If your child has been diagnosed with adolescent idiopathic scoliosis, it is likely that your orthopedic specialist will, at some point, prescribe a scoliosis brace for your child if scoliosis reaches 20–25 degrees.
One of the most common scoliosis orthotics (not to be confused with prosthetics) prescribed in the United States is the Boston Brace, which is but one of several scoliosis braces commonly referred to as a TLSO (thoracic-lumbar-sacral-orthotics).
An Overview of the Boston Brace
This brace was invented in the 1970s and essentially replaced the Milwaukee Brace, often considered to be too aggressive, uncomfortable, and difficult for children to tolerate. It was clear different types of braces were needed. The Boston Brace was one of the first orthotics made from hard plastic, a polypropylene high-density mold that also contained no metal. It was considered an improvement due to its lightweight and improved comfort.
Despite the results of the TLSO version being controversial and potentially inferior to its predecessor (the Milwaukee Brace), the fact that kids were more likely to comply and attempt wearing it, the Milwaukee Brace took a backseat and is now considered obsolete.
The current version of this TLSO scoliosis brace is now referred to as the Boston Brace 3D. Scoliosis is a three-dimensional deformity of the spine and therefore taking on a more three-dimensional approach seemingly makes sense. The brace is custom fit using a laser scan of the patient’s body — along with x-rays — to optimize the temporary correction when wearing it. Typically, an in-brace x-ray is taken to measure the performance and overall effect the patient has when the brace is fully secured at maximum tension with straps. Research data suggests that a rigid spinal orthosis, when used to prevent growth-related curve progression, requires a minimum of 50% in-brace cobb angle correction.
Unfortunately, due to multiple factors — such as the orthotist’s clinicians scoliosis experience (clinicians who makes the brace), or the orthopedic surgeon’s confidence in bracing — scoliosis bracing outcomes have been mixed for prevention of spinal fusion surgery for any given individual patient.
Boston Brace International, the company that makes the scoliosis brace, also has adopted a common functional stance originally presented by European back brace pioneers like Cheneau, who claimed that allowing open space zones for rotation correction delivers superior outcomes. Boston Brace 3D refers to these areas of relief as shift/push.
There are multiple disadvantages to using bracing-only as a scoliosis treatment, including the high rate of non-compliance (primarily due to interference with school and sports-related activities), the potential impact on respiratory function, the psychological impact of scoliosis bracing during social/school times, and the inability of the Boston Brace to treat certain spinal curvature patterns effectively.
The Boston brace is chiefly recommended for spinal curve types that have an apical (apex of the curve) vertebra lower than T8 apex in the rib cage, which is commonly referred to as a thoraco lumbar (abdomen) or lumbar (lower back) scoliosis type (see a list of scoliosis locations and curvature types). Unfortunately, only 20% of scoliosis curvatures, especially in adolescent cases, fall into this category of curve type.
More than 70% of kids diagnosed with scoliosis have a thoracic type curve, as well as an additional thoracolumbar or lumbar curve (double or ‘S’ curve), for which a scoliosis brace is not recommended for best results. Therefore, a significant group of children wearing a brace may not see any benefit for their respective curve patterns, even if they are fully compliant with their prescribed wear time until skeletal maturity.
Finally, scoliosis bracing itself does not address the underlying or associated non-spinal scoliosis symptoms, such as neurotransmitter imbalances, hormone metabolism and genetic variants, and bone density differences. Since it is possible that these compounding factors may be what trigger the curve to increase, failing to address them may invariably sabotage any scoliosis treatment. However, there are times, as you will read below, where combining appropriate scoliosis bracing with a comprehensive management approach like ScoliSMART may create a positive synergistic effect in certain specific cases.
When Was ScoliSMART First Used to Treat Scoliosis?
Physical therapy treatment options have been used extensively for postural awareness and postural rehabilitation training for over a century; however, many of the exercises were not originally developed for adolescent idiopathic scoliosis specifically. ScoliSMART exercise methods and devices have been used in postural training and rehabilitation since the early 1990s.
In 2011, the Scoliosis Activity Suit was developed. Shortly thereafter, information about neurotransmitter disruptions, hormone imbalances, and genetic variations was identified in scoliosis patients. The ScoliSMART clinicians immediately incorporated all of this new information about these non-spinal scoliosis symptoms — along with a “Scoliosis Activity Suit” — into a comprehensive management strategy.
ScoliSMART has continuously made efforts to advance its management strategies as newly published evidence becomes available. Some of these advancements have been in their rehabilitative exercise methods, collectively referred to as “reflex response” re-training. Other areas include identifying genetic variants in scoliosis and taking proactive functional medical approaches to minimize their impact on curve progression.
The ScoliSMART Activity Suit works primarily by training the areas of the brain that are responsible for spinal and postural muscle control. Posture control is essentially the same thing as muscle or postural memory. In the case of scoliosis, the posture memory is abnormal.
To learn more about how to treat the whole scoliosis condition and not only the curve, connect with our passionate providers at ScoliSMART. You can schedule a no-cost or obligation phone consultation with a ScoliSMART doctor to consider a non-brace/surgical approach to treating your child’s scoliosis condition. Please contact us today!
Therefore, exercises need to be selected that can help to change the posture memory back to normal. Unfortunately, voluntary exercises, such as intentionally sitting up or standing up straighter, or pulling your shoulder blades back, do not impact posture memory. Posture memory has to be trained automatically, in a way that teaches the brain how to sit and stand straighter without consciously doing it.
Not all exercises can accomplish this task. This is why the ScoliSMART exercises are referred to as reflexive response training. Any exercise or task designed to change muscle memory must be performed a minimum of 400–500 repetitions in order to make a lasting muscle memory change (think of retraining a golf swing or shooting a free throw, or any repetitive task). Changing the posture memory serves to either prevent growth-related worsening of scoliosis or improve scoliosis measurements when patients are not in a growth cycle.
Online consultation scheduling is available!
Now it’s even easier to connect with ScoliSMART. Schedule your no-cost, no-obligation phone or Zoom consultation online with a ScoliSMART physician. Visit the ScoliSMART BootCamp page and click the “Schedule Online” button at the top of the page. Then select the best date and time to connect with a physician. Schedule your consultation right here!
What Types of Scoliosis Respond Best to ScoliSMART?
Published peer-reviewed literature has shown that nearly all types of scoliosis respond positively to ScoliSMART treatment. Single primary curves tend to respond the best compared to cases that have two or more major curves. Unlike the Boston Brace, children with thoracic curves centered above T8 do respond well to this treatment of scoliosis, whereas they often experience further progression, despite wearing the SpineCor (a different type of brace) or Boston Brace.
Additional Read – ScoliSMART Activity Suit vs SpineCor Brace
Can You Combine a Boston Brace With ScoliSMART?
Yes, in specific cases the combination of traditional bracing and physiotherapy is warranted.
1. In cases where there are distinct overlapping spinal abnormalities (e.g. spina bifida, hemivertebra, facet tropism, etc.), or in cases where there is demonstrable joint hyper flexibility (such as Ehlers-Danlos syndrome), combining these approaches is logical.
2. There are times when a young child (age 3–10) diagnosed with the spine’s curvature above 30 degrees, known as juvenile idiopathic scoliosis, may need a combined approach to best decrease the risk of progression to the surgical threshold (above 50 degrees).
ScoliSMART Clinics is committed to treating the WHOLE scoliosis condition, not only the curve. Genetic & clinical testing with targeted nutrient therapies, expert in-office treatment programs, and the world’s only ScoliSMART Activity Suit provides patients of all ages with the most comprehensive, most effective, and least invasive treatment options available worldwide.