Journal article
Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis
Spine deformity, Vol.8(4), pp.597-604
08/01/2020
DOI: 10.1007/s43390-020-00060-1
PMID: 32026441
Abstract
Study designSurvey.ObjectivesBracing is the mainstay of conservative treatment in Adolescent Idiopathic Scoliosis (AIS). The purpose of this study was to establish best practice guidelines (BPG) among a multidisciplinary group of international bracing experts including surgeons, physiatrists, physical therapists, and orthotists utilizing formal consensus building techniques.Summary of background dataCurrently, there is significant variability in the practice of brace treatment for AIS and, therefore, there is a strong need to develop BPG for bracing in AIS.MethodsWe utilized the Delphi process and the nominal group technique to establish consensus among a multidisciplinary group of bracing experts. Our previous work identified areas of variability in brace treatment that we targeted for consensus. Following a review of the literature, three iterative surveys were administered. Topics included bracing goals, indications for starting and discontinuing bracing, brace types, brace prescription, radiographs, physical activities, and physiotherapeutic scoliosis-specific exercises. A face-to-face meeting was then conducted that allowed participants to vote for or against inclusion of each item. Agreement of 80% throughout the surveys and face-to-face meeting was considered consensus. Items that did not reach consensus were discussed and revised and repeat voting for consensus was performed.ResultsOf the 38 experts invited to participate, we received responses from 32, 35, and 34 for each survey, respectively. 11 surgeons, 4 physiatrists, 8 physical therapists, 3 orthotists, and 1 research scientist participated in the final face-to-face meeting. Experts reached consensus on 67 items across 10 domains of bracing which were consolidated into the final best practice recommendations.ConclusionsWe believe that adherence to these BPG will lead to fewer sub-optimal outcomes in patients with AIS by reducing the variability in AIS bracing practices, and provide a framework future research.Level of evidenceLevel IV.
Details
- Title: Subtitle
- Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis
- Creators
- Benjamin D. Roye - Columbia University Medical CenterMatthew E. Simhon - Columbia University Medical CenterHiroko Matsumoto - Columbia University Medical CenterPrachi Bakarania - Columbia University Medical CenterHagit Berdishevsky - Columbia University Medical CenterLori A. Dolan - University of IowaKelly Grimes - Columbia University Medical CenterTheodoros B. Grivas - Tzaneion General HospitalMichael T. Hresko - Boston Children's HospitalLori A. Karol - Texas Scottish Rite Hospital for ChildrenBaron S. Lonner - Department of Orthopaedic Surgery, Mount Sinai Hospital, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.Michael Mendelow - Shriners Hospitals for Children - GreenvilleStefano Negrini - University of BresciaPeter O. Newton - Rady Children's Hospital-San DiegoEric C. Parent - University of AlbertaManuel Rigo - Elena Salvá Institute (Rigo Quera Salvá S.L.P.), VÍa Augusta 185, 08021, Barcelona, Spain.Luke Strikeleather - National Scoliosis Center, 3023 Hamaker Court, Suite LL-50, Fairfax, VA, 22124, USA.John Tunney - Columbia University Medical CenterStuart L. Weinstein - University of Iowa Hospitals and ClinicsGrant Wood - Align TechnologyMichael G. Vitale - Columbia University Medical Center
- Resource Type
- Journal article
- Publication Details
- Spine deformity, Vol.8(4), pp.597-604
- Publisher
- Springer Nature
- DOI
- 10.1007/s43390-020-00060-1
- PMID
- 32026441
- ISSN
- 2212-134X
- eISSN
- 2212-1358
- Number of pages
- 8
- Grant note
- Scoliosis Research Society
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
- Record Identifier
- 9984304714602771
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