces on average. Forty-two out of 90 (46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5-100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014).
Conclusions
Patients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1 (95% CI 1.2-7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays.
Trial registration
ClinicalTrials.gov— NCT02412137 , initial registration date April 2015
Level of evidence
III
... For example, in-brace correction is a value measuring the percent decrease in curve magnitude while the patient wears his or her brace compared to the curve magnitude without the brace. Braces that correct the scoliotic curve by at least 40-50% have been shown to stabilize or improve curves while braces that lead to less than 10% correction have been associated with an increased risk of brace failure [10,15]. ...
Background
In-brace correction and brace compliance with Thoraco-Lumbo-Sacral Orthotic (TLSO) braces are associated with successful treatment of Adolescent Idiopathic Scoliosis (AIS). This paper compares patients who had consistent radiographic documentation of in-brace correction to those who did not.Methods
All skeletally immature (Risser 0–2) patients were treated for AIS (25°-45°) with full-time TLSO braces that had compliance temperature monitors. All patients wore their braces at least 12 hours a day. Brace failure was defined as curve progression to a surgical magnitude (≥ 50°). All patients were followed until brace discontinuation.Results90 patients (F:82, M:8) with an average age of 12.1(10.1–15.0) years, Risser grade 0(0–2), BMI percentile 48.5(0.0-98.8), and daily brace wear of 16.5(12.1–21.6) hrs/day were treated for 24.3(8.0-66.6) months. Patients went through 1.7(1–4) braces on average. 42/90(46.7%) patients had some amount of brace time with an unknown in-brace correction, which, on average, was 66.1% of their total treatment course (11.5–100). On univariate analysis, patients that did not have a repeat in-brace x-ray with major brace adjustments or new brace fabrication tended to be more skeletally immature (Risser 0 and tri-radiate open, p = 0.028), wear more braces throughout their treatment (2.0 vs 1.4, p < 0.001), were treated for a longer period of time (27 vs 22 months, p = 0.022), and failed bracing more often (47.6% vs 22.9%, p = 0.014).Conclusions
Patients who did not have new in-brace x-rays with major brace adjustments and/or new brace fabrication were 3.1(95% CI 1.2–7.6) times more likely to fail bracing than patients who were re-checked with new in-brace x-rays. Trial Registration: ClinicalTrials.gov - NCT02412137, Initial Registration Date April 2015
... AIS causes many problems, such as cosmetic, respiratory, and mobilization problems (3) . Bracing for 23 hours per day is the conservative treatment of choice when the Cobb angle is between 20 and 40 degrees with remaining growth potential, whereas spinal fusion is in order when the Cobb angle is >40 degrees with remaining growth potential or >45 degrees at skeletal maturity (4,5) . Studies reporting conservative treatment emphasize the importance of early diagnosis and treatment (6) . ...
Objective: Although adolescent idiopathic scoliosis (AIS) is the most commonly observed spinal deformity, there is limited bibliographic analysis
of AIS in the literature. The aims of this study were to identify and analyze the top 50 most cited articles on AIS.
Materials and Methods: On February 6th, 2020, we searched the Thomson Reuters Web of Science-Science Citation Index Expanded database
using the term, “AIS”. We listed the articles by their number of citations. The titles of the articles, citation number, citation density, article content,
journal of publication, author name, publishing country, institute, publishing specialty, and year of publication were noted.
Results: The mean citation number was 210.4±148 (range: 117-873); the mean citation density was 12.8±14 (range: 3-46). The contents of 25
articles (50%) were related to surgical treatment outcomes. Most of the articles (74%) were published in “Spine”, and the total citation number
was 6978. Most of the articles (67%, 33 articles) were published from the United States (USA). The first specialty of the primary authors of 46
articles was orthopedic surgery; LG Lenke and YJ Kim had the most citations for AIS-related articles. There was only one level 1 study.
Conclusion: Our bibliographic analysis showed that most studies were based on surgical treatment for AIS in the USA, and that “Spine” had
published more than 50% of these studies. Although the number of publications has increased rapidly over the years, prospective randomized
trials for AIS treatment are still lacking.
Keywords: Adolescent idiopathic scoliosis, citation analysis, bibliographic analysis, classic papers
... Finally, it is known that bracing outcomes are strongly influenced by the compliance of patients to brace-wear prescriptions [1,[35][36][37][38]. As stated above, one of the key potential benefits of night-time bracing is greater compliance with treatment. ...
Study designSystematic review of the literature.PurposeTo systematically review the literature to assess the efficacy of night-time bracing in controlling curve progression with respect to traditional full-time thoraco-lumbo-sacral orthoses (TLSOs) in patient with adolescent idiopathic scoliosis.Methods
PubMed, Ovid, Cochrane Reviews and Google Scholar were all accessed and a combination of terms and keywords pertaining to the core concept was used in the research. Case reports, technical notes, instructional courses, literature reviews, biomechanical and/or in vitro studies were all excluded, as well as case series (level IV studies). The methodological quality of the selected articles was assessed using the MINORS methodology score. Given the overall level and quality of the available evidence, conclusions were drawn based on a summary of the evidence.ResultsSeven studies were included. Five papers reported no differences in curve progression between traditional TLSOs and night-time braces and the remaining two studies reported TLSO to be superior.Conclusion
The current available literature does not permit us to draw conclusions about night-time braces. The low methodological quality of the studies examined makes it impossible to compare the effectiveness of the night-time braces with that of traditional TLSOs. Prospective well-designed clinical trials applying SRS inclusion and evaluation criteria are mandatory to better define the role of night-time orthosis in the treatment of adolescent idiopathic scoliosis.
The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of scoliosis in scoliotic disease. The current classification, diagnostics features, and clinical course of the disease are addressed. Current approaches to the choice of medical rehabilitation methods for scoliotic disease in children are described: therapeutic exercise, hydrokinesiotherapy, massage, physiotherapeutic treatment, kinesiotaping, and corseting. Special consideration is given to postoperative management and stages of medical rehabilitation of children with scoliosis, including resort treatment.
