Guidelines for the conservative treatment of spinal deformities - Questionnaire for a Delphi consensus

Results of Gensingen Bracing in Patients With Adolescent Idiopathic Scoliosis: Retrospective Cross-Sectional Feasibility Study

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.

Effects of Pilates exercises on idiopathic scoliosis: a scoping review of the literature

PURPOSE

Scoliosis is a deformity involving changes in three planes. These changes include lateral curvature in the frontal plane, changes in physiological thoracic kyphosis and lumbar lordosis angles in the sagittal plane, and rotation of the vertebrae in the transverse plane. The aim of this scoping review was to review and summarize the available literature to determine whether Pilates exercises are an effective treatment for scoliosis.

METHODS

The Cochrane Library (reviews, protocols, trials), PubMed, Web of Science, Ovid, Scopus, PEDro, Medline, CINAHL (EBSCO), ProQuest, and Google Scholar electronic databases were used to search for published articles from inception to February 2022. All the searches included English language studies. Keywords were determined as "scoliosis and Pilates" or "idiopathic scoliosis and Pilates", "curve and Pilates", "spinal deformity and Pilates."

RESULTS

Seven studies were included; one study was a meta-analysis study, three studies compared Pilates and Schroth exercises, and three applied Pilates exercises in combined therapy. The studies included in this review used outcome measurements of Cobb angle, ATR, chest expansion, SRS-22r, posture assessment, weight distribution, and psychological factors such as depression.

CONCLUSIONS

The results of this review suggest that the level of evidence regarding the effect of Pilates exercises on scoliosis-related deformity is very limited. Pilates exercises can be applied to reduce asymmetrical posture in individuals with mild scoliosis with reduced growth potential and progression risk.