The outcome of a modified version of the Cheneau brace in adolescent idiopathic scoliosis (AIS) based on SRSand SOSORTcriteria

A retrospective study

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Bracing therapy for patients with adolescent idiopathic scoliosis (AIS) continues to be a controversial issue. As a consequence, to achieve an adequate level of evidence, there is a strong need for specific studies conducted according to standard outcome and management criteria.AIM: To assess the outcomes of a modified version of the Cheneau brace, ("Cheneau-P") in patients with AIS, based on SRS and SOSORT criteria.DESIGN: Retrospective study.SETTING: Scoliosis Unit of a Clinical Center.POPULATION: Sixty-seven patients, 56 females and 11 males.METHODS: Inclusion criteria were: diagnosis of AIS, age ≥10 years, Risser Score 0-2, Cobb degrees 20-40, no previous treatment, beginning of brace treatment within 1 year after menarche and minimum 2-year follow-up. According to SRS criteria, bracing outcomes were classified, as follows: "improved" (reduction of the curve ≥6°), "unchanged" (5° curve progression or reduction), "worsened" (≥6° curve progression), and "over 45°" (curve exceeding 45° or undergone surgery during the follow-up). The outcomes "improved" and "unchanged" were considered as successful outcomes. Groups and related subgroups were created according to curve type (thoracic, thoraco-lumbar, lumbar and double major) and magnitude (20°-30°; 30°-40°) and to skeletal age (Risser score 0, 1, 2). Aseparate analysis was also performed on the 37 patients, 30 females and 7 males, who completely fulfilled the SRS eligibility criteria, showing spinal curves between 25 and 40 Cobb degrees.RESULTS: In the whole group SRSoutcome after bracing treatment was successful in 93% and in 81% of patients, at per protocol (PP) and intention to treat (ITT) analysis, respectively, the latter also including drop-outs as worst outcomes. Cobb angles significantly decreased in all subgroups except in patients showing double major curves, lower curve magnitude (20-30°) and Risser score 2. Rib humps and balance rate also significantly improved in the whole sample (12.78±4.54 at T0 vs. 6.83±4.33 at T1 P<0.001; 60% at T0 vs. 94% at T1 P<0.001, respectively). In the subgroup that completely fulfilled the SRS eligibility criteria, the outcome was successful in 92% and 83% of patients, at PP and ITT analysis, respectively, the latter also including, even in this case, drop-outs as worst outcomes.CONCLUSIONS: This study shows that in patients with AIS the treatment with the "Cheneau-P" brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria.

Original languageEnglish
Pages (from-to)618-629
Number of pages12
JournalEuropean Journal of Physical and Rehabilitation Medicine
Volume52
Issue number5
Publication statusPublished - Oct 1 2016

Fingerprint

Braces
Scoliosis
Retrospective Studies
Intention to Treat Analysis
Therapeutics
Menarche
Ribs
Thorax

