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Kuru Çolak T, Dereli EE, Akçay B, Apti A, Lasa Maeso S. The Efficacy of Night Bracing in the Treatment of Adolescent İdiopathic Scoliosis: A Systematic Review. J Clin Med 2024; 13:3661. [PMID: 38999227 PMCID: PMC11242083 DOI: 10.3390/jcm13133661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: The effectiveness of night braces alone or in combination with other treatments for adolescent idiopathic scoliosis remains unclear. This systematic review study aimed to review and analyze the available literature to determine whether night braces are an effective treatment for idiopathic scoliosis. Methods: A total of 162 databases, including Cochrane Library (reviews, protocols, trials), Web of Science, PubMed, Medline, Scopus, PEDro, CINAHL (EBSCO), Ovid and Google Scholar, were searched for published articles from inception to February 2024. The available literature was screened by the following terms: "scoliosis and night-time brace", "scoliosis and night brace", "scoliosis and part-time bracing", "scoliosis and Providence" and "scoliosis and Charleston". Results: Twenty studies were included; only one study was a randomized controlled trial, and most of the studies were retrospectively designed. Providence, Charleston and Boston braces were used as night braces. The Cobb angle was evaluated in all studies, and Cobb angle change after treatment and surgical treatment rates were the parameters that were evaluated the most. In one study, the angle of trunk rotation, quality of life, perception of spinal appearance, and physical activity level were measured. In one study, sagittal plane assessments were performed in addition to the Cobb angle. Conclusions: The results of this review suggest that there is no evidence to support the use of night braces in the treatment of adolescent idiopathic scoliosis. Randomized controlled trials with a well-designed methodology are needed to determine the efficacy of night braces.
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Affiliation(s)
- Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul 34854, Turkey
| | - Elif Elçin Dereli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul 34060, Turkey
| | - Burçin Akçay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir 10250, Turkey
| | - Adnan Apti
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Kültür University, Istanbul 34158, Turkey;
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Weiss HR. Letter to the editor regarding Unuvar BS, Yilmaz K, and Celik F: the acute effects of brace use on lower extremity performance in individuals with adolescent idiopathic scoliosis. Ir J Med Sci. 2023. Ir J Med Sci 2024; 193:1321-1322. [PMID: 38217673 PMCID: PMC11128379 DOI: 10.1007/s11845-024-03605-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Affiliation(s)
- Hans-Rudolf Weiss
- Schroth Best Practice Academy, Haarbergweg 2, 55546, Neu-Bamberg, Germany.
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Nan X, Kuru Çolak T, Akçay B, Xie H, Zhao L, Borysov M. Results of Gensingen Bracing in Patients With Adolescent Idiopathic Scoliosis: Retrospective Cross-Sectional Feasibility Study. JMIR Rehabil Assist Technol 2024; 11:e50299. [PMID: 38198197 PMCID: PMC10809064 DOI: 10.2196/50299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Bracing is an essential part of scoliosis treatment. The standard of brace treatment for patients with scoliosis today is still very variable in terms of brace quality and outcome. The Gensingen brace is a further developed Chêneau brace derivative with individual design, which can be adapted through computer-aided design. OBJECTIVE This study aims to generate a template to obtain a database for prospective multicenter studies study to analyze the results of high-corrective asymmetric Gensingen brace treatment for patients with adolescent idiopathic scoliosis (AIS). METHODS A template for the database was created, which contains the patients' basic data (age, menarcheal status, Risser Sign, curve pattern, and daily brace wearing time), the Cobb angles of curvature, and the cosmetically relevant angles of trunk rotation (ATR). A retrospective review of medical records of patients with AIS, who met the Scoliosis Research Society's inclusion criteria for brace studies, was performed to test the feasibility of the template. Template items were filled in by the researchers. RESULTS Out of 115 patients between 2014 and 2018, the complete data of 33 patients followed up at least 3 months after complete Gensingen brace weaning could be analyzed. The mean age was 12 years, the mean Cobb angle was 33.6°, and the mean Risser value was 0.7 at the beginning of the treatment. The mean improvement in the Cobb angle on in-brace x-ray imaging was -26.1० (80% of in-brace correction). The Cobb angle of the major curvature changed as follows: curve stabilization was achieved in 7 (21.2%) cases, and curve improvement was achieved in 26 (78.8%) cases. None of the patients showed a curve progression. The Cobb angle was significantly reduced in the brace at the end of treatment and at follow-up evaluation (P<.001). ATR improved significantly for thoracic (P<.001) and lumbar curves (P<.001). CONCLUSIONS The database proved to be informative in the assessment of radiological and clinical outcome parameters. The example data set we have generated can be a helpful tool for professionals who work in clinics but do not store regular patient data. Especially with regard to different patient collectives worldwide, different results may be achieved with the same standards of care. In addition, the results of this study suggest that above-average correction effects with a full-time brace application lead to significant improvements in the Cobb angle after brace treatment has been completed.
