1. No category

Soft braces in the treatment of Adolescent
Idiopathic Scoliosis (AIS) – Review of the literature
and description of a new approach
Weiss and Werkmann
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
REVIEW
Open Access
Soft braces in the treatment of Adolescent
Idiopathic Scoliosis (AIS) – Review of the literature
and description of a new approach
Hans-Rudolf Weiss1* and Mario Werkmann2
Abstract
Background: The use of soft braces to treat scoliosis has been described by Fischer as early as 1876. With the help
of elastic straps, as the authors suggested, a corrective movement for individual curve patterns should be
maintained in order to inhibit curve progression. Today this concept has been revived besides soft 3 point pressure
systems. Some shortcomings have been revealed in literature in comparison with hard braces, however the
concept of improving quality of life of a patient while under brace treatment should furtherly be considered as
valuable. Purpose of this review is to gather the body of evidence existent for the use of soft braces and to present
recent developments.
Method: A review of literature as available on Pub Med was performed using the key words ‘scoliosis’ and ‘soft
brace’ at first. The search was expanded using ‘scoliosis’ and the known trademarks (1) ‘scoliosis’ and ‘SpineCor’,
(2) ‘scoliosis’ and ‘TriaC’, (3) ‘scoliosis’ and ‘St. Etienne brace’, (4) ‘scoliosis’ and ‘Olympe’. The papers considered for
inclusion were new technical descriptions, preliminary results, cohort studies and controlled studies.
Results: When searching for the terms ‘scoliosis’ and ‘SpineCor’: 20 papers have been found, most of them
investigating a soft brace, for ‘scoliosis’ and ‘TriaC’: 7 papers displayed, for ‘scoliosis’ and ‘St. Etienne brace’: one
paper displayed but not meeting the topic and for ‘scoliosis’ and ‘Olympe’: No paper displayed. Four papers found
on the SpineCor™ were of prospective controlled or prospective randomized design. These papers partly presented
contradictory results. Two papers were on soft Boston braces used in patients with neuromuscular scoliosis.
Discussion: There is a small but consistent body of evidence for the use of soft braces in the treatment of scoliosis.
Contradictory results have been published for samples treated during the pubertal growth spurt. In a biomechanical
analysis the reason for the lack of effectiveness during this period has been elaborated. Improved materials and the
implementation of corrective movements respecting also the sagittal correction of the scoliotic spine will hopefully
contribute to an improvement of the results achievable.
Conclusions: The treatment of scoliosis using soft braces is supported by some papers providing a small body of
evidence. During the growth spurt the use of soft braces is discussed contradictory. There is insufficient evidence to
draw definite conclusions about effectiveness and safety of the intervention.
* Correspondence: [email protected]
1
Orthopedic Rehabilitation Services, Alzeyerstr. 23, Gensingen D-55457,
Germany
Full list of author information is available at the end of the article
© 2012 Weiss and Werkmann; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
Background
The use of soft braces to treat scoliosis has first been
described by Fischer (1876, cited by Schanz [1], see also
Additional file 1). With the help of elastic straps, as the
authors suggested, a corrective movement for individual
curve patterns should be maintained in order to inhibit
curve progression (Figure 1).
However soft braces have been forgotten for long:
Hard braces have been proposed by Wullstein (1902)
not long after the first publications on soft braces [2].
Later the Milwaukee brace has been proposed [3], the
Chêneau brace [4,5] and the Boston brace [6], all of
them hard braces with reasonable impact on the quality
of life of the patients treated.
While the Milwaukee brace was less effective [4], early
outcome studies have described the Chêneau brace [4,5]
and the Boston brace as effective in the prevention of curve
progression during growth [6]. Prospective controlled multicenter [7] and long-term studies [8] have shown the Boston
brace to be effective, but there were also outcome studies
on the Chêneau brace clearly demonstrating that in-brace
correction and compliance are crucial to the outcome of
brace treatment [9].
