Trial of Flexible Bracing Treatment of Adolescents Idiopathic Scoliosis
Trial of Flexible Bracing Treatment of Adolescents Idiopathic Scoliosis
Scoliosis is the three-dimensional (3D) deformity of the spine and trunk. The majority or 80%
 of the scoliosis cases are idiopathic which means that the cause is unknown. The progression
 of scoliosis is much more frequently seen in females and severely scoliotic patients face a
 higher risk of different health problems in their adult life Bracing is the most commonly
 used non-invasive treatment for patients with smaller spinal curves which are usually between
 21 and 40 degrees at Risser stage 0, 1 or 2. However, scoliosis braces are traditionally
 constructed based on the experience of orthotists. Since 3D spinal deformities are complex,
 the design and evaluation of braces are challenging with no consensus on an optimal brace
 design. AI and ML methods therefore constitute a new approach to address the difficulties in
 designing braces.
The designs of flexible brace include: an artificial hinge bone is used to stabilize the
 corrective components. Corrective straps are attached to the artificial hinge to exert
 corrective forces onto the scoliotic spine. Semi-rigid silicon pads with high conformability
 to the body are used to enhance the corrective forces.

 This study is a multi-disciplinary collaborative project with experts in computer science,
 orthopaedics, materials science, garment technology, engineering and biomechanics. A
 biomechanical computational model will be developed to recommend modifications to the
 flexible brace design. The effectiveness of the flexible braces will be evaluated through
 low-dose X-ray radiography at pre-, post-expert and post-ML designed treatment. A polynomial
 scoring system will be created to assess the therapeutic similarity of the ML-designed
 flexible brace to the expert-designed flexible brace based on an estimate of the corrective
 forces applied through the braces. Reinforcement learning with scores based on estimated
 pressure force will guide AI training towards superior therapeutic designs.
Inclusion Criteria:

 -  Teenagers diagnosed with adolescent idiopathic scoliosis

 -  Cobb's angle between 20 to 45 degrees

 -  Immature skeletons (Risser grade 0-2)

 -  Types of scoliosis are classified by the Lenke classification system

 -  Have received rigid brace treatment

 Exclusion Criteria:

 -  Contraindications for x-ray exposure

 -  Diagnosis of other musculoskeletal or developmental illness that might be responsible
 for the spinal curvature

 -  History of previous surgical treatment for AIS

 -  Contraindications for pulmonary and/ or exercise tests

 -  Psychiatric disorders

 -  Recent trauma

 -  Recent traumatic (emotional) event