Scoliosis: Exercises for brace weaning

Scoliosis Journal posted the following information regarding: Specific exercises performed in the period of brace weaning can avoid loss of correction in Adolescent Idiopathic Scoliosis (AIS) patients: Winner of SOSORT's 2008 Award for Best Clinical Paper

Published: 7 2009

Authors: Fabio Zaina, Stefano Negrini, Salvatore Atanasio, Claudia Fusco, Michele Romano and Alessandra Negrini email

Background
Exercises are frequently performed in order to improve the efficacy of bracing and avoid its collateral effects. Very frequently there is a loss of correction during brace weaning in AIS treatment. Aim: To verify the efficacy of exercises in reducing correction loss during brace weaning. Study Design: Retrospective controlled study. Population: Sixty-eight consecutive patients (eight males), age 15+/-1 and Cobb angle 22+/-2degrees at start of brace weaning.

Methods
The start of brace weaning was defined as the first visit in which the wearing of brace for less than 18/24 hours was prescribed (according to our protocol, at Risser 3). Patients were divided into two groups according to whether or not exercises were performed: (1) EX (exercises), included 39 patients and was further divided into two sub-groups: SEAS (who performed exercises according to our institute's protocol, 14 patients) and OTH (other exercises, 25 patients) and (2) CON (controls, 29 patients) that was divided into two other sub-groups: DIS (discontinuous exercises, 19 patients) and NO (no exercises, 10 patients). Cobb angles and ATR were evaluated at the start and after complete brace weaning. Complete brace weaning was defined as the first visit in which the brace was no longer prescribed (ringapophysis closure or Risser 5, according to our protocol). ANOVA and Chi Square tests were performed.

Results
There was no difference between groups at baseline. However, at the end of treatment, 2.7 years after the start of the weaning process, Cobb angle increased significantly in both the DIS and NO groups (3.9degrees and 3.1degrees Cobb, respectively). The SEAS and OTH groups did not change. Comparing single groups, OTH (with respect to DIS) had a significant difference (P<0.05).

Conclusions
Exercises can help reduce the correction loss in brace weaning for AIS.

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