Evaluating the Effectiveness of Posture Correction Girdle for Adolescents With Early Scoliosis
Evaluating the Effectiveness of Posture Correction Girdle for Adolescents With Early Scoliosis
Through the ITF-Tier 3 project (ITS/ 237/ 11), a prototype of the posture correction girdle
 based on the clinical, textile science, material and ergonomics engineering analyses has been
 developed for preteen and teenage girls aged 10 to 13 who have the early stages of scoliosis.
 The girdle provides a corrective force onto the torso by the warping and elastic extension of
 the shoulder straps and waistband and the insertion of semi-rigid EVA padding and uses a
 point-pressure support system to achieve the target of posture improvement and spinal
 progression control with physical and psychological comfort.

 In order to evaluate the effectiveness of the posture correction girdle, it is proposed to
 recruit 10 patients to take low dose x-ray (sterEOS) at QMH at supine position. Then, the
 patient should wear the girdle for two hours and take another x-ray at standing position. If
 the Cobb's angle of the patient on girdle at standing position can be same as her supine
 position. It can prove the effectiveness of the girdle.
Background Information Scoliosis in patients between 10 and 18 years of age is termed
 adolescent scoliosis. The most common type of scoliosis is one of which the cause is not
 known. This is called "idiopathic" or "adolescent idiopathic scoliosis (AIS)". The main risk
 factors of curve progression could be skeletal immaturity, female gender and large curve
 magnitude. It has been found that nearly 10% of all adolescents have some degree of spinal
 curve or deformity after their tenth year. The health of patients, such as cardiac and
 pulmonary functions, may be affected if their spinal deformity is very serious. Hence, the
 most ideal way is to monitor and control spinal curvature once AIS has been found.

 Treatment options for scoliosis In general, patients are suggested to undergo different types
 of treatments according to their spine situations and stage of scoliosis. Surgery is
 suggested for patients with spinal curves that are greater than 41-50 degrees, while bracing
 is a non-invasive treatment suggested for those with spinal curves between 21-40 degrees.
 Thoraco-lumber-sacral-orthosis (TLSO) or cervico-thoraco-lumbo-sacral orthosis (CTLSO) braces
 are the most commonly prescribed and used braces. The 3-point pressure system is primarily
 applied by all TLSO braces in order to correct the spinal curve and reduce the curve
 progression. The plaster cast is tailor-made according to the body shape of each patient. The
 upper torso of the wearer needs to be tightly compressed by this non-breathable material for
 23 hours every day. The duration of the treatment duration will be for years until the bones
 are fully mature.

 Aside from the fact that newer types of flexible brace products in the market are not
 available in large numbers, their effectiveness continues to be controversial and there is
 much room for improvement. The SpineCor Dynamic brace is one of the flexible braces used to
 treat AIS. The theory behind the SpineCor system is known as spinal coupling. Spinal coupling
 corrects deformities by reversing abnormal posture and body shape into their opposite
 position so that the abnormal alignment of the spine can be corrected. As the spinal curve of
 each patient is different, thus appropriate positions and tensions of the elastics will be
 respectively placed and adjusted by a professional before the patient wears the brace. It has
 been found that the curve progression rate of those who wear the SpineCor Dynamic brace is
 significantly higher than those who wear the rigid brace. It is believed that the
 ineffectiveness of the flexible brace may be caused by the shifting of the elastic bands. The
 elastic bands present on the brace are not fixed to the body of the wearer, and may easily
 shift to other areas during movement. Hence, the corrective force will no longer be exerted
 onto the correct position for posture and body shape correction.

 A summary of the research rationale is listed below. Research rationale 1: Low treatment
 compliance Treatment through the use of a hard brace has low compliance due to discomfort and
 psychological issues, such as an awkward and bulky appearance. Flexible braces have other
 issues, such as discomfort caused by the elastic bands, inconvenience when going to the
 toilet, and unusual designs, which also result in low compliance. New designs that aim to
 improve compliance are therefore extremely important.

 Research rationale 2: Limited product choice for adolescents with early scoliosis Hard brace
 treatment is overly excessive for adolescents with early scoliosis due to the high corrective
 force which nearly constrains all movements. The flexible brace treatment is an alternative
 option; however, its efficacy remains controversial. Intimate apparel that has a specialized
 design for teenagers with scoliosis is limited and a large majority can only provide some
 improvement for poor postures, such as hunchback. A scientific approach should be used to
 design and develop functional intimate apparel as a treatment option for adolescents with
 early scoliosis.
Inclusion Criteria:

 -  • Satisfy SRS criteria for bracing15

 -  Curretly treated for rigid underarm brace

 -  Primary Cobb angle between 25 to 40 degrees

 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 or orthotic treatment for AIS

 -  Contraindications for pulmonary and / or exercise tests

 -  Psychiatric disorders

 -  Recent trauma

 -  Recent traumatic (emotional) event