During the late 80’es and early 90’es in France soft
braces with the 3-point pressure approach have been
described like the St. Etienne brace and the Olympe
[10,11], but these have not been investigated furtherly.
During the 90’es soft brace treatment was re-developed
[12]. The soft brace as presented by Coillard [12-14], comparable to the brace described by Schanz [1], was indroduced another time and the first results were published in
2003 [13]. A cohort of patients from 4 – 14 years of age
have been treated successfully with the help of this brace.
Later on more positive results have been published [14].
Page 2 of 10
However, as Coillard and Rivard have pointed out the
group of patients at risk for progression (first signs of
maturation, premenarchial) showed to have the least
positive effects [14].
In two independend prospective controlled studies the
soft brace as presented by Coillard [12-14] has been
shown to be less effective than hard braces [15,16]. This
fact has been analyzed and the unsatisfactorily correction of the sagittal profile in the soft brace as presented
by Coillard [12-14] has been accused to be the reason
for this [17].
As a matter of fact a relordosation of the lumbar spine
is not induced when using the soft brace as presented
by Coillard [12-14]. Therefore the compressive forces
generated in this application may destabilize the spine,
while a restoration of the sagittal profile can stabilize
and even correct scoliosis as has been described by van
Loon in 2008 [18]. Other reviews, experimental studies
or case series seem to support these findings [19-26].
As it seems, to improve the results of soft braces during
the high risk phase of the pubertal growth spurt, the sagittal plane seems to be important to focus on in order to
improve the results of treatment also in the population at
risk for progression (Figure 2).
Purpose of this development was to improve the corrective movements in frontal plane as have been described
[12-14] and add a considerable correction of the sagittal
plane in order to stabilize the spine while it is compressed
by the elastic straps, wrapped around the entire trunk.
However, some shortcomings [15-17] have been revealed
in literature in comparison with hard braces, however the
concept of improving quality of life of a patient while
under brace treatment should furtherly be considered as
valuable. Purpose of this review is to gather the body of
Figure 1 Left the soft brace as described by Fischer 1876 and a soft brace of current standard as distributed today (middle and right).
Unfortunately no picture from the rear exists for the Fischer brace, however the adjustment of the corrective ribbon from the front seems rather
identical. (With kind permission by Pflaum, Munich).
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
Page 3 of 10
Figure 2 Universal Spine Orthosis as developed 2007. This brace uses shifting of shoulder and pelvic girdle against each other as well as a
restoration of the sagittal profile (right). (With kind permission by Pflaum, Munich).
evidence existent for the use of soft braces and to present
recent developments.
Method
A review of literature as available on Pub Med was performed (January 31st. 2012) using the key words ‘scoliosis’
and ‘soft brace’ at first. The search was expanded using
‘scoliosis’ and the known trademarks (1) ‘scoliosis’ and
‘SpineCor’, (2) ‘scoliosis’ and ‘TriaC’, (3) ‘scoliosis’ and
‘St. Etienne brace’, (4) ‘scoliosis’ and ‘Olympe’.
A case report is presented to demonstrate the in-brace
correction achievable in a recent development.
Results
Using the key words ‘scoliosis’ and ‘soft brace’ 16 articles
displayed, only, four of them meeting the topic. Two
were referring to the treatment of patients with IS, two
were on the treatment of neuromuscular scoliosis. The
expanded search revealed the following:
(1) ‘scoliosis’ and ‘SpineCor’: 20 papers have been
found, most of them investigating a soft brace.
(2) ‘scoliosis’ and ‘TriaC’: 7 papers displayed.
(3) ‘scoliosis’ and ‘St. Etienne brace’: one paper
displayed but not meeting the topic
(4) ‘scoliosis’ and ‘Olympe’: No paper displayed.
The papers considered for inclusion were new technical
descriptions, preliminary results, cohort studies and
controlled studies [12-16,27-44].
Four papers found on the SpineCor™ were of prospective
controlled or prospective randomized design [15,16,39,42].
