EFFECTIVENESS OF CHENEAU VERSUS BOSTON BRACE IN ADOLESCENT IDIOPATHIC SCOLIOSIS: SYSTEMATIC REVIEW
Authors:
Muh. Basuki Nurikhsan
Vivin Agustiana Dewi
Clinical Attachment Program
Polytechnic of Health Science Jakarta I Ministry of Healthof Republic Indonesia
Prosthetic Orthotic Department
Effectiveness of Cheneau versus Boston Brace in Adolescent Idiopathic Scoliosis: Systematic Review
Vivin Agustiana Dewi, Muh. Basuki
Abstract
Background. Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but lack of sources outcomes about comparing by brace type. We compared effectiveness outcomes of AIS patients treated with Chêneau and custom-molded Boston-style.
Objective. The aim of this paper is to evaluate the effectiveness of the Cheneau Brace and Boston Brace in treating Adolescent Idiopathic Scoliosis through a systematic review of the literature.
Methods. A search was carried out using the following databases including ScienceDirect, PubMed, and Google Scholar. Inclusion criteria for eligible for studies were as follows; (1) subjects diagnosed with AIS, (2) age ≤18 years, (3) treated with Boston and Cheneau brace, (4) evaluate the effectiveness of the brace, (5) conducted study over the past 5 years, (6) conducted study in English language. Articles identified were screened based on titles and abstracts. The quality of the studies was evaluated using CASP checklist. Data were summarized based on PICO style.
Results. Based on the key words, screening, and clinical appraisal 6 papers were selected. The result of this study shows that bracing treatment recommended for AIS treatment. Both of the braces are able to control the progression of curvature and reduce risk of surgery. However, Cheneau brace provides more effectiveness compared with Boston brace.
Limitations. This study conducted in a very short time, only used reduction of cobb angle as parameters. Therefore, the result may not be precise. Statistical evidence not provided about how much Cheneau is more effective than Boston brace.
Conclusions. Cheneau brace provides better effectiveness than Boston brace. Cheneu brace gives a higher degree of curve correction than Boston brace. Several factors may also influence the effectiveness of the bracing treatment.
Recommendations. Future studies should examine differences in parameters and outcomes by brace type in other settings and in larger samples, they also should investigate the impact of compliance and time wearing between Cheneau and Boston groups. Predictive factors of should be considered.
Keywords. Cheneau brace, Boston brace, effectiveness, and AIS.
Introduction
Scoliosis is a lateral curvature of the spine measuring at least 10⁰ on an X-ray as determined by the Cobb method. Structural scoliosis is characterized by vertebral and trunk rotation. There are several types of scoliosis, each with its own specific characteristics. Adolescent idiopathic scoliosis (AIS) comprises approximately 80% of diagnosed scoliosis cases. Other known types of scoliosis are congenital (10%) and neuromuscular (5%-7%) (Schiller, Thakur and Eberson, 2010; Kalichman, Kendelker and Bezalel, 2016).
The onset age of AIS usually ranges from 10 to 16 years and a significantly high risk of curve progression exists during puberty. Untreated cases of adolescent idiopathic scoliosis (AIS) may progress, and severe cases are at an increased risk for various morbidity problems and mortality (Kuroki, 2008; Shi et al., 2016).
Bracing of patients with AIS has been controversial for a long time (Pasquini et al., 2016). However, there are many conducted studies about bracing treatment for AIS and resulting ability to control the progression of the Cobb angle. Various brace designs are available for scoliotic subjects including the Milwaukee brace (MB), Boston, Wilmington, Charleston bending brace, Providence, SpineCor, Lyon, TriaC, Chêneau, Gensingen, Rosenberger and derotational braces. One of the braces which has been used for scoliotic subjects is the Chêneau and Boston brace (Karimi, Rabczuk and Kavyani, 2018).
Cheneau brace were developed approximately two decades ago, with the intent to combine biomechanical forces in three dimensions, including curve derotation. They use an open pelvis design with anterior opening, while Boston brace open in the back and corrects spinal scoliosis by pushing the spine with small pads. These pads are placed against the ribs to achieve partial rotational correction. The configurations of the pads inside the brace also increase the upright position of the spine (Karimi, Rabczuk and Kavyani, 2018; Karimi and Rabczuk, 2019). Figure 1 shows the picture of Cheneau and Boston brace.
Figure 1. Cheneau brace (left), Boston brace (right)
However, there is still a lack of resources comparing the efficacy of Cheneau and Boston brace. Therefore, the aim of this paper is to evaluate the effectiveness of the Cheneau versus Boston Brace in treating Adolescent Idiopathic Scoliosis through a systematic review of the literature.
