Nighttime Bracing Effective for Adolescent Idiopathic Scoliosis

Research Article| September 01 2024 Nighttime Bracing Effective for Adolescent Idiopathic Scoliosis AAP Grand Rounds (2024) 52 (3): 29. https://doi.org/10.1542/gr.52-3-29 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Nighttime Bracing Effective for Adolescent Idiopathic Scoliosis. AAP Grand Rounds September 2024; 52 (3): 29. https://doi.org/10.1542/gr.52-3-29 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: adolescent idiopathic scoliosis, braces Source: Charalampidis A , Diarbakerli E , Dufvenberg M , et al . Nighttime bracing or exercise in moderate-grade adolescent idiopathic scoliosis: a randomized clinical trial. JAMA Netw Open. 2024;7(1):e2352492; doi: https://doi.org/10.1001/jamanetworkopen.2023.52492.Google Scholar Investigators from multiple institutions in Sweden conducted a randomized clinical trial to assess the effectiveness of night-time bracing (NB) or a scoliosis-specific exercise (SSE) program, compared to a control of physical activity (PA), as conservative treatment for adolescent idiopathic scoliosis (AIS). Participants were youths 9–17 years old with previously untreated moderate-grade AIS, defined as a primary curve Cobb angle of 25° to 40° apex T7 or caudal. Only patients who were skeletally immature, based on an estimated remaining growth of ≥1 year, and not more than 1 year after menarche in females, were eligible. At enrollment, participants were randomized 1:1:1 to each of the 3 treatment groups. Those assigned to NB wore a scoliosis night brace at least 8 hours each night. Those in the SSE group were instructed on self-corrective procedures for posture and prescribed a 30-minute daily exercise program. These participants had monthly visits with a physiotherapist for 3 months, and as needed after that. Patients in the PA group were encouraged to engage in ≥60 minutes of exercise daily. Participants had study visits every 6 months after enrollment. At the study visits, radiographs were obtained to assess scoliosis curve progression; height also was measured. The primary outcome was curve progression of ≤6° by skeletal maturity (treatment success) or curve progression of >6° (treatment failure). Odds ratios (OR) for rate of treatment success for NB, or SSE, compared to PA were calculated. Patients with treatment failure were offered full-time braces and/or surgical correction. A main secondary outcome was need for surgical correction for AIS within 2 years after completing the study. A total of 135 youths were enrolled in the study, with 45 assigned to each of the 3 treatment groups. The mean age of participants was 12.7 ±1.4 years, 82% were female, and mean Cobb angle at baseline was 31°. There were 13 participants who dropped out of the study. Among youths assigned to NB, 34/45 (76%) had treatment success compared to 24/45 (53%) of those randomized to PA (OR, 2.7; 95% CI, 1.1, 6.6). Among participants randomized to SSE, 26/45 (58%) had treatment success, which was not a significantly higher success rate than for those in the PA group (OR, 1.2; 95% CI, 0.5, 2.8). For those with treatment failure, 9 participants in each of the 3 treatment groups had surgical correction within 2 years after completing the study. The authors conclude that NB was significantly more effective than PA in preventing curve progression of >6° degrees than PA. Dr Hennrikus has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. AIS develops in about 3 % of children, and about 10% of those with AIS need treatment.... You do not currently have access to this content.