Figure 3 Corrective movement during a ‘Power Schroth’ exercise. (With kind permission by Pflaum, Munich).
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
Page 4 of 10
Figure 4 Corrective movement in the Gensingen brace™. In immature patients and single curve patterns an overcorrection is not rare.
(With kind permission by Pflaum, Munich).
Two papers were on soft Boston braces used in patients
with neuromuscular scoliosis [45,46].
Recent developments
The idea of using soft braces and reducing the impact
braces have on the patients is appreciated. However as
there seem to be certain shortcomings, these should be
ruled out to increase patients’ safety and enlarge the
range of indications.
The corrective movement in frontal plane as described
by Fischer [1] and later by Coillard [12-14] should be
preserved while lumbar lordosis should be augmented
with the help of a newly designed soft brace. The first
step into this direction was the development of a soft
Figure 5 Aspects of the Spinealite™ soft brace attached for a 3CL pattern according to the ALS classification.
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
brace called “Universal Spine Orthosis (USO)™” (patent
pending) in 2007, which has not been applied widely.
The harness for adjustment of the corrective ribbons
provided using the soft brace as presented by Coillard
[12-14] was replaced by a small plastic fixation element
where the elastic ribbons can be adjusted to. This fixation
element is adjusted to augment lumbar lordosis (Figure 2).
The USO™ allows to adjust the corrective ribbons in
multiple ways for different purposes and therefore can be
used for other indications than scoliosis treatment as well.
However the USO, like other softbraces in use today
[12-14] is not easy to adjust and also with this softbrace
the patients may experience some problems in everday
use (eg. clothes change, toilet use). Therefore we found
further developments necessary to (1) make the brace
easier to adjust, (2) easier to use and (3) to implement
the corrective movements necessary in 3D.
Within the Scoliologic™ ‘Best Practice’ program of
physiotherapy we have a simple 3D system of postural
corrections. This consists of (1) pelvic girdle correction, (2)
shifting of shoulder girdle against pelvic girdle, (3) spiral
Page 5 of 10
shoulder girdle correction and (4) correction of the sagittal
profile [21,22].
These are also the main principles of correction we
find in the Scoliologic™ ‘Best Practice’ hard braces
(Chêneau light™, Gensingen brace™) leading to high inbrace corrections (Figure 3 and 4) as has been documented recently [22-24]. The application of the Scoliologic™ ‘Best Practice’ braces has been shown to have the
least rate of surgery [25], when compared to other studies
respecting the SRS inclusion criteria.
Therefore it was the aim of our recent development to
implement all these principles of correction and by the
same time make the new soft brace development smaller
and more easy to adjust. The result of this development
is demonstrated in the following.
A new soft brace for 3D correction of scoliosis – the
Spinealite™
Correcting ribbon materials
Contrary to the correcting ribbon material as used in
the soft brace as presented by Coillard [12-14] we apply
Figure 6 The ALS classification. (With kind permission by Pflaum, Munich).
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
materials with much less elasticity (Figure 5). In
principle the materials we use are of endelastic entity
and do not lose the tension force after a few weeks time
of wearing. The correction as adjusted can be maintained, however as there is no unlimited freedom of
movement like in the soft brace as presented by Coillard
[12-14], this brace is not as comfortable to wear. However less comfort is outwighted by a constant force of
correction leading to the best possible results as achievable with soft braces considering that correction in brace
treatment is crucial to the outcome [9,26].
Adjustment
The adjustment of the Spinealite™ is pattern dependent
(Figure 6). We derive the adjustment of the system from
the ALS Classification (Augmented Lehnert-Schroth
Classification). The shift is adjusted for all curvature patterns containing a thoracic curvature (3CH, 3CN, 3CTL,
3CL, 4C). In these cases the shoulder girdle is retracted
on the thoracic convex side and shifted over to the thoracic
concave side. In patterns without a significant lumbar
curve (3CH, 3CN, 3CTL) the pelvic attachment is made
more central, in patterns containing a significant lumbar
curve (3CL,4C, 4CL, 4CTL) the attachment to the pelvic
part of the system has to be made more lateral in order to
allow a lifting of the hemipelvis on the side of the lumbar
convexity (Additional file 2).
