Top

European Spine Journal

Published in:

01-02-2016 | Original Article

How quantity and quality of brace wear affect the brace treatment outcomes for AIS

Authors: Edmond H. M. Lou, Douglas L. Hill, Jim V. Raso, Marc Moreau, Douglas Hedden

Published in: European Spine Journal | Issue 2/2016

Abstract

Purpose

To determine the reliability of a prognostic curve progression model and the role of the quantity and quality of brace wear for adolescent idiopathic scoliosis (AIS) brace treatment.

Methods

To develop a curve progression model for full-time AIS brace treatment, 20 AIS subjects (Group 1) prescribed full-time thoracolumbar sacral orthosis (TLSO) were monitored and followed for 2 years beyond maturity. The developed curve progression model was: curve progression (in degrees) = 33 + 0.11 × Peterson risk (%) − 0.07 in-brace correction (%) − 0.45 × quality (%) − 0.48 × quantity (%) + 0.0062 × quantity × quality. To validate the model, 40 new (test) subjects (Group 2) who met the same inclusion criteria and used the same type of monitors, were monitored and followed for 2 years after bracing.

Results

For the 40 test subjects (Group 2), the average in-brace correction was 40 ± 22 %. The average quantity and quality of the brace wear were 56 ± 19 and 55 ± 17 %, respectively. Twelve subjects (30 %) progressed of which 10 subjects (25 %) required surgery and 28 subjects (70 %) showed no progression. The accuracy of the model to determine which patients would progress was 88 % (35/40) which was better than the Peterson’s risk model (68 %; 26/40) alone. Patients who had the combined quantity times the quality over a threshold 43 % had a success treatment rate of 95 %.

Conclusions

This study showed the prognostic model of brace treatment outcome on AIS patients treated with full-time TLSO was reliable. Both the quantity and quality of the brace wear were important factors in achieving successful brace treatment.

Lonstein JE (1994) Adolescent idiopathic scoliosis. Lancet 344:1407–1412PubMedCrossRef

Negrini S, Grivas TB, Kotwicki T, Maruyama T, Rigo M, Weiss HR, The Members of The Scientific Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) (2006) Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper. Scoliosis 1:4

Weinstein SL, Dolan LA, Wright JG, Dobbs MB (2013) Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 396:1512–1521CrossRef

Ajemba P, Ramirez L, Durdle N, Hill D, Raso J (2005) A support vectors classifier approach to predicting the risk of progression of adolescent idiopathic scoliosis. IEEE Trans Inf Technol Biomed 9:276–282PubMedCrossRef

Lonstein JE, Carlson M (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg 66:1061–1071PubMed

Negrini S, Aulisa A, Aulisa L, Circo A (2011) 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 7:3–37CrossRef

Peterson LE, Nachemson AL (1985) Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. J Bone Joint Surg 77(6):823–827

Wynasky GT, Schultz AB (1991) Optimization of skeletal configuration: studies of scoliosis correction biomechanics. J Biomech 24(8):721–732CrossRef

Lou E, Raso VJ, Hill DL, Durdle NG, Mahood JK, Moreau MJ (2004) Correlation between quantity and quality of orthosis wear and treatment outcomes in AIS. Prosthet Orthot Int J 28:49–54

10.

Lou E, Hill D, Raso J, Mahood J, Moreau M (2006) Prediction of brace treatment outcomes by monitoring brace usage. Stud Health Technol Inform 123:239–244PubMed

11.

Richards BS, Bernstein RM, D-Amato CR et al (2005) Standardization of criteria for adolescent idiopathic scoliosis brace studies: SRS Committee on Bracing and Nonoperative Management. Spine 30:2068–2075PubMedCrossRef

12.

Upadhyay S, Nelson I, Ho E, Hsu L, Leong J (1995) New prognostic factors to predict the final outcome of brace treatment in adolescent idiopathic scoliosis. Spine 20:537–545PubMedCrossRef

13.

Katz D, Herring J, Browne R, Kelly D, Birch J (2010) Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg 92:1343–1352PubMedCrossRef

14.

Dolan L, Weinstein S (2007) Surgical rates after observation and bracing for adolescent idiopathic scoliosis. Spine 32:S91–S100PubMedCrossRef

15.

Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas T, Kotwicki T, Maruyama T, Romano M, Vasiliadis E (2010) Braces for idiopathic scoliosis in adolescents. Spine 35:1285–1293PubMed

16.

Rowe D, Michigan K (2003) Idiopathic scoliosis. The Scoliosis Research Society Brace Manual. http://www.srs.org/professionals/education_materials/SRS_bracing_manual/. Accessed 2003

17.

Wu H, Ronsky J, Cheriet F, Kupper J, Harder JA, Xue D, Zernicke RF (2010) Prediction of scoliosis progression with serial three-dimensional spinal curves and the artificial progression surface technique. Med Biol Eng Comput 48:1065–1075PubMedCrossRef

18.

Wu H, Ronsky J, Poncet P, Cheriet F, Xue D, Harder JA, Zernicke RF (2005) Prediction of scoliosis progression in time series using a hybrid learning technique. In: Proceedings of the 2005 IEEE engineering in medicine and biology 27th annual conference, Shanghai, China, pp 6452–6455

19.

Peduzzi P, Concato J, Feinstein AR, Holford TR (1995) Importance of events per independent variable in proportional hazards regression analysis. II. Accuracy and precision of regression estimates. J Clin Epidemiol 48(12):1503–1510PubMedCrossRef

Title: How quantity and quality of brace wear affect the brace treatment outcomes for AIS
Authors: Edmond H. M. Lou
Douglas L. Hill
Jim V. Raso
Marc Moreau
Douglas Hedden
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4233-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How quantity and quality of brace wear affect the brace treatment outcomes for AIS

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2016

The influence of brace immobilization on the remodeling potential of thoracolumbar impaction fractures in children and adolescents

Announcements for issue 2, 2016

Factors predicting postoperative complications following spinal fusions in children with cerebral palsy scoliosis

The impact of posterior temporary internal distraction on stepwise corrective surgery for extremely severe and rigid scoliosis greater than 130°

Interest of T1 parameters for sagittal alignment evaluation of adolescent idiopathic scoliosis patients