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CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

Frequency: Bi-Monthly

ISSN 1973-9087

Online ISSN 1973-9095

 

European Journal of Physical and Rehabilitation Medicine 2016 May 04

The outcome of modified version of the Cheneau brace in Adolescent Idiopathic Scoliosis (AIS) based on SRS and SOSORT criteria: a retrospective study

Guido PASQUINI, Francesca CECCHI, Christian BINI, Raffaele MOLINO-LOVA, Federica VANNETTI, Chiara CASTAGNOLI, Anita PAPERINI, Roberta BONI, Claudio MACCHI, Biase CRUSCO, Simone CEPPATELLI, Alvaro CORIGLIANO

Don Gnocchi Foundation, Florence, Italy

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.
METHODS: Sixty-seven patients, 56 females and 11 males, participated in the study. 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). A separate 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 SRS outcome 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.
CLINICAL REHABILITATION IMPACT: The “Cheneau-P” brace proved effective as a conservative treatment for AIS by stabilizing curve progression and limiting the need for surgical treatment.

language: English


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