The adjustment is described in more detail in the
accompanying product description.
Page 6 of 10
Case report of the in-brace correction possible in the
Spinealite™
A 12.6 year old girl from Russia presented in the practice
of the senior author for brace treatment. The girl was
2 months postmenarchial with a Cobb angle of 28°
thoracic and 22° lumbar in summer 2011 when she was
treated with a Chêneau brace for the first time (Angle
of Trunk Rotation [ATR] thoracic 8°, lumbar 3°). The
in-brace correction in the 1st. brace for a double curve
pattern was fairly good to 10° thoracic and 11° lumbar
(Figure 7). After 6 months she had outgrown the first
brace and returned for a second brace. The curve has
been stable with 27° thoracic and 22° lumbar. As at the
time of the last presentation the clinical pattern tended
more to a single thoracic pattern (Angle of Trunk Rotation
[ATR] thoracic 7°, lumbar 0°) it was decided to treat the
girl with a 3CN type of brace from the Gensingen library.
As the patient reported some problems with compliance
in hard braces it was decided to offer the Spinealite™ soft
brace additionally so she could change braces wearing the
Spinealite™ for 12 hrs. over daytime and the Gensingen
brace™ for 12 hrs. in the evenings and at night.
Both braces were able to overcorrect the main thoracic
curvature to −16° (Figure 8 and Figure 9). However the
patient felt comfortable in the hard brace without any
pains and uncomfortable in the soft brace when full correction was applied. So for the start we reduced the correction to a comfortable position and asked the parents
to increase the correction every week as the ribbons can
be easily be readjusted at home.
Figure 7 The patient presented in the case report in her 1st. Gensingen brace™. A 3CL Gensingen brace™ was adjusted leading to an
acceptable correction. The initial angle of curvature was 28° and in brace correction was 10°.
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
Page 7 of 10
Figure 8 The patient presented in the case report in her 2nd. Gensingen brace™. A 3CN Gensingen brace™ was adjusted leading to an
overcorrection. The initial angle of curvature was 27° and in brace correction was −16°. The little amount the apical vertebra is rotated shows a
high flexibility of the curve. Nevertheless, an overcorrection has only been achieved when the correction was changed to single curve correction
without addressing the lumbar curve.
A video showing the adjustment of correction in this
new soft brace is available [47].
Discussion
There is a small body of evidence for the use of soft
braces in the treatment of scoliosis [12-17,27-44].
Contradictory results have been published for samples
treated during the pubertal growth spurt [15-17,30,32,34].
In a biomechanical analysis the reason for the lack of
effectiveness during this period has been elaborated
[17]. Improved materials and the implementation of
corrective movements respecting also the sagittal correction of the scoliotic curve will contribute to an improvement of the results achievable (Figure 5 and 9).
Figure 9 The patient presented in the case report in her Spinealite™ soft brace. Spinealite™ soft brace was adjusted leading to an
overcorrection. The initial angle of curvature was 27° and in brace correction was −16°. The lumbar counter curve in frontal plane does not seem
to be corrected much, however the axial load of this system when applied to the maximum correction obviously leads to an increased rotation.
Therefore we would not allow the use of this system alone without hard brace and we will always propose regular clinical controls.
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
At this moment we apply the new soft brace system
(Spinealite™) together with high corrective hard braces,
12 hrs. each, however with increasing numbers of
patients and increased experience we do hope to offer
this new soft brace as the sole form of treatment for
adolescents during growth in the near future.
Although there is a small body of papers on soft brace
treatment as found in literature [12-17,27-44] we would
not expose our patients to the risk of sole softbrace
treatment as some of the papers reveal contradictory
outcomes [15-17,30,32,34] and restrictions to use certain
types of braces with respect to curve patterns [30].
