Andrew Chan1, Edmond Lou2, Doug Hill3. 1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada. 2. Department of Surgery, Glenrose Rehabilitation Research Center, University of Alberta, 10230-111 Ave., Edmonton, AB T5G 0B7 Canada ; Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, AB Canada. 3. Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, AB Canada.
Abstract
PURPOSE: To report on the current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis. METHODS: A comprehensive literature review was performed to determine the effectiveness of bracing, to report on imaging techniques that can assist in the assessment of bracing, to understand the roles of the biomechanical treatment concepts on bracing and to address the importance of the quality of life of the brace wearers. RESULTS: The effectiveness of bracing still remains controversial. Many technologies are still in development to improve the bracing process and quantify the effects of bracing. Imaging techniques with decreased or no radiation are promising in providing more frequent data on curve progression for patients. Computer-assisted design models have been used for both fitting and manufacturing the brace to patient contours. Ultrasound has been developed as a new means of diagnosing scoliosis and determining the effects of a brace on a patient's spine in real time. The brace treatment outcomes are correlated to the quantity and the quality of brace usage. Compliance monitors and force sensors have been developed to track the quality of brace usage. Improvements to brace wear also require consideration of patient quality of life. Surveys have been developed to describe the effects of family influence and self-image on bracing effectiveness of patient quality of life. CONCLUSIONS: Bracing remains a highly qualitative process, relying on the empirical judgment of the physicians and orthotists, along with buy-in with the patient. The suggested improvements will help to push bracing into a more evidence-based practice.
PURPOSE: To report on the current technologies and methods supplementing brace treatment in adolescent idiopathic scoliosis. METHODS: A comprehensive literature review was performed to determine the effectiveness of bracing, to report on imaging techniques that can assist in the assessment of bracing, to understand the roles of the biomechanical treatment concepts on bracing and to address the importance of the quality of life of the brace wearers. RESULTS: The effectiveness of bracing still remains controversial. Many technologies are still in development to improve the bracing process and quantify the effects of bracing. Imaging techniques with decreased or no radiation are promising in providing more frequent data on curve progression for patients. Computer-assisted design models have been used for both fitting and manufacturing the brace to patient contours. Ultrasound has been developed as a new means of diagnosing scoliosis and determining the effects of a brace on a patient's spine in real time. The brace treatment outcomes are correlated to the quantity and the quality of brace usage. Compliance monitors and force sensors have been developed to track the quality of brace usage. Improvements to brace wear also require consideration of patient quality of life. Surveys have been developed to describe the effects of family influence and self-image on bracing effectiveness of patient quality of life. CONCLUSIONS: Bracing remains a highly qualitative process, relying on the empirical judgment of the physicians and orthotists, along with buy-in with the patient. The suggested improvements will help to push bracing into a more evidence-based practice.
Authors: C McKenna; R Wade; R Faria; H Yang; L Stirk; N Gummerson; M Sculpher; N Woolacott Journal: Health Technol Assess Date: 2012 Impact factor: 4.014
Authors: C E Aubin; H Labelle; A Ruszkowski; Y Petit; D Gignac; J Joncas; J Dansereau Journal: Spine (Phila Pa 1976) Date: 1999-02-15 Impact factor: 3.468