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Compliance comparison of different bracing concepts
Scoliosis volume 5, Article number: O59 (2010)
Success in AIS-Bracing depends completely on patients’ compliance. Compliance is an irreplaceable condition of IAS-Bracing. The investigation tries to find out differences in compliance between different bracing-methods and it compares especially Full-Time- and Night-Time-Bracing.
Material and methods
200 AIS patients (70 traditional Full-Time-Braces, 96 double treatments with traditional Day-Brace plus additional Night-Time-Brace and 34 patients with isolated Night-Time-Braces) have been included in a comprehensive, anonymous compliance survey. We distinguished daytime- and nighttime-compliance and various kinds of activity. We also asked patients and parents for their preferences concerning Early Night-Time-Bracing (ENTB).
Among the users of traditional Full-Time-Braces we found an noncompliance rate of more than 40% during daytime. All of the braces were worn much more regularly during the night. Noncompliance rates for night use ranged from 15.3% (traditional Full-Time-Braces) to only 8% for isolated Night-Time-Braces. 86.6% of the patients indicated that their quality of life (QOL) was most affected during daytime use and only 7.2% during night use. 98% of patients and parents preferred ENTB and were against waiting for verification of progression, because the avoidance of Full-Time-Treatment had highest priority for them. But facts are completely reverse: Only 13% of AIS brace-patients get an Early-Night-Time-Treatment. The majority of patients are still getting treatment at more than 25° Cobb and ad hoc 23 hours.
All the results of our compliance research show that physical and psychological stress of AIS Full-Time-Bracing is much higher than with Night-Time-Bracing, and the compliance rates are much lower during the day. Patients and parents want progression to be stopped as soon as possible to be, in particular, sure to avoid Full-Time-Bracing. On the other hand, success of bracing is 100% dependent on patients’ compliance. All of these facts underline the need for a treatment concept which can avoid AIS progression effectively while at the same time causing a minimal effect on the QOL. The most careful way of bracing is ENTB of moderate curvatures. In the range of 16 - 25° Cobb it is possible to stop progression and avoid Full-Time-Bracing with a success rate of 85%  by only using Night-Time-Braces with moderate correction forces, whereon patients respond with best acceptance.
By far the best compliance of AIS brace-treatment we found among patients who wear Night-Time-Braces at a point of moderate curvatures and enjoy daytime life without a brace. Their curves can be stopped with minimal effect on their QOL. Accordingly, in the future ENTB should become an integral part of AIS-therapy in between only physiotherapy and Full-Time-Bracing.
Andreas Selle, Jens Seifert, Carl Gustav Carus: Early night-time-bracing – an alternative in AIS management. Scoliosis. 2010, 5 (Suppl 1): O57-
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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Selle, A., Seifert, J. & Carus, C.G. Compliance comparison of different bracing concepts. Scoliosis 5 (Suppl 1), O59 (2010). https://doi.org/10.1186/1748-7161-5-S1-O59
- Public Health
- Success Rate
- Minimal Effect
- Psychological Stress
- Compliance Rate