At this stage there is no evidence that the Spinealite™
can improve the outcome of soft bracing, however the
principle of applying corrective movements as described
by Fischer [1] and later by Coillard [12-14] has been
found to be beneficial to some extent. The trunk shift in
combination with the other 3D corrective movements is
Page 8 of 10
a powerful corrective force as can be seen on Figure 4.
The addition of a sagittal corrective movement theoretically should enable to improve the outcome of soft bracing
additionally [18-20], but this finally has to be proven in
future studies.
This new soft brace has been shown to be able to correct a scoliosis to an extent comparable to high corrective
hard braces. Therefore we expect beneficial outcomes
when the brace can be worn as prescribed [9,26].
In principle the Fischer brace, SpineCor and the Spinealite
are using a certain corrective movement mainly derived
from physical therapy approaches, while the only other
soft brace on the market today, the TriaC is using the
standard three-point system and can only be applied
for certain single curves.
The Spinealite, contrary to the Fischer brace and the
SpineCor, only uses one dorsal compressive force
(Figure 10), allowing a lordosation of the trunk in the
Figure 10 Simplified model of the trunk compression as applied in soft braces using the corrective movement principle. While in the
Fischer brace and in the SpineCor ventral and dorsal compression forces are applied, the Spinealite only uses one dorsal compressive force
(Figure 10), allowing a lordosation of the trunk in the middle between the two attachment areas (Shoulder and thigh), which is at the
thoracolumbar junction / high lumbar region.
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
middle between the two attachment areas (Shoulder and
thigh), which is at the thoracolumbar junction / high
lumbar region. This corrective movement in sagittal
plane has been shown to be beneficial for curve correction [18]. Additionally, the materials used are less elastic
than in the SpineCor preventing free mobility (also into
the deformity), but this exactly may be viewed as the
difference between a corrective brace and a t-shirt.
The full correction as possible should not be applied
from the very start. A slight corrective movement should
be visible in frontal and sagittal plane which can be
increased every week. The application of this new system,
however requires an experienced clinician able to distinguish between the different curve patterns of the ALS
classification used for a proper adjustment of both, hardand soft brace.
The Spinealite™ soft brace / biofeedback device is using
certain corrective movements which have been described
earlier on [21,22,48-51], however, according to a recent
review it should be emphasized that the power of exercises should not be overestimated [52], see Figure six
from that article. Nevertheless, we propose to perform
the Scoliologic™ ‘Best Practice’ program as described by
Borysov and Borysov extensively [51].
Conclusions
1. The treatment of scoliosis using soft braces is
supported by some papers providing a small body of
evidence.
2. During the growth spurt the use of soft braces is
discussed contradictory.
3. There are shortcomings with respect to limitations of
indication.
4. There is insufficient evidence to draw definite
conclusions about effectiveness and safety of the
intervention (soft brace treatment).
Consent
Written informed consent was attained by the patients
and parents to permit the publication of the clinical
pictures.
Additional files
Additional file 1: Some pages from Schanz [1] showing, that at the
beginning of the last century there already was a wide knowledge
about the possibility of soft brace adjustment. Various kinds of soft
braces were known as well as combinations of hard braces with soft
(elastic) parts.
Additional file 2: Short description of the Spinealite™ application.
Competing interests
HRW is advisor of Koob-Scolitech, Abtweiler, Germany and has applied for
patents.
Page 9 of 10
MW declares to have no competing interest.
Authors’ contribution
HRW: Review of the data base, hand review, manuscript writing, patient
acquisition. MW: Patient acquisition, technical support, prototype production
according to the adjustment plan, brace / biofeedback device adjustment to
the patient. All authors read and approved the final manuscript.
Acknowledgements
I wish to thank Pflaum Company for permitting the publication of pictures
taken or modified from the book with the title Weiss HR: Best practice in
conservative scoliosis care. 4th edition 2012.
