Evaluation of the efficacy of part-time versus full-time brace wear in subjects with adolescent idiopathic scoliosis (AIS): a review of literature

Abstract

Background: Scoliosis is a musculoskeletal disorder that can be managed by wearing an orthosis full or part time. It is not well understood whether the effectiveness of part-time orthotic management of spinal curve progression is as efficacious as full-time wear. The aim of this review was to determine the efficiency of part-time bracing (with a focus on night-time braces), compared to full-time bracing. Moreover, the study aimed to determine which part-time brace demonstrated the most efficacy. Method: A literature review was conducted via a Medline search in PubMed, ISI Web of knowledge, Scopus, Ebsco, Embasco, and Google Scholar. Key words (part time, night braces) were used in combination with adolescent idiopathic scoliosis. The quality of the selected papers was evaluated based on the Downs and Black tool. Results: Fifty papers were found. Following application of inclusion and exclusion criteria based on titles and abstracts, 19 papers were selected for final analysis. These papers were divided into three categories: (1) evaluation of the efficacy of night braces on progression of scoliotic curve (seven papers); (2) Comparison of efficacy between night and full-time bracing (10 studies); and (3) three-dimensional modeling and finite element analysis of part-time bracing. Conclusions: The Providence brace appears to provide an effective treatment approach to influence curve progression in scoliotic patients. However, it should be emphasized that its maximal effect is for lumbar, lumbosacral, and thoracic curves with a low apex. It is recommended to use the Charleston Bending brace only for patients with a single scoliotic curve. The efficacy of full-time bracing for double curves, thoracolumbar curves, and curves more than 35 degrees indicates that more than just a night brace is necessary. However, it seems that there is no difference between the effects of part-time and full-time bracing for curves of smaller magnitude (less than 35 degrees).