Soft Braces, AIS a Review

ScoliosisJournal recently reported about soft braces in the treatment of AIS - Review the literature and description of a new approach

Authors: Hans-Rudlof Weiss and Mario Werkmann

Background
The use of soft braces to treat scoliosis has been described by Fischer as early as 1876. With the help of elastic straps, as the authors suggested, a corrective movement for individual curve patterns should be maintained in order to inhibit curve progression. Today this concept has been revived besides soft 3 point pressure systems. Some shortcomings have been revealed in literature in comparison with hard braces, however the concept of improving quality of life of a patient while under brace treatment should furtherly be considered as valuable. Purpose of this review is to gather the body of evidence existent for the use of soft braces and to present recent developments.

Method
A review of literature as available on Pub Med was performed using the key words ,scoliosis and ,soft brace at first. The search was expanded using ,scoliosis and the known trademarks (1) ,scoliosis and ,SpineCor, (2) ,scoliosis and ,TriaC, (3) ,scoliosis and ,St. Etienne brace, (4) ,scoliosis and ,Olympe. The papers considered for inclusion were new technical descriptions, preliminary results, cohort studies and controlled studies.

Results
When searching for the terms ,scoliosis and ,SpineCor: 20 papers have been found, most of them investigating a soft brace, for ,scoliosis and ,TriaC: 7 papers displayed, for ,scoliosis and ,St. Etienne brace: one paper displayed but not meeting the topic and for ,scoliosis and ,Olympe: No paper displayed. Four papers found on the SpineCor? were of prospective controlled or prospective randomized design. These papers partly presented contradictory results. Two papers were on soft Boston braces used in patients with neuromuscular scoliosis.

Discussion
There is a small but consistent body of evidence for the use of soft braces in the treatment of scoliosis. Contradictory results have been published for samples treated during the pubertal growth spurt. In a biomechanical analysis the reason for the lack of effectiveness during this period has been elaborated. Improved materials and the implementation of corrective movements respecting also the sagittal correction of the scoliotic spine will hopefully contribute to an improvement of the results achievable.

Conclusion
The treatment of scoliosis using soft braces is supported by some papers providing a small body of evidence. During the growth spurt the use of soft braces is discussed contradictory. There is insufficient evidence to draw definite conclusions about effectiveness and safety of the intervention.


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