Author details
1
Orthopedic Rehabilitation Services, Alzeyerstr. 23, Gensingen D-55457,
Germany. 2Orthomed Scolicare, Orthopedic Technical Services, Alzeyerstr. 23,
Gensingen D-55457, Germany.
Received: 18 February 2012 Accepted: 23 April 2012
Published: 28 May 2012
References
1. Schanz A: Die statischen Belastungsdeformitäten der Wirbelsäule mit
besonderer Berücksichtigung der kindlichen Wirbelsäule. Stuttgart: Enke;
1904:158.
2. Weiß HR: Wirbelsäulendeformitäten – Konservatives Management. München:
Pflaum; 2003.
3. Lonstein JE, Winter RB: The Milwaukee brace for the treatment of
adolescent idiopathic scoliosis. A review of one thousand and twenty
patients. J Bone Joint Surg Am 1994, 76(8):1207–1221.
4. von Deimling U, Wagner UA, Schmitt O: [Long-term effect of brace
treatment on spinal decompensation in idiopathic scoliosis. A
comparison of Milwaukee brace--Chêneau corset]. Z Orthop Ihre Grenzgeb
1995, 133(3):270–273.
5. Hopf C, Heine J: Long-term results of the conservative treatment of
scoliosis using the Cheneau brace. Z Orthop Ihre Grenzgeb 1985, 123
(3):312–322.
6. Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME: The Boston bracing system
for idiopathic scoliosis. Follow-up results in 295 patients. Spine 1986, 11
(8):792–801.
7. Nachemson AL, Peterson LE: Effectiveness of treatment with a brace in
girls who have adolescent idiopathic scoliosis. A prospective, controlled
study based on data from the Brace Study of the Scoliosis Research
Society. J Bone Joint Surg Am 1995, 77(6):815–822.
8. Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL: A prospective study of
brace treatment versus observation alone in adolescent idiopathic
scoliosis: a follow-up mean of 16 years after maturity. Spine 2007, 32
(20):2198–2207.
9. Landauer F, Wimmer C, Behensky H: Estimating the final outcome of
brace treatment for idiopathic thoracic scoliosis at 6-month follow-up.
Pediatr Rehabil 2003, 6(3–4):201–207.
10. Ollier M: Olympe (Orthèse Lyonnaise MassuesPression Elastique) “Strech
Brace“. In Paper at the 19th annual meeting. Modena: GEKTS,
October 18th – 19th; 1991.
11. Daler S, Mouilleseaux B, Diana G: Orthèse élastique trois points pour le
traitement des scolioses lombaires idiopathiques évolutives de
l’adolescent. In Paper at the 21st annual meeting. Geneva: GEKTS, October
15th – 16th; 1991.
12. Coillard C, Leroux MA, Zabjek KF, Rivard CH: Reductibility of idiopathic
scoliosis during orthopedic treatment. Ann Chir 1999, 53(8):781–791.
13. Coillard C, Leroux MA, Zabjek KF, Rivard CH: SpineCor–a non-rigid brace
for the treatment of idiopathic scoliosis: post-treatment results. Eur Spine
J 2003, 12(2):141–148.
14. Coillard C, Circo AB, Rivard CH: SpineCor treatment for early scoliosis: 15
to 25°. In 5th International Conference on the Conservative Management of
Spinal Deformities: Athens, April 2–5; 2008.
15. Weiss HR, Weiss GM: Brace treatment during pubertal growth spurt in
girls with idiopathic scoliosis (IS): a prospective trial comparing two
different concepts. Pediatr Rehabil 2005, 8(3):199–206.
16. Wong MS, Cheng JC, Lam TP, Ng BK, Sin SW, Lee-Shum SL, Chow DH,
Tam SY: The effect of rigid versus flexible spinal orthosis on the clinical
Weiss and Werkmann Scoliosis 2012, 7:11
http://www.scoliosisjournal.com/content/7/1/11
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
efficacy and acceptance of the patients with adolescent idiopathic
scoliosis. Spine 2008, 33(12):1360–1365.
