Children's Health: High-tech brace keeps scoliosis treatment on track

Alberta researchers are developing a "smart" brace for children with scoliosis, a sideways curvature of the spine.

Scoliosis affects two to three per cent of the population. The most common form occurs in otherwise healthy children around the time of puberty, and girls are more likely than boys to develop a significant spinal curvature.

Dr. Marc Moreau, a pediatric orthopedic surgeon and clinical professor at the University of Alberta in Edmonton, says the aim of bracing is to prevent the spinal curvature from progressing to the point where surgery is needed. But wearing a brace is a big commitment, and studies of bracing effectiveness have been hampered by a lack of information on how often the brace is worn and whether it is being worn properly. "Nobody knows how it works," Moreau says. "We're heading down that trail to find out how it works, and we're using modern technology to be able to do it."

The smart brace, developed by engineers and surgeons at the University of Alberta and Glenrose Rehabilitation Hospital, is based on a standard plastic-and-foam device but incorporates pressure sensors and an electronically controlled pump that adjusts the air pressure inside an inflatable pad.

In a preliminary study, five girls and one boy, average age 13 years, were asked to wear the brace for an average of 17.5 hours over four weeks. The first two weeks involved monitoring only, and during the remaining two weeks the force maintenance system was activated from 8 a.m. to 10 p.m. each day. As a result, the time that the pressure level was in the target range increased from 53 to 68 per cent.

However, the children wore their brace for only 42 to 84 per cent of the prescribed time, despite the fact they knew they were being monitored. Reassuringly, the average spinal curvature remained unchanged at the end of the study at just over 30 degrees.

Moreau says the smart brace is mainly a research tool, but his team is working with colleagues in Hong Kong to expand the pool of available patients, and if the device continues to prove useful, it could be marketed commercially.