A Systematic Comprehensive Review and Synthesis of Different Mechanisms of Action for Scoliosis Braces in English and FrenchLiterature
DOI:
https://doi.org/10.47363/fc38cs36Keywords:
Systematic Review, Scoliosis, Brace, Mechanism of action, Biomechanism, Brace ConceptAbstract
A very wide variety of braces have been developed around the world during the last decades. This diversity often complicates therapeutic decisions. It is, therefore, more pragmatic to categorize braces based on their mechanisms of action. This study aims to identify and classify these mechanisms into three categories: passive, active, and secondary.
To achieve this, a comprehensive review of existing literature in both English and French was conducted following the PRISMA diagram. 1575 articles were identified. After removing duplicates, 69 articles were found to highlight 24 mechanisms of action: comprising 12 passive, 6 active, and 6 Secondary.
12 Passive Mechanisms are Including: 1. Concave to convex tissue transfer under T10, 2. Rib-cage/spine coupling patterns between T2-T10, 3. plane geometry, 4. solid geometry, 5. Three-point system or derotation torque, 6. Derotation on Z axis, 7. global bending, 8. regional bending, 9. mobility under the brace, 10. Unloading, 11. recentering of the apical nucleus, and 12. sagittal normalization.
6 Active Mechanisms are Including: 1. vertebral growth modulation, 2. rebalance stress distribution, 3. active pulling, 4. active pushing, 5. elastic forces, 6. Ponseti-type intervention.
6 Secondary Mechanisms are Including: 1. vital capacity, 2. material tolerance, 3. closures, 4. Physiotherapy & gait modification, 5. Management, 6. Monitoring.
Generic braces are a testament to the geographical schools of thought and research experiences from which they originate. The ideal brace remains nameless, as it represents a balanced choice of action mechanisms, striving for a compromise between effective three-dimensional correction and patient tolerance.