Weiss HR: SpineCor vs. natural history - explanation of the results
obtained using a simple biomechanical model. Stud Health Technol Inform
2008, 140:133–136.
van Loon PJ, Kühbauch BA, Thunnissen FB: Forced lordosis on the
thoracolumbar junction can correct coronal plane deformity in
adolescents with double major curve pattern idiopathic scoliosis. Spine
2008, 33(7):797–801.
Weiss HR, Dallmayer R, Gallo D: Sagittal counter forces (SCF) in the
treatment of idiopathic scoliosis: a preliminary report. Pediatr Rehabil
2006, 9(1):24–30.
Weiss HR, Rigo M: The chêneau concept of bracing - actual standards.
Stud Health Technol Inform 2008, 135:291–302.
Weiss HR: Befundgerechte Physiotherapie bei Skoliose Edited by: Ingeborg
Liebenstund. Pflaum: Munich Pflaum Physiotherapie 3; 2011.
Weiss HR: Best Practice in conservative scoliosis care. 4th edition. Munich:
Pflaum; 2012.
Weiss HR: “Brace Technology” Thematic Series - the Gensingen brace(TM)
in the treatment of scoliosis. Scoliosis 2010, 5:22.
Weiss HR: Korsettversorgung bei Skoliose. Orthopädie Technik 2011, 62:7.
488–498.
Werkmann M, Weiss HR: Rate of surgery in patients under treatment with
a Chêneau light brace using the SRS inclusion criteria. Scoliosis 2012, 7
(Suppl 1):O45.
Clin J, Aubin CÉ, Sangole A, Labelle H, Parent S: Correlation between
immediate in-brace correction and biomechanical effectiveness of brace
treatment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2010, 35
(18):1706–1713.
Veldhuizen AG, Cheung J, Bulthuis GJ, Nijenbanning G: A new orthotic
device in the non-operative treatment of idiopathic scoliosis. Med Eng
Phys 2002, 24(3):209–218.
Bulthuis GJ, Veldhuizen AG, Nijenbanning G: Clinical effect of continuous
corrective force delivery in the non-operative treatment of idiopathic
scoliosis: a prospective cohort study of the TriaC-brace. Eur Spine J 2008,
17(2):231–239. Epub 2007 Oct 10.
Wynne JH: The Boston Brace and TriaC systems. Disabil Rehabil Assist
Technol 2008, 3(3):130–135.
Zeh A, Planert M, Klima S, Hein W, Wohlrab D: The flexible Triac-Brace for
conservative treatment of idiopathic scoliosis. An alternative treatment
option? Acta Orthop Belg 2008, 74(4):512–521.
Grivas TB, Kaspiris A: European braces widely used for conservative
scoliosis treatment. Stud Health Technol Inform 2010, 158:157–166.
Hasler CC, Wietlisbach S, Büchler P: Objective compliance of adolescent
girls with idiopathic scoliosis in a dynamic SpineCor brace. J Child Orthop
2010, 4(3):211–218.
Coillard C, Circo AB, Rivard CH: SpineCor treatment for Juvenile Idiopathic
Scoliosis: SOSORT award 2010 winner. Scoliosis 2010, 5:25.
Gammon SR, Mehlman CT, Chan W, Heifetz J, Durrett G, Wall EJ: A
comparison of thoracolumbosacral orthoses and SpineCor treatment of
adolescent idiopathic scoliosis patients using the Scoliosis Research
Society standardized criteria. J Pediatr Orthop 2010, 30(6):531–538.
Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas TB,
Kotwicki T, Maruyama T, Romano M, Vasiliadis ES: Braces for idiopathic
scoliosis in adolescents. Spine (Phila Pa 1976) 2010, 35(13):1285–1293.
