Night-Time Braces for Treatment of Adolescent Idiopathic Scoliosis
By Grivas, Theodoros B.; Rodopoulos, Georgios I.; Bardakos, Nikolaos V.; Disability and Rehabilitation: Assistive Technology, Vol. 3, No. 3, pp. 120-129Publication Date: May 2008
Review article on the basic science and clinical information underlying the use of nocturnal braces for adolescent idiopathic scoliosis (AIS). The National Institutes of Health online medical database, Medline, was used to retrieve all articles pertinent to clinical research on night-time bracing. Information was also collected from manufacturing companies and from literature on the pathomechanics of scoliosis. Overall, the effectiveness of night-time braces was found to lay in their ability to hypercorrect the scoliotic curvature, thereby eliminating the asymmetric water accumulation that occurs in the apical and adjacent intervertebral discs, and restoring a close-to-normal application to the endplates, thus preventing curve progression. The two nocturnal braces mostly used were found to be (1) the Charleston Bending Brace, a rigid, custom-made orthosis based on the premise that scoliosis is caused by muscle imbalance accentuated by asymmetric forces and accompanied by soft-tissue stretching on the convex side and contracture on the concave side; the brace works by stretching the contracted side at night-time, when muscle tone is minimal; and (2) the Providence Night-time Scoliosis System fabricated of polypropylene plastic from a plaster impression scanned into a CAD/CAM computer, providing a frame that applies direct corrective forces to the patient. The authors conclude that, based on clinical results available, night-time braces constitute an attractive option for single major lumbar/thoracolumbar curves not exceeding 35 degrees in magnitude, but caution that rigid multi-center, randomized studies are needed to better define the role of nocturnal bracing in the conservative treatment of AIS.
Published by: Taylor & Francis, Limited (Website:http://taylorandfrancis.org)
International Society of Physical and Rehabilitation Medicine (Web Site: http://www.isprm.org )
This publication is included in the library of the National Rehabilitation Information Center (NARIC), accession number J55300
