Volume 9 Supplement 1

11th International Conference on Conservative Management of Spinal Deformities - SOSORT 2014 Annual Meeting

Open Access

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

  • Suzanna Blandford1,
  • John Marsden1,
  • Martin Matthews2 and
  • Jenny Freeman1
Scoliosis20149(Suppl 1):O30

https://doi.org/10.1186/1748-7161-9-S1-O30

Published: 4 December 2014

Background

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.

Aim

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

Design

Retrospective audit.

Method

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.

Results

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.

Conclusions

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.

Authors’ Affiliations

(1)
Plymouth University
(2)
DM Orthotics

References

  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.View ArticleGoogle Scholar
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  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.View ArticlePubMedGoogle Scholar

Copyright

© Blandford et al; licensee BioMed Central Ltd. 2014

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 (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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