Article

Bracing does not change the sport habits of patients

Physical and Rehabilitation Medicine, University of Brescia, Italy.
Studies in health technology and informatics 06/2012; 176:437-40. DOI: 10.3233/978-1-61499-067-3-437
Source: PubMed

ABSTRACT

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 [13]. In our view, several factors are needed to make patients able to freely perform sport: specific physician prescription, a strong and committed treating team [12] [14], and a good brace allowing freedom of limb movements (active brace concept) [15] [16]. 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. "

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    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.
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