Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis

Benjamin D. Roye; Matthew E. Simhon; Hiroko Matsumoto; Prachi Bakarania; Hagit Berdishevsky; Lori A. Dolan; Kelly Grimes; Theodoros B. Grivas; Michael T. Hresko; Lori A. Karol; Baron S. Lonner; Michael Mendelow; Stefano Negrini; Peter O. Newton; Eric C. Parent; Manuel Rigo; Luke Strikeleather; John Tunney; Stuart L. Weinstein; Grant Wood; Michael G. Vitale

doi:10.1007/s43390-020-00060-1

Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis

Benjamin D. Roye, Matthew E. Simhon, Hiroko Matsumoto, Prachi Bakarania, Hagit Berdishevsky, Lori A. Dolan, Kelly Grimes, Theodoros B. Grivas, Michael T. Hresko, Lori A. Karol, Baron S. Lonner, Michael Mendelow, Stefano Negrini, Peter O. Newton, Eric C. Parent, Manuel Rigo, Luke Strikeleather, John Tunney, Stuart L. Weinstein, Grant WoodMichael G. Vitale

Research output: Contribution to journal › Review article › peer-review

42 Scopus citations

Abstract

Study design: Survey. Objectives: Bracing 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 data: Currently, 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. Methods: We 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. Results: Of 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. Conclusions: We 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 evidence: Level IV.

Original language	English
Pages (from-to)	597-604
Number of pages	8
Journal	Spine Deformity
Volume	8
Issue number	4
DOIs	https://doi.org/10.1007/s43390-020-00060-1
State	Published - 1 Aug 2020

Keywords

Adolescent idiopathic scoliosis
Best practice guideline
Bracing

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10.1007/s43390-020-00060-1

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Roye, B. D., Simhon, M. E., Matsumoto, H., Bakarania, P., Berdishevsky, H., Dolan, L. A., Grimes, K., Grivas, T. B., Hresko, M. T., Karol, L. A., Lonner, B. S., Mendelow, M., Negrini, S., Newton, P. O., Parent, E. C., Rigo, M., Strikeleather, L., Tunney, J., Weinstein, S. L., ... Vitale, M. G. (2020). Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis. Spine Deformity, 8(4), 597-604. https://doi.org/10.1007/s43390-020-00060-1

@article{dfc77c8947d743fa83a099929dba944c,

title = "Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis",

abstract = "Study design: Survey. Objectives: Bracing 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 data: Currently, 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. Methods: We 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. Results: Of 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. Conclusions: We 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 evidence: Level IV.",

keywords = "Adolescent idiopathic scoliosis, Best practice guideline, Bracing",

author = "Roye, {Benjamin D.} and Simhon, {Matthew E.} and Hiroko Matsumoto and Prachi Bakarania and Hagit Berdishevsky and Dolan, {Lori A.} and Kelly Grimes and Grivas, {Theodoros B.} and Hresko, {Michael T.} and Karol, {Lori A.} and Lonner, {Baron S.} and Michael Mendelow and Stefano Negrini and Newton, {Peter O.} and Parent, {Eric C.} and Manuel Rigo and Luke Strikeleather and John Tunney and Weinstein, {Stuart L.} and Grant Wood and Vitale, {Michael G.}",

note = "Publisher Copyright: {\textcopyright} 2020, Scoliosis Research Society.",

year = "2020",

month = aug,

day = "1",

doi = "10.1007/s43390-020-00060-1",

language = "English",

volume = "8",

pages = "597--604",

journal = "Spine Deformity",

issn = "2212-134X",

publisher = "Elsevier BV",

number = "4",

}

Roye, BD, Simhon, ME, Matsumoto, H, Bakarania, P, Berdishevsky, H, Dolan, LA, Grimes, K, Grivas, TB, Hresko, MT, Karol, LA, Lonner, BS, Mendelow, M, Negrini, S, Newton, PO, Parent, EC, Rigo, M, Strikeleather, L, Tunney, J, Weinstein, SL, Wood, G & Vitale, MG 2020, 'Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis', Spine Deformity, vol. 8, no. 4, pp. 597-604. https://doi.org/10.1007/s43390-020-00060-1

TY - JOUR

T1 - Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis

AU - Roye, Benjamin D.

AU - Simhon, Matthew E.

AU - Matsumoto, Hiroko

AU - Bakarania, Prachi

AU - Berdishevsky, Hagit

AU - Dolan, Lori A.

AU - Grimes, Kelly

AU - Grivas, Theodoros B.

AU - Hresko, Michael T.

AU - Karol, Lori A.

AU - Lonner, Baron S.

AU - Mendelow, Michael

AU - Negrini, Stefano

AU - Newton, Peter O.

AU - Parent, Eric C.

AU - Rigo, Manuel

AU - Strikeleather, Luke

AU - Tunney, John

AU - Weinstein, Stuart L.

AU - Wood, Grant

AU - Vitale, Michael G.

PY - 2020/8/1

Y1 - 2020/8/1

N2 - Study design: Survey. Objectives: Bracing 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 data: Currently, 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. Methods: We 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. Results: Of 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. Conclusions: We 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 evidence: Level IV.

AB - Study design: Survey. Objectives: Bracing 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 data: Currently, 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. Methods: We 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. Results: Of 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. Conclusions: We 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 evidence: Level IV.

KW - Adolescent idiopathic scoliosis

KW - Best practice guideline

KW - Bracing

UR - http://www.scopus.com/inward/record.url?scp=85079773890&partnerID=8YFLogxK

U2 - 10.1007/s43390-020-00060-1

DO - 10.1007/s43390-020-00060-1

M3 - Review article

C2 - 32026441

AN - SCOPUS:85079773890

SN - 2212-134X

VL - 8

SP - 597

EP - 604

JO - Spine Deformity

JF - Spine Deformity

IS - 4

ER -

Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis

Abstract

Keywords

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