IMMEDIATE EFFECT OF CUSTOM-MADE BOSTON-TYPE THORACO-LUMBO-SACRAL ORTHOSIS ON BALANCE AND POSTURAL STABILITY IN ADOLESCENT IDIOPATHIC SCOLIOSIS

Abstract

Adolescent idiopathic scoliosis (AIS) can impair postural stability and balance functions. Boston brace systems with varying external corrective force strategies are used as one of the common conservative treatments in AIS. Although multiple studies have found that various orthotic therapies enhance curve advancement, the effects of spinal bracing on postural equilibrium and stability remain unknown. The primary objective of this study was to examine the effect of the immediate use of custom-made Boston-type thoraco-lumbo-sacral orthosis (TLSO) on balance and postural stability in AIS. Postural balance using the center of pressure (CoP) measures was measured by the HUMACⓇ Balance & Tilt System (CSMi, Stoughton, MA). The line laser tool (Bosch, GLL 3 X P, Stuttgart, Germany) was used for measuring the decompensation distance for postural evaluation. The balance parameters such as stability score (%), path length (cm), average velocity (cm/s), and compensation–decompensation for posture were evaluated and compared between brace-on and brace-off conditions. Improvement of standing posture indicates spinal symmetry and cosmesis whereas enhancement of static balance was statistically nonsignificant ([Formula: see text] > 0.05). Although the mean stability score, path length and average velocity of CoP in braced condition (91.4 ± 4.57, 115.62 ± 22.34 cm and 1.05 ± 0.12 cm/s) was found to be improved than unbraced condition (90.5 ± 5.09, 121.46 ± 35.52 cm and 1.11 ± 0.24 cm/s), the results were nonsignificant ([Formula: see text] = 0.078, 0.425 and 0.263). The scoliotic compensation was improved in the braced condition (0.64 ± 0.60 cm) compared to brace-off condition (1.74 ± 0.61 cm) showing improved posture ([Formula: see text] = 0.00013). Wearing the custom-made Boston-type TLSO showed positive effects on static posture and mean balance parameters. In future studies, the long-term effectiveness of this brace should be examined in patients with different spinal curve patterns and degrees of scoliosis.