The recent ISICO study confirm wearing time increases results especially when wearing time exceeds 18 hours per day. ( Comment by Dr. J Hartley)
“The Idiopathic Scoliosis Graphical Representation Of Worsening Trend of Natural History (IS-GROWTH) communication tool provides a reliable prediction useful to manage long-term treatment during growth” and “Wearing a brace for idiopathic scoliosis above 18 hours/day shows a dose-response effect on the outcomes improvement and end-of-treatment Cobb angle below 30 degrees”.
Two studies which, although very different from each other, focus on key themes for our daily practice: the effectiveness of bracing and communication with patients.
Over 18 hours a day: the “brace-effect” gets confirmed.
Our study “Wearing a brace for idiopathic scoliosis above 18 hours/day shows a dose-response effect on the outcomes improvement and end-of-treatment Cobb angle below 30 degrees” shows that wearing a brace for more than 18 hours a day leads to significantly better outcomes in the treatment of adolescent idiopathic scoliosis.
The findings of this research, conducted on 884 adolescent patients, reinforce what was already highlighted by the BrAIST (Bracing in Adolescent Idiopathic Scoliosis Trial) study, but also show that the benefit does not stop at 18 hours: the more the brace is worn, the greater the chance of ending treatment with a curve below 30°, thus reducing the risk of problems in adulthood.
Key findings include:
- Wearing the brace for over 18 hours a day avoids surgery in 97-98% of cases.
- With strong compliance, exceeding the 50° Cobb threshold is highly unlikely
- The more time the brace is worn, the higher the likelihood of ending with a curve below 30° Cobb.
- In the most compliant patients, curve improvement exceeds 60%.
“This study settles a debate that has gone on for years: wearing the brace for longer, if well tolerated, produces better results. The progression of scoliosis is avoided and the curve is improved, in a therapeutic path based on decisions shared with patients and families,” highlights Professor Stefano Negrini, one of the study’s authors. “Working with a personalised and collaborative approach with patients has enabled us to achieve very high compliance, even exceeding what is commonly reported in the literature. It demonstrates that it is possible to be effective even in everyday clinical practice,” concludes Negrini.
