Bracing Scoliosis according to‚ Best Practice’ Standards

Introduction: As previously proven, today’s scoliosis bracing concepts include symmetric and asymmetric hard braces constructed of polyethylene (PE), as well as soft braces. At the moment, the plaster cast method appears to be the most widely used method for making hard braces around the world. There are CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technologies that allow brace changes without the use of plaster. We tried to build our hand-made braces according to this specification by cast modelling because CAD/CAM technology is not available in Ukraine. The goal of this study is to compare in-brace repairs made by hand using Best Practice Chêneau standards with published results on Chêneau braces in the literature.

Methods: The outcome of bracing is obviously determined by in-brace correction and compliance. As a result, one of the most essential parameters for estimating brace quality is the in-brace correction. We’ve been looking at the outcomes of our department’s training in the building, adjustment, and use of CAD/CAM Chêneau braces that follow best practises. All braces constructed between January 2009 and December 2010 (for a total of 207 patients) were examined for in-brace correction. Because not all of the patients were in the normal range of brace indication (Cobb 20–45°; age 10–14 years), we searched our database for a suitable subset that met the following inclusion criteria: Only girls; Adolescent Idiopathic Scoliosis (AIS) diagnosis; Cobb 20–45°; age 10–14 years).

Discussion: A total of 92 patients (Cobb 20–45°; age 10–14 years) met the inclusion criteria. The average Cobb angle was 29.2° (SD 6) and the average Cobb angle in the brace was 12.8°. (SD 6.2). The overall sample had a 56 percent in-brace correction rate.

Conclusion: With proper training, an experienced CPO can produce a hand-made bracing standard that is similar to the most contemporary CAD/CAM bracing standard. In theory, the results might be replicated. More research on our hand-made brace series is needed to (1) assess brace comfort and (2) assess brace effectiveness using the SRS inclusion criteria. Less experienced technicians are encouraged to select CAD/CAM services that are standardised, expert-driven, and well-established.

Author(s) Details

Maksym Borysov
Orttech Plus Rehabilitation Service, Kharkiv, Ukraine.

Artem Borysov
Orttech Plus Rehabilitation Service, Kharkiv, Ukraine.

Alexander Kleban
Lomonosov Moscow State University. Faculty of Mechanics and Mathematics, Moscow, Russia.

Hans-Rudolf Weiss
Schroth Best Practice Academy, Neu-Bamberg, Germany.

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