Effect of in- and outpatient brace adaptation protocols on brace compliance in adolescent patients with idiopathic scoliosis

In the past , there has been a lot of debate about the effectiveness of brace treatments for adolescent idiopathic scoliosis (AIS). Recently, the Bracing in Adolescent Idiopathic Scoliosis Trial made an important contribution to this continueing debate as they showed that bracing significantly reduces the risk of progression and the subsequent risk to ondergo surgery. However, this benefit of bracing was only achieved with good compliance (i.e. many hours of brace wear). Few children with AIS wear the brace for the prescribed number of hours per day. Since the brace has to be worn for 20 hours a day over a long period of time, the bracing has a significant impact on daily life of AIS patients. Initiation of the brace treatment is done differently in scoliosis centers world wide. It can be done in an in- and outpatient setting. Whether the setting in which the brace treatment is initiated influences the short- and long-term compliance is unknown. The objective of this study is to evaluate the effect of in- and outpatient brace adaptation on short- and long-term brace compliance.

An inpatient brace adaptation protocol increases therapy compliance and brace comfort for the patient compared to an outpatient brace adaptation protocol.

Start bracing is considered enrollment (T=0). Outpatient clinic visits at 2 months and 6 months. After 6 months the visits are every 6 months. Last visit is at stop brace treatment when skeletal maturity is reached (T=e)

outpatient brace adaptation or inpatient brace adaptation