Keywords

  • Adolescent
  • Braces
  • Scoliosis

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

@article{ee207b08723e49d78de10d94135f9ad9,
title = "The outcome of a modified version of the Cheneau brace in adolescent idiopathic scoliosis (AIS) based on SRSand SOSORTcriteria: A retrospective study",
abstract = "BACKGROUND: Bracing therapy for patients with adolescent idiopathic scoliosis (AIS) continues to be a controversial issue. As a consequence, to achieve an adequate level of evidence, there is a strong need for specific studies conducted according to standard outcome and management criteria.AIM: To assess the outcomes of a modified version of the Cheneau brace, ({"}Cheneau-P{"}) in patients with AIS, based on SRS and SOSORT criteria.DESIGN: Retrospective study.SETTING: Scoliosis Unit of a Clinical Center.POPULATION: Sixty-seven patients, 56 females and 11 males.METHODS: Inclusion criteria were: diagnosis of AIS, age ≥10 years, Risser Score 0-2, Cobb degrees 20-40, no previous treatment, beginning of brace treatment within 1 year after menarche and minimum 2-year follow-up. According to SRS criteria, bracing outcomes were classified, as follows: {"}improved{"} (reduction of the curve ≥6°), {"}unchanged{"} (5° curve progression or reduction), {"}worsened{"} (≥6° curve progression), and {"}over 45°{"} (curve exceeding 45° or undergone surgery during the follow-up). The outcomes {"}improved{"} and {"}unchanged{"} were considered as successful outcomes. Groups and related subgroups were created according to curve type (thoracic, thoraco-lumbar, lumbar and double major) and magnitude (20°-30°; 30°-40°) and to skeletal age (Risser score 0, 1, 2). Aseparate analysis was also performed on the 37 patients, 30 females and 7 males, who completely fulfilled the SRS eligibility criteria, showing spinal curves between 25 and 40 Cobb degrees.RESULTS: In the whole group SRSoutcome after bracing treatment was successful in 93{\%} and in 81{\%} of patients, at per protocol (PP) and intention to treat (ITT) analysis, respectively, the latter also including drop-outs as worst outcomes. Cobb angles significantly decreased in all subgroups except in patients showing double major curves, lower curve magnitude (20-30°) and Risser score 2. Rib humps and balance rate also significantly improved in the whole sample (12.78±4.54 at T0 vs. 6.83±4.33 at T1 P<0.001; 60{\%} at T0 vs. 94{\%} at T1 P<0.001, respectively). In the subgroup that completely fulfilled the SRS eligibility criteria, the outcome was successful in 92{\%} and 83{\%} of patients, at PP and ITT analysis, respectively, the latter also including, even in this case, drop-outs as worst outcomes.CONCLUSIONS: This study shows that in patients with AIS the treatment with the {"}Cheneau-P{"} brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria.",
keywords = "Adolescent, Braces, Scoliosis",
author = "Guido Pasquini and Francesca Cecchi and Christian Bini and {Molino Lova}, Raffaele and Federica Vannetti and Chiara Castagnoli and Anita Paperini and Roberta Boni and Claudio Macchi and Biase Crusco and Simone Ceppatelli and Alvaro Corigliano",
year = "2016",
month = "10",
day = "1",
language = "English",
volume = "52",
pages = "618--629",
journal = "European Journal of Physical and Rehabilitation Medicine",
issn = "1973-9087",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "5",

}

TY - JOUR

T1 - The outcome of a modified version of the Cheneau brace in adolescent idiopathic scoliosis (AIS) based on SRSand SOSORTcriteria

T2 - A retrospective study

AU - Pasquini, Guido

AU - Cecchi, Francesca

AU - Bini, Christian

AU - Molino Lova, Raffaele

AU - Vannetti, Federica

AU - Castagnoli, Chiara

AU - Paperini, Anita

AU - Boni, Roberta

AU - Macchi, Claudio

AU - Crusco, Biase

AU - Ceppatelli, Simone

AU - Corigliano, Alvaro

PY - 2016/10/1

Y1 - 2016/10/1

N2 - BACKGROUND: Bracing therapy for patients with adolescent idiopathic scoliosis (AIS) continues to be a controversial issue. As a consequence, to achieve an adequate level of evidence, there is a strong need for specific studies conducted according to standard outcome and management criteria.AIM: To assess the outcomes of a modified version of the Cheneau brace, ("Cheneau-P") in patients with AIS, based on SRS and SOSORT criteria.DESIGN: Retrospective study.SETTING: Scoliosis Unit of a Clinical Center.POPULATION: Sixty-seven patients, 56 females and 11 males.METHODS: Inclusion criteria were: diagnosis of AIS, age ≥10 years, Risser Score 0-2, Cobb degrees 20-40, no previous treatment, beginning of brace treatment within 1 year after menarche and minimum 2-year follow-up. According to SRS criteria, bracing outcomes were classified, as follows: "improved" (reduction of the curve ≥6°), "unchanged" (5° curve progression or reduction), "worsened" (≥6° curve progression), and "over 45°" (curve exceeding 45° or undergone surgery during the follow-up). The outcomes "improved" and "unchanged" were considered as successful outcomes. Groups and related subgroups were created according to curve type (thoracic, thoraco-lumbar, lumbar and double major) and magnitude (20°-30°; 30°-40°) and to skeletal age (Risser score 0, 1, 2). Aseparate analysis was also performed on the 37 patients, 30 females and 7 males, who completely fulfilled the SRS eligibility criteria, showing spinal curves between 25 and 40 Cobb degrees.RESULTS: In the whole group SRSoutcome after bracing treatment was successful in 93% and in 81% of patients, at per protocol (PP) and intention to treat (ITT) analysis, respectively, the latter also including drop-outs as worst outcomes. Cobb angles significantly decreased in all subgroups except in patients showing double major curves, lower curve magnitude (20-30°) and Risser score 2. Rib humps and balance rate also significantly improved in the whole sample (12.78±4.54 at T0 vs. 6.83±4.33 at T1 P<0.001; 60% at T0 vs. 94% at T1 P<0.001, respectively). In the subgroup that completely fulfilled the SRS eligibility criteria, the outcome was successful in 92% and 83% of patients, at PP and ITT analysis, respectively, the latter also including, even in this case, drop-outs as worst outcomes.CONCLUSIONS: This study shows that in patients with AIS the treatment with the "Cheneau-P" brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria.

AB - BACKGROUND: Bracing therapy for patients with adolescent idiopathic scoliosis (AIS) continues to be a controversial issue. As a consequence, to achieve an adequate level of evidence, there is a strong need for specific studies conducted according to standard outcome and management criteria.AIM: To assess the outcomes of a modified version of the Cheneau brace, ("Cheneau-P") in patients with AIS, based on SRS and SOSORT criteria.DESIGN: Retrospective study.SETTING: Scoliosis Unit of a Clinical Center.POPULATION: Sixty-seven patients, 56 females and 11 males.METHODS: Inclusion criteria were: diagnosis of AIS, age ≥10 years, Risser Score 0-2, Cobb degrees 20-40, no previous treatment, beginning of brace treatment within 1 year after menarche and minimum 2-year follow-up. According to SRS criteria, bracing outcomes were classified, as follows: "improved" (reduction of the curve ≥6°), "unchanged" (5° curve progression or reduction), "worsened" (≥6° curve progression), and "over 45°" (curve exceeding 45° or undergone surgery during the follow-up). The outcomes "improved" and "unchanged" were considered as successful outcomes. Groups and related subgroups were created according to curve type (thoracic, thoraco-lumbar, lumbar and double major) and magnitude (20°-30°; 30°-40°) and to skeletal age (Risser score 0, 1, 2). Aseparate analysis was also performed on the 37 patients, 30 females and 7 males, who completely fulfilled the SRS eligibility criteria, showing spinal curves between 25 and 40 Cobb degrees.RESULTS: In the whole group SRSoutcome after bracing treatment was successful in 93% and in 81% of patients, at per protocol (PP) and intention to treat (ITT) analysis, respectively, the latter also including drop-outs as worst outcomes. Cobb angles significantly decreased in all subgroups except in patients showing double major curves, lower curve magnitude (20-30°) and Risser score 2. Rib humps and balance rate also significantly improved in the whole sample (12.78±4.54 at T0 vs. 6.83±4.33 at T1 P<0.001; 60% at T0 vs. 94% at T1 P<0.001, respectively). In the subgroup that completely fulfilled the SRS eligibility criteria, the outcome was successful in 92% and 83% of patients, at PP and ITT analysis, respectively, the latter also including, even in this case, drop-outs as worst outcomes.CONCLUSIONS: This study shows that in patients with AIS the treatment with the "Cheneau-P" brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria.

KW - Adolescent

KW - Braces

KW - Scoliosis

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M3 - Article

VL - 52

SP - 618

EP - 629

JO - European Journal of Physical and Rehabilitation Medicine

JF - European Journal of Physical and Rehabilitation Medicine

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