Material & Methods
Search Strategy
A search was done in PubMed, ScienceDirect, and Google Scholar database. The main key words used in this study were Cheneau brace, Boston brace, effectiveness, and AIS. This search was done from late December 2020 – early January 2021. Titles and abstracts of all articles mentioning at least one of the key words were reviewed. Relevant study design including systematic review, literature review, and journal article. Two reviewers (blinded for review) independently screened the titles, abstract, and full-text articles identified by the literature search for inclusion. Full-text articles were retrieved if the abstract passed the first eligibility screening.
Selection Criteria
Inclusion criteria for eligible for studies were as follows; (1) subjects diagnosed with AIS, (2) age ≤18 years, (3) treated with Boston and Cheneau brace, (4) evaluate the effectiveness of the brace, (5) conducted study over the past 5 years, (6) conducted study in English language. Exclusion criteria were; (1) studies reporting on other types of selected braces, (2) studies were reporting spinal surgery, (3) studies including patients with other types of scoliosis (e.g., congenital, neuromuscular or degenerative scoliosis). Full-text articles were independently screened for inclusion by two reviewers (blinded for review).
Data Extraction
The following data of included studies were extracted: title, year of publication, study design, number of patients, intervention, definition of treatment failure and success (if reported), and reported predictive factors of treatment out-come, including their method of measurement. Data extraction was done by manually screened and using excel tables.
Methodological Quality
This method on this paper was similar to (Karimi, Rabczuk and Kavyani, 2018), in which every method of the study was summarized based on PICO style. The PICO model helps to determine the research question where P stands for population, I for intervention, C for comparison treatment, O for outcome of the studies. All included studies were subjected to a quality assessment (clinical appraisal) based on CASP checklist. There are 2 categories of selected study. Systematic review category and Cohort study category. Items were scored with 2 points if yes, 1 point unclear, and 0 points in case of missing data or insufficient information regarding a question. A high-quality study if it exceeds 75% maximum score. Maximum score of the systematic review category is 20 points. Studies scoring >15 were considered as high-quality studies, whereas studies scoring <15 low quality. For the cohort category the maximum score is 28, with study scoring >21 was considered as high-quality studies, whereas studies scoring <21 low quality. In case of disagreement, these points were discussed in a consensus meeting, or by consulting a third reviewer (blinded for review).
Results
The literature search generated a total of 32 references in PubMed, ScienceDirect, and Google Scholar database. After removing duplicates, 25 references remained. A total of 19 studies were excluded due to not meeting the criteria. In total, 6 studies met the inclusion criteria and were included (Fig. 1) (Van den Bogaart et al., 2019). There were three papers examined Cheneau bracing, two studies examined Boston bracing, comparing the efficiency of the Boston brace compared to Cheneau brace. Table 1 summarizes the results of quality assessment based on CASP checklist.
The results of the studies carried out on the evaluation of the efficiency of Cheneau and Boston brace on scoliosis progression curve highlighted the following points:
- Good scoliotic curve correction is achieved with the Chêneau or Boston brace,
- Chêneau or Boston brace is effective in reducing the incidence of surgery in comparison with natural history,
- Several factors influence the cobb angle progression and treatment.
Table 1. The results of quality assessment based on CASP checklist
| Author | Questions | |||||||||||||||
| Q1 | Q2 | Q3 | Q4 | Q5 A | Q5 B | Q6 A | Q6 B | Q7 | Q8 | Q9 | Q10 | Q11 | Q12 | TOTAL | ||
| Cohort | ||||||||||||||||
| (Pasquini et al., 2016) | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 28 | |
| (Minsk et al., 2017) | 2 | 2 | 1 | 1 | 2 | 1 | 2 | 2 | 2 | 1 | 2 | 2 | 1 | 2 | 23 | |
| (Xu et al., 2019) | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 1 | 2 | 2 | 27 | |
| (Weniger et al., 2019) | 2 | 0 | 1 | 2 | 2 | 1 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 24 | |
| Systematic Review | ||||||||||||||||
| Author | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | Q9 | Q10 | TOTAL | |||||
| (Karimi et al., 2018) | 2 | 2 | 2 | 1 | 2 | 2 | 1 | 2 | 2 | 2 | 18 | |||||
| (Karimi & Rabczuk, 2019) | 2 | 2 | 2 | 1 | 2 | 2 | 1 | 2 | 2 | 2 | 18 | |||||
| Note: Q = Question on CASP checklist Answer score: 0 = No, or not stated, 1 = Unclear, 2 = Yes | ||||||||||||||||
All of the studies exceeded 75% of maximum score (Table 1). Both studies on systematic review have the same score, same author on both studies may be the cause. Study conducted by (Minsk et al., 2017) has the lowest score on the cohort category. The authors did not set the wear time for both groups. However, the result still exceeded 75% of the maximum score. Appendix 1 show the details about the question checklist
Discussion
Scoliosis as a complex deformity of the spine should be considered not only in the frontal plane but also in the sagittal and transverse planes. Various braces have been used for this group of subjects to decrease the progression of the scoliotic curve.