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Affiliation(s)
- Xiaofeng Nan
- Nan Xiaofeng's Spinal Orthopedic Workshop, Xi'an Shaanxi, China
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, İstanbul, Turkey
| | - Burçin Akçay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Hua Xie
- Schroth Health Technology, Chongqing, China
| | - Liwei Zhao
- National Research Centre for Rehabilitation Technical Aids, Schroth Health Technology, Beijing, China
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Widjaja BS, Varani R. Impact of Gensingen brace treatment on Lenke 5 curvatures and chronic low back pain in late adolescent and adult scoliosis patients. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1585. [PMID: 35402746 PMCID: PMC8991184 DOI: 10.4102/sajp.v78i1.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/08/2021] [Indexed: 11/01/2022] Open
Abstract
Background Lenke 5C (lumbar and or thoracolumbar) curve patterns lead to loss of lumbar lordosis which is associated with low back pain in later adulthood. We undertook our study to investigate if brace treatment may have an effect on low back pain and on improving the cosmetic appearance in late adolescents and adults. Objectives To estimate if conservative treatment may have an effect on pain in single lumbar curvatures in late adolescent and adult patients with Adolescent Idiopathic Scoliosis (AIS) using a Gensingen Brace by Weiss (GBW). Method We investigated AIS patients with Lenke 5C pattern who wore a GBW prospectively. The inclusion criteria of our study were age over 15 years, Cobb angle greater than 20° before treatment and Risser 4 or 5. A verbal pain rating scale was used (no pain, mild pain, moderate pain, severe pain, very severe pain). Results A total of 26 patients met the inclusion criteria. The average age was 17.7 years and the average Cobb angle was 41.5°. Nineteen patients (73.1%) experienced mild or moderate chronic low back pain before treatment and seven patients (26.9%) were asymptomatic but seeking treatment for cosmetic reasons. At follow-up, a 23% correction of the curve was achieved. All previously symptomatic patients reported that they no longer experienced low back pain after having worn the brace regularly. Conclusion High correction bracing seems to have a positive effect on the curve and on chronic low back pain in patients with a scoliosis and a Lenke 5C curve pattern. Clinical implications High correction, pattern specific bracing with a GBW may be applied aiming at reducing structural curves and chronic low back pain in late adolescent and adult patients with AIS and with a single lumbar curvature.
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Affiliation(s)
- Budi S Widjaja
- Schroth Best Practice Academy, Neu-Bamberg, Germany.,Spine Clinic Family Holistic, Jakarta, Indonesia
| | - Regina Varani
- Schroth Best Practice Academy, Neu-Bamberg, Germany.,Spine Clinic Family Holistic, Jakarta, Indonesia
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Costa L, Schlösser TPC, Kruyt MC, Castelein RM. Reply to Weiss, H.-R. Comment on "Costa et al. The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 2145". J Clin Med 2022; 11:918. [PMID: 35207191 PMCID: PMC8880013 DOI: 10.3390/jcm11040918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/02/2022] [Indexed: 02/05/2023] Open
Abstract
We would like to thank you for the opportunity to reply to the comments in regard of the letter by Dr. Weiss [...].
