Skip to main content

Dynamic elastomeric fabric orthoses in neuropathic scoliosis management: an audit of the frequency and characteristics of use


Scoliosis is a common consequence of neuromuscular diseases with an incidence of 25% in cerebral palsy (CP) [1] and 75-90% in non-ambulant Duchenne muscular dystrophy [2]. Evidence from case studies demonstrates that dynamic elastomeric fabric orthoses (DEFO’s) may provide an effective alternative to rigid bracing [3], which often causes discomfort and hence is associated with non-compliance.


We aimed to describe the routine management of paediatric neuropathic scoliosis, more specifically orthotic management; and explore the progression of scoliosis with DEFO use.


Retrospective audit.


The physiotherapy notes of children with neurological conditions were audited in five Healthcare Trusts across England. A standardized data collection form was used to gather diagnostic and demographic information and scoliosis characteristics and management.


180 notes were audited (85 male; mean age 9 years [SD 4y 7mo]). Diagnoses included cerebral palsy (44%), neuromuscular dystrophy (3%), spinal pathology (2%), developmental delay (23%) and others (28%), including Retts syndrome and epilepsy.

Scoliosis (Cobb angle ≥10 degrees) was confirmed in 77 children of whom 45% had been prescribed a DEFO. This was replaced by a rigid orthoses for 4 children; another 4 stopped using the DEFO or any other form of orthoses. DEFO management was far less likely in those with severe scoliosis. Of those with radiographic/ medical records enabling their scoliosis to be categorized according to severity, 28/42 (72%) with mild scoliosis, 5/8 (63%) with moderate scoliosis and 1/8 (13%) with severe scoliosis used a DEFO. A developing scoliosis was seen in 43 children of whom 51% used a DEFO. No scoliosis was observed in 77 children, all of whom wore a DEFO as a preventative measure. In children wearing a DEFO, in whom the Cobb angle was monitored over time, there was a deterioration of >10o in only 1/8.


DEFO use varied across region and was used in a variety of neuromuscular conditions. It was used more commonly in the management of less severe scoliosis and as a preventative measure. Where serial monitoring was performed, Cobb angle progression was only minimal in those using a DEFO.


  1. Tsirikos AI, Spielmann P: Spinal deformity in paediatric patients with cerebral palsy. C Orthop. 2007, 21: 122-134. 10.1016/j.cuor.2007.01.001.

    Article  Google Scholar 

  2. Kinali M, Messina S, Mercuri E, Lehovsky J, Edge G, Manzur AY, Muntoni F: Management of Scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study. Dev med child neurol. 2006, 48: 513-518. 10.1017/S0012162206001083.

    Article  CAS  PubMed  Google Scholar 

  3. Matthews M, Crawford R: The use of dynamic Lycra orthosis in the treatment of scoliosis: A case study. Prosthet Orthot Int. 2006, 30 (2): 174-181. 10.1080/03093640600794668.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blandford, S., Marsden, J., Matthews, M. et al. Dynamic elastomeric fabric orthoses in neuropathic scoliosis management: an audit of the frequency and characteristics of use. Scoliosis 9 (Suppl 1), O30 (2014).

Download citation

  • Published:

  • DOI: