Adolescence is a challenging time for adolescents, but particularly so as they navigate scoliosis. There is no doubt that when an adolescent is diagnosed with idiopathic scoliosis that there is a lot for them to take in. There is the diagnosis, numerous appointments and absorbing all the information. They are not quite young children, where they generally do as their parents ask, and they are not quite yet adults and want to assert their independence. So, what happens when an adolescent is recommended that bracing is the best option? Will they wear it? Before we dig into that answer let’s start by looking at what the risks are if the brace is not worn as recommended.
How Effective Will the Brace Be if Worn Less than Recommended?
After many years of debate about the effectiveness of bracing for adolescents with idiopathic scoliosis (AIS) there is now evidence to support the use of bracing, particularly in conjunction with physiotherapeutic scoliosis specific exercises (PSSE), as a management option [1, 2]. The effectiveness of bracing is reliant on brace wear time [1]. So, you can have the best brace in the world, but if the child is not wearing it as prescribed, the results will not likely be as hoped [1].
Will Adolescents Actually Wear the Brace?
Compliance is going to be impacted by the patient and the type of treatment. Of course every child is different, however we do have some literature that has recently looked into this in more detail. A group of authors investigated brace wear compliance and found that these patients do have good compliance with good support [3]. This included the wearing of a thermobrace. A thermobrace is a heat sensory to measure the actual wear time of the patient. The thermobrace used with the ScoliBrace is called an iButton. It sits inside the brace.
The ScoliBrace has been designed with compliance in mind. We find that patients report it to be quite comfortable, especially once they have worn it for a while. Of course, like anything (even wearing a new pair of shoes), it takes time to adjust to wearing the brace. However, once that initial wear time has passed, compliance can be quite good. Experienced ScoliBrace Providers also support all patients with their brace wear, and the iButton is one part of that support and compliance monitoring system.
Author: Rosemary Marchese, Physiotherapist, ScoliCare Head of Education and Research
References:
- Weinstein, S.L., et al., Effects of Bracing in Adolescents with Idiopathic Scoliosis. N Engl J Med, 2013. 369(16): p. 1512-1521.
- Negrini, S., et al., 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord, 2018. 13(1): p. 3-3.
- Donzelli, S., F. Zaina, and S. Negrini, In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace. Scoliosis, 2012. 7(1): p. 12-12.