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Affiliation(s)
| | | | | | - René M. Castelein
- Department of Orthopaedic Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; (L.C.); (T.P.C.S.); (M.C.K.)
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Weiss HR. Comment on Costa et al. The Effectiveness of Different Concepts of Bracing in Adolescent Idiopathic Scoliosis (AIS): A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 2145. J Clin Med 2022; 11:jcm11030752. [PMID: 35160205 PMCID: PMC8836822 DOI: 10.3390/jcm11030752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/02/2021] [Accepted: 01/27/2022] [Indexed: 02/05/2023] Open
Abstract
I read the above-mentioned work with great interest, and I would like to thank the authors for considering two papers from our working group [...]
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Tournavitis N, Çolak TK, Voutsas C. Effect of Chêneau style braces on vertebral wedging amongst individuals with adolescent idiopathic scoliosis. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1617. [PMID: 34966856 PMCID: PMC8689379 DOI: 10.4102/sajp.v77i2.1617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/15/2021] [Indexed: 11/05/2022] Open
Abstract
Background It is generally accepted that braces can stop curve progression but little evidence exists regarding structural improvement in the spine using spinal bracing. Our study aimed to investigate the possible structural improvements of vertebral wedging with high correction bracing. Objectives The aim of our study was to assess whether spinal brace treatment may influence vertebral wedging in adolescent idiopathic scoliosis (AIS). Method We reviewed our database according to the following inclusion criteria: girls with a diagnosis of AIS, Risser 0–2, age 10–14 years with Cobb angles greater than 35°. Our study cohort consisted of 27 patients fulfilling the inclusion criteria with an average brace wearing time of 16.6 h per day and Cobb angles between 36° and 79°. The target value for our study was the apical vertebra wedging, measured twice before brace treatment commenced and twice after the average follow-up period of 20.5 months of treatment. Results The average apex wedging noted before brace wearing started was 9.8° (median: 9) and after a period of 20.5 months of brace wearing, it had reduced to an average of 5.8° (median: 4.9), (p < 0.001). This would indicate a structural correction of 44%. Conclusions Our study supports the hypothesis that spinal high correction braces improve the degree of vertebral wedging in skeletally immature girls with AIS. Clinical implications Structural corrections of the apical vertebra seem possible when high correction asymmetric braces are used in the treatment of patients with AIS.
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Affiliation(s)
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Marmara University, Istanbul, Turkey
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Çolak TK, Weiss HR. Spinal deformities: Evidence and patient safety in management. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1757. [PMID: 34966857 PMCID: PMC8689376 DOI: 10.4102/sajp.v77i2.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Hans-Rudolf Weiss
- Schroth Best Practice Academy, Neu-Bamberg, Germany.,Koob Scolitech GmbH, Neu-Bamberg, Germany
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Dereli EE, Gong S, Çolak TK, Turnbull D. Guidelines for the conservative treatment of spinal deformities - Questionnaire for a Delphi consensus. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1587. [PMID: 34957343 PMCID: PMC8678962 DOI: 10.4102/sajp.v77i2.1587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background Spinal deformity is the oldest disease known to humankind. Many types of treatment methods, including both conservative and surgical, are in use. Objective We aimed to validate a published guideline protocol based on the conservative treatment of spinal deformities. Method A modified Delphi technique was used with a questionnaire sent out to professionals worldwide regarding the conservative treatment of spinal deformities. Results Our study was completed after two rounds. A strong level of agreement of 80% and more (consensus cut-off point) was achieved in most questions in the first round. Some statements were below this margin, and they were sent to the participants via email in the second round for re-evaluation. Consensus was achieved in almost all of the statements in the second round. Only two items did not reach the cut-off point but were close to this value. Conclusion This proposed Guideline Protocol was approved by the participants using the Delphi method and can be used as a valid tool for the conservative treatment of spinal deformities. Clinical implications A conservative treatment guideline in spinal deformity management, will provide consistency in treatment and will facilitate comparability with surgery. It will be useful in determining the cost-effectiveness of treatment and in choosing the right patient for the right method of treatment. This guideline might help in this context, and may also create a systematic method for clinicians to use as a reference in both research and clinical practice.
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Affiliation(s)
- Elif E Dereli
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Program, Istanbul Bilgi University, Istanbul, Turkey
| | - Shaopeng Gong
- Wuhan Schroth Scoliosis Service Center, Wuhan, Hubei, China
| | - Tuğba Kuru Çolak
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Deborah Turnbull
- School of Health and Social Care, University of Teesside, Middleborough, MA, United States of America.,The London Orthotic Consultancy, Kingston upon Thames, United Kingdom
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Weiss HR, Lay M, Best-Gittens T, Moramarco M, Jimeranez M. Conservative treatment of a scoliosis patient after two heart surgeries in early childhood - A case report. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1588. [PMID: 34917835 PMCID: PMC8661293 DOI: 10.4102/sajp.v77i2.1588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/14/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD). Patient presentation, management and outcome Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve of 65° Cobb. Because of the high risk for progression, immediate brace treatment was proposed as the father declined surgery. The patient received intensive treatment according to the Schroth Best Practice® programme and a Gensingen Brace® designed for large thoracic curves. Over the 18 months following the initial visit, she received two additional braces. As a result, the progression of the main curve was prevented. The patient continues to maintain an improved cosmetic result and is currently at a Risser 2. Conclusion Surgery performed for CHD in rare cases may lead to stiff spinal deformity as a consequence of that surgery. Progression of a severe and stiff curve was prevented during the most vulnerable phase of the pubertal growth spurt with an improved clinical result. Therefore, we assume that the patient may have a normal life in adulthood with minor restrictions only. Supported by pattern-specific high correction exercises and braces, these typical single thoracic curves can be re-compensated to a more balanced appearance, less prone to progression in adulthood. Clinical implications Because of the relative high risks of spinal fusion and the long-term unknowns of such an intervention, high-impact conservative treatment should be implemented first before surgical correction is considered.
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Affiliation(s)
- Hans-Rudolf Weiss
- Schroth Best Practice Academy, Neu-Bamberg, Germany.,Koob Scolitech GmbH, Neu-Bamberg, Germany
| | - Manuel Lay
- Orthopedic Technology, Orthopädietechnik Lay GmbH, Zell-Barl, Germany
| | | | - Marc Moramarco
- Scoliosis3DC/Private Practice, Woburn, United States of America
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Weiss HR, Çolak TK, Lay M, Borysov M. Brace treatment for patients with scoliosis: State of the art. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1573. [PMID: 34859162 PMCID: PMC8603182 DOI: 10.4102/sajp.v77i2.1573] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/29/2021] [Indexed: 11/03/2022] Open
Abstract
Background Physiotherapy, brace applications or surgery are the treatment options utilised to manage patients with scoliosis. Many different brace applications are used, and the success rates of orthoses vary. Objectives Brace applications can have detrimental impacts on the patient leading to physical discomfort, psychological discomfort, and in some instance the use of braces may even be painful. Therefore, future developments in this field should be aimed at improving the success rate and reducing physical distress experienced by the patient while using brace applications. The purpose of this article is to provide recommendations with respect to the most appropriate bracing approach in general. Method A narrative review of the scientific literature was carried out to substantiate the statements made in this article. Results The most important braces provided for the treatment of patients with scoliosis and the treatment results that can be achieved are presented and discussed, taking into account the most recent systematic reviews. A wide range of success rates have been found for the different brace applications. Conclusion Given that brace application may impact the patient leading to physical discomfort and psychological distress, good quality management in brace application for patients with scoliosis is needed to ensure the best possible outcome and the least stressful management. Clinical implications Safety in brace application for patients with scoliosis needs improvement. The use of standardised and reliable computer aided design (CAD) libraries and appropriate patient information based on published guidelines is suggested.
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Affiliation(s)
| | - Tuğba Kuru Çolak
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Manuel Lay
- Institution of Orthopädie-Technik Lay GmbH, Zell-Barl, Mosel, Germany
| | - Maksym Borysov
- Institution of Orttech-plus Rehabilitation Service, Charkiv, Ukraine
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