Szwed A, Kołban M, Jałoszewski M: Results of SpineCor dynamic bracing
for idiopathic scoliosis. Ortop Traumatol Rehabil 2009, 11(5):427–432.
Coillard C, Circo A, Rivard CH: A new concept for the non-invasive
treatment of Adolescent Idiopathic Scoliosis: the Corrective Movement
principle integrated in the SpineCor System. Disabil Rehabil Assist Technol
2008, 3(3):112–119.
Coillard C, Alin C, Rivard CH: Treatment of early adolescent idiopathic
scoliosis using the SpineCor System. Stud Health Technol Inform 2008,
135:341–355.
Coillard C, Vachon V, Circo AB, Beauséjour M, Rivard CH: Effectiveness of
the SpineCor brace based on the new standardized criteria proposed by
the scoliosis research society for adolescent idiopathic scoliosis. J Pediatr
Orthop 2007, 27(4):375–379.
Coillard C, Leroux MA, Badeaux J, Rivard CH: SPINECOR: a new therapeutic
approach for idiopathic scoliosis. Stud Health Technol Inform 2002,
88:215–217. Review.
Page 10 of 10
41. Griffet J, Leroux MA, Badeaux J, Coillard C, Zabjek KF, Rivard CH:
Relationship between gibbosity and Cobb angle during treatment of
idiopathic scoliosis with the SpineCor brace. Eur Spine J 2000,
9(6):516–522.
42. Coillard C, Circo A, Rivard C: A prospective randomized study of the
natural history of idiopathic scoliosis versus treatment with the SpineCor
brace. Scoliosis 2012, 7(Suppl 1):O24.
43. Coillard C, Circo A, Rivard C: Effectiveness of the SpineCor treatment for
large scoliotic curves compared to moderate and small curves. Scoliosis
2012, 7(Suppl 1):O25.
44. Herrero C, Herrero E: SpineCor treatment – the Spanish experience. First
results. Scoliosis 2012, 7(Suppl 1):O39.
45. Letts M, Rathbone D, Yamashita T, Nichol B, Keeler A: Soft Boston orthosis
in management of neuromuscular scoliosis: a preliminary report. J
Pediatr Orthop 1992, 12(4):470–474.
46. Leopando MT, Moussavi Z, Holbrow J, Chernick V, Pasterkamp H, Rempel G:
Effect of a Soft Boston Orthosis on pulmonary mechanics in severe
cerebral palsy. Pediatr Pulmonol 1999, 28(1):53–58.
47. Weiss HR: The Spinealite™ Soft Brace. You Tube Video; http://www.youtube.
com/watch?v=bkNP7juQ7VY.
48. Weiss HR, Hollaender M, Klein R: ADL based scoliosis rehabilitation--the
key to an improvement of time-efficiency? Stud Health Technol Inform
2006, 123:594–598. PubMed Abstract | Publisher Full Text.
49. Weiss HR, Klein R: Improving excellence in scoliosis rehabilitation: a
controlled study of matched pairs. Pediatr Rehabil 2006, 9(3):190–200.
PubMed Abstract.
50. Weiss HR: Spinal deformities rehabilitation-state of the art review.
Scoliosis 2010, 5:28. PubMed Abstract | BioMed Central Full Text DOI:dx.doi.
org | PubMed Central Full Text.
51. Borysov M, Borysov A: Scoliosis short-term rehabilitation (SSTR) according
to ‘Best Practice’ standards - are the results repeatable? Scoliosis 2012, 7:1.
52. Weiss HR: Physical therapy intervention studies on idiopathic scoliosisreview with the focus on inclusion criteria. Scoliosis 2012, 7:4.
doi:10.1186/1748-7161-7-11
Cite this article as: Weiss and Werkmann: Soft braces in the treatment of
Adolescent Idiopathic Scoliosis (AIS) – Review of the literature and
description of a new approach. Scoliosis 2012 7:11.
Submit your next manuscript to BioMed Central
and take full advantage of:
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at
www.biomedcentral.com/submit