Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: A preliminary analysis

Background: Despite the positive effects of spinal braces on postural stability, they may constrain movement, resulting in poor balance control in patients with adolescent idiopathic scoliosis (AIS). Therefore, assessment of postural dynamics may aid in designing new less-constraining braces. Objectives: The effects of a spinal brace on postural stability and Cobb angle were investigated in this study. Methods: Thirteen pediatric patients (10 females, three males) with AIS were recruited to participate in the study. Cobb angle was assessed by X-ray analyses, and postural stability was tested by computerized dynamic posturography in braced and unbraced conditions. A polyethylene underarm corrective spinal brace was fabricated for the subjects. Results: Thoracic and lumbar curvature decreased to 18.88 +/- 11.73 degrees and 17.70 +/- 10.58 degrees, respectively, after bracing (p < 0.05). Lower equilibrium scores were observed in the "eyes closed'' condition and higher scores in the "eyes closed with a swaying support'' condition; higher composite equilibrium scores were also observed for the sensory organization test (p < 0.05) in the braced condition. Lower scores were observed for the "toes-up adaptation test'' in the braced condition (p < 0.05). In the braced condition, the reaction time was slower in the right-backward direction and movement velocity was higher in the right-front direction on the limits of stability test (p < 0.05). Furthermore, lower on-axis velocity during forward/backward dynamic balance control was observed in the braced condition (p < 0.05). Conclusions: Wearing a spinal brace improved postural stability in terms of increased proprioception, equilibrium performance, and rhythmic movement ability in patients with AIS. (C) 2014 Elsevier B.V. All rights reserved.