Aims
There is a paucity of literature regarding the conservative management of adults with scoliosis. The aim of this study was to review and summarise the existing literature on the efficacy of bracing for adults with scoliosis.
Methods
CINAHL, Embase, CENTRAL, PubMed and PEDro were searched. The authors sought to retrieve all studies investigating brace treatment for adults with scoliosis. Studies were included if A) clinical outcomes were collected from B) participants ≥18 years C) receiving brace treatment for D) degenerative de novo scoliosis or progressive adolescent scoliosis in the adult. Data were extracted, and a risk of bias assessment was performed.
Results
10 studies (4 case reports and 6 cohort studies [2 retrospective and 4 prospective]) were included which detailed the clinical outcomes of soft (2/10) or rigid (8/10) bracing, used as a standalone therapy (6/10) or in combination with physiotherapy/rehabilitation (4/10), in 339 participants with various types of scoliosis. Most (7/10) studies included only females. Commonly reported outcomes were pain, function and cobb angles, with follow-up times ranging from 2 days to 17 years. Brace wear prescriptions ranged from 2-23 hours per day, and there was mixed brace-compliance reported. Most studies reported a significant reduction in pain and improvement in function at follow-up. There were no direct harms associated with bracing. Each of the six cohort studies were of low quality.
Conclusions
Bracing appears to have a positive influence on pain and functional outcomes in adults with progressive ASA and DDS. From a clinical perspective the evidence would suggest that some patients may benefit in the short- to medium-term from bracing. However, the current evidence is scant and of low quality due to reliance on samples drawn from clinical databases. Properly constructed prospective trials are required to truly understand the efficacy of bracing for adults with scoliosis.