Use of sensory dynamic orthosis in paediatric neuromuscular scoliosis: A pilot single-group pre-post study.
Idoia Gandarias-Mendieta, María Galán-Olleros, Carmen Martínez-González and 2 others
The SDO did not change spinal curvature over six months in 25 non-ambulatory children with neuromuscular scoliosis.
It did improve posture while worn, and caregivers reported high satisfaction. No pain or function changes were detected.
Key findings
1Cobb angle showed no significant change over six months, with or without the SDO. The orthosis reduced the angle while worn (median difference −2.6° at baseline, −4.0° at final, both p<0.001), but this is a postural effect during wear, not a structural correction.
2Coronal balance improved modestly over time even without the orthosis (5.9 cm to 5.8 cm, p=0.049) and showed significant within-subject improvement during SDO use at both time points (−2.1 cm at baseline, −1.8 cm at final).
3Caregivers most frequently reported improvements in posture, attention, hand use, transfers, and school activities. The majority selected the highest satisfaction ratings for ease of use, tolerance, and willingness to recommend the orthosis.
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What it does not show
Single-group pre-post design with no control group; each child is their own control, so any time-related change (maturation, standard care) cannot be separated from the orthosis effect. Only 25 children completed the study, and the cohort is heterogeneous (CP, chromosomopathy, Rett syndrome, and others), making it hard to generalise to any single diagnosis. The six-month follow-up is too short to judge whether the SDO slows curve progression, which is the main clinical concern in NMS. The caregiver questionnaire was custom-built and not validated, so satisfaction and functional improvement scores cannot be compared with other studies. Pain and ADL scores were at or near the floor (FLACC-R all zero, Barthel median 20), so the instruments may not have been sensitive enough to detect small changes. Post-study use was not monitored, so there is no information on what happens after the SDO is removed. No formal correction for multiple comparisons was applied, increasing the chance of false-positive findings.
Declared interests
No external funding. Medigarments (the manufacturer) provided the SDO Ad. orthoses free of charge but declared no role in study design, data collection, analysis, interpretation, or manuscript preparation. Authors declare no conflicts of interest.
The easy way to misread this
Do not read the 2.6° to 4.0° Cobb angle reduction as evidence the SDO corrects the spinal curve. Those numbers are the difference between wearing and not wearing the garment at the same time point. The longitudinal change over six months was not significant (p > 0.05), meaning the underlying curve did not improve. The SDO is providing postural support while it is on, not changing the spine.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →