Brace treatment for patients with scoliosis: State of the art.
Hans-Rudolf Weiss, Tuğba Kuru Çolak, Manuel Lay and 1 others
PMID 34859162WHAT IT FOUND
Brace success for adolescent idiopathic scoliosis varied widely.
Physiotherapy was indicated for moderate progression risk and bracing for higher risk, while night-time and soft brace evidence was inconsistent.
Key findings
01For adolescent idiopathic scoliosis, the paper states that physiotherapy is indicated when progression probability is 40% to 60%, and bracing when it is 60% or more.
02Reported brace success rates varied widely: Boston-type and other symmetric braces were 60% to 75% after excluding a non-comparable sample, and Chêneau-style braces were less than 50% to more than 90%.
03Night-time brace results were contradictory, with 89% success in one Providence study and 57% in another; SpineCor soft brace success was 73.1% in one randomised study but lower than rigid orthoses in independent studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative review, not a systematic review, so the included studies were not selected with the same rigour or pre-specified methods. Success definitions varied across studies, and some studies used selective cohorts or different inclusion criteria, which limits comparison. The review did not pool patient-level data or report a single participant count, so it cannot tell an individual therapist which brace will work for their patient. Brace models are not fully standardised, and hand-crafted asymmetric braces depend heavily on technician skill, which may explain wide success rates.
The easy way to misread this
Do not conclude that any Boston, Chêneau, night-time or soft brace will prevent curve progression. The review shows success rates varied widely, and night-time and soft brace evidence was inconsistent, so brace choice depends on individual curve pattern, fit, correction and wearing time.