In our Institute for many years we have asked patients to perform sport activities freely while in treatment, wearing braces or not, because of the physical and psychological advantages. Our aim was to verify whether it is really possible for patients to perform sport with the brace on, and if they complied with this proposal.
Retrospective cohort study nested in a prospective clinical database. Inclusion criteria: Adolescent Idiopathic Scoliosis (AIS), start of brace treatment, never treated before, Risser 0-3, age 10-16 years.
607 patients, 13.0±2.1 of age, 33.1°±12.0° Cobb. The sport practice in the first six months of bracing was evaluated, searching for changes in the number of patients performing sport activities and in the average sport activity in the considered subgroups. Groups considered included type of brace (Lyon, LSO, Sforzesco, Sibilla, others) and hours of bracing: 22-24 (sport in brace), 19-21, 18 (sport without the brace).
Patients with worst curves (and more hours of bracing prescribed) at the baseline practiced less sport then the others. Sport behaviour did not change with treatment: number of patients performing sport were 51.3% at start, 49.9% at the end. The hours of sport per week had a slightly but statistically significant reduction from 1.3±1.6 to 1.2±1.5 (P<0.05), mainly due to the decreased number of patients performing two sports (22.4% before, 18.1% after). General results were confirmed in the different subgroups, with no difference between groups performing in-brace or out-of-brace sport. CONCLUSION; It is possible to undergo brace treatment and continue normally practicing sport, if this is explained to patients and parents and if braces are designed in a way to allow it.
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"this is true even if they really wear their orthosis full time (23 hours per day), in accordance with Thermobrace sensor studies performed by the same research group . In our view, several factors are needed to make patients able to freely perform sport: specific physician prescription, a strong and committed treating team  , and a good brace allowing freedom of limb movements (active brace concept)  . We can easily hypothesize that sports can have a greater effect in accumulating BMD, due to its higher bone impact together with a bigger aerobic activation than PSSE; in this respect, sport can really be the active partner of PSSE. "
[Show abstract][Hide abstract] ABSTRACT: Brace treatment is often recommended for adolescents with idiospathic scoliosis with moderate curvature and has recently been demonstrated to slow down curve progression even in cases of more severe curvature. However, brace treatment may come at a physiological cost. Namely, the restrictive nature of bracing could preclude or discourage physical activity, while its rigidity might reduce core muscle use and therefore, core muscle strength. Both of these could potentially result in lower bone mineral accrual during the growing years and lower peak bone mass at adulthood. While scoliosis-specific exercises may sometimes be used independently or in conjunction with brace treatment, we believe that any treatment for AIS, and especially brace treatment, should include exercise protocols that prevent bone mineral loss and promote bone mineral gain.
No preview · Article · May 2014 · The Spine Journal
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To evaluate the effectiveness of a combined Traditional Chinese Medicine (TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis. METHODS: One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group (TCMG) and a brace group (CG). TCMG patients underwent Daoyin, Tuina, and acupotomology therapies. CG patients were treated with a Milwaukee brace. Each patient's Cobb angle was measured after 12 and 24 months of treatment, and pulmonary function was determined after 12 months of treatment. Average electromyogram (AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months. RESULTS: The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment (P < 0.05). The percentages of original Cobb angle in TCMG and CG were 51.4% and 47.8% (P > 0.05) after 12 months and 62.5% and 34.7% (P < 0.05) after 24 months, respectively. Pulmonary function significantly improved after 12 months in TCMG (P < 0.05) but significantly decreased in CG (P < 0.05). The AEMG ratio was significantly lower (P < 0.01) and tended to remain at 1 after stopping treatment in TCMG, but increased in CG (P < 0.05). CONCLUSION: TCM combined therapy can prevent the progression of scoliosis. The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.
Full-text · Article · Oct 2015 · Journal of Traditional Chinese Medicine