Cheneau and Boston brace are the braces which seem to decrease the progression of the scoliosis curve. The aim of this review study was to determine the efficiency of the Chêneau brace compared to Boston brace. The question is which one of the braces is more effective for treating AIS? There were 3 studies which evaluated the efficiency of Cheneau brace, 2 studies evaluated the efficiency of Boston brace, and 1 study comparing the efficiency of Cheneau vs Boston brace. The results of most of these studies support the effectiveness of those braces to control the progression of the scoliotic curve (Table 2).
In the conducted study by (Xu et al., 2019) 90 participants were recruited. The results confirm that the scoliosis angle improved by more than 5° in 37.8% and stable in 13.3% of the participants by Boston brace. This is also similar with study done by (Karimi and Rabczuk, 2019), the result of the literature review is most of these studies support the efficiency of Boston brace to control the progression of scoliotic curve. The result of our study showed that Boston brace able to control the curve progression. This also supported by conducted study of (Shi et al., 2016), they reviewed 200 participants and they support the efficiency of Boston brace to control scoliotic curve progression.
For a long term follow up study of time wearing in brace, (Pellios et al., 2016) were re-evaluated 25 years after the end of 77 participants after successful treatment. There was no significant difference in the mean Cobb angle between 18 hours and 23 hours of brace wearing. In contrast study (Wiley et al., 2000), there was a significant difference in the amount of initial correction seen in the brace on 49% participants, and Boston brace when used 18 or more hours per day is effective in preventing progression of large curves of 9.8 years after bracing discontinued.
The study done by (Weniger et al., 2019) Cheneau brace and physiotherapy could prevent 85.5% the progression of the curve of 159 participants and 25.4% improvement of cobb angle ≥ 6°. Nine participants also show improvement of cobb angle ≥ 10⁰. This is also similar with the result study of (Pasquini et al., 2016), 93% of the participants have improved the cobb angle and 81% remain unchanged. This was supported with study conducted by (Karimi, Rabczuk and Kavyani, 2018), the results of this study also determined that the correction achieved with this brace was above the average compared to other available braces. The result of our study shows that Cheneau brace is able to significantly control curve progression. This result supported by (Zabrowska-Sapeta et al., 2010), they reviewed 79 AIS participants with Cheneau brace and the cobb angle was decreased on average by 9.8⁰.
Table 2. Studies carried out with the Chêneau and Boston brace
In the other study conducted by (Minsk et al., 2017), they compared Cheneau and Boston brace. The result is the final outcome of treatment with the Chêneau brace was more than that with the Boston brace (34% of the Boston group required surgery, compared to none in the Chêneau group). The cobb angle at follow up was improved ≥ 6⁰ in 31% of the Cheneau group and 13% of the Boston group. This study also reports that braces are effective to control scoliotic curve progression especially in lumbar and thoracolumbar parts. This corresponds with conducted study by (Pasquini et al., 2016), thoracic curve has significantly wider cobb angle compared with lumbar, thoracic and double major curve show “worsened” or progress ≥ 6⁰ in 13% and 12%. According to (Negrini et al., 2009) thoracic curve “worsened” 14% of their participants. T-curves are at greater risk of curve progression than patients with lumbar curves (Thompson et al., 2017).
Various possible predictive factors for brace treatment outcome have been reported e.g., age, menarche, gender, curve magnitude, curve location, brace wear time, and bone mineral status (Van den Bogaart et al., 2019). Conducted research by (Xu et al., 2019) found low Risser grade, main T-curve, and low initial age had significantly higher incidence of curve progression. In line with (Karol et al., 2016), they reviewed a large number of patients at various Risser stages who received brace treatment. They found that patients at Risser stage 0, especially with open triradiate cartilage, may be at highest risk for bracing failure. The risk of the progression of scoliosis can be significantly reduced by a timely and correct identification of the indicators and consistent wearing time (Weniger et al., 2019).
Bracing has been shown good evidence to control the curve progression and cobb angle and influence the natural history of scoliosis (Yrjönen et al., 2007; Ganjavian et al., 2011). Both Cheneau or Boston brace proved to be an effective conservative treatment for AIS. Based on the results of the studies it can be concluded that Cheneau brace is more effective for AIS treatment including controlling the curve progression or decreasing the curve based on cobb angle. Cheneau brace has a higher rate of decreasing the cobb angle. Published studies show both of the braces able to decrease the cobb angle >5⁰, but in published studies also shown Cheneau brace able to decrease 9.8⁰ compared to Boston brace up to 8⁰. However, this result still needs further evaluation.
This study has several limitations and results therefore may not be directly applicable to the individual patient. First, this study conducted less than one month. The result of this study may not be precise due to lack of time. Second, the parameter that we use for measuring the efficacy is only based on the reduction of cobb angle. The compliance and time wearing may also influence the efficacy. Third, we did not conduct meta-analyses, so we cannot prove the statistical evidence of how much Cheneau brace is more effective.
Conclusion
Bracing treatment is strongly recommended for AIS especially for riser level and initial age of treatment. Cheneau brace provides better effectiveness than Boston brace. Cheneu brace gives a higher degree of curve correction than Boston brace. Several factors like age, riser grade, location of curve may also influence the effectiveness of the bracing treatment.
Future studies should examine differences in parameters and outcomes by brace type in other settings and in larger samples, they also should investigate the impact of compliance and time wearing between Cheneau and Boston groups. Predictive factors of should be considered.
Conflict of Interest
Authors have no conflicts of interest to declare.
References
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Ganjavian, M. S. et al. (2011) ‘Results of Milwaukee and Boston braces with or without metal marker around pads in patients with idiopathic scoliosis’, Acta Medica Iranica, 49(9), pp. 598–605.
Kalichman, L., Kendelker, L. and Bezalel, T. (2016) ‘Bracing and exercise-based treatment for idiopathic scoliosis’, Journal of Bodywork and Movement Therapies, 20(1), pp. 56–64. doi: 10.1016/j.jbmt.2015.04.007.
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Minsk, M. K. et al. (2017) ‘Effectiveness of the Rigo Chêneau versus Boston-style orthoses for adolescent idiopathic scoliosis: A retrospective study’, Scoliosis and Spinal Disorders, 12(1), pp. 1–6. doi: 10.1186/s13013-017-0117-z.
Negrini, S. et al. (2009) ‘Effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises) based on SOSORT management criteria: Results according to the SRS criteria for bracing studies – SOSORT Award 2009 Winner’, Scoliosis, 4. doi: 10.1186/1748-7161-4-19.
Pasquini, G. et al. (2016) ‘The outcome of modified version of the Cheneau brace in Adolescent Idiopathic Scoliosis ( AIS ) based on SRS and SOSORT criteria : a retrospective study . EUROPEAN JOURNAL OF PHYSICAL AND REHABILITA’.
Pellios, S. et al. (2016) ‘Curve progression 25 years after bracing for adolescent idiopathic scoliosis: Long term comparative results between two matched groups of 18 versus 23 hours daily bracing’, Scoliosis and Spinal Disorders, 11(1), pp. 16–22. doi: 10.1186/s13013-016-0065-z.
Schiller, J. R., Thakur, N. A. and Eberson, C. P. (2010) ‘Brace management in adolescent idiopathic scoliosis’, Clinical Orthopaedics and Related Research, 468(3), pp. 670–678. doi: 10.1007/s11999-009-0884-9.
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Thompson, R. M. et al. (2017) ‘Brace Success Is Related to Curve Type in Patients with Adolescent Idiopathic Scoliosis’, pp. 923–928.
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Appendix 1. Clinical appraisal result based on CASP checklist
Table 3. Clinical Appraisal of Systematic Review Category
| NO | QUESTION | ANSWER | COMMENT | |
| (Karimi, Rabczuk and Kavyani, 2018) | (Karimi and Rabczuk, 2019) | |||
| Q1 | Did the review address a clearly focused question? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): population, intervention, outcome considered clearly explained(Karimi and Rabczuk, 2019): population, intervention, outcome considered clearly explained |
| Q2 | Did the authors look for the right type of papers? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): the review question stated clearly(Karimi and Rabczuk, 2019): the review question stated clearly, used RCT selected papers method |
| Q3 | Do you think all the important, relevant studies were included? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): used publish study and used trustworthy database(Karimi and Rabczuk, 2019): used publish study and used trustworthy database |
| Q4 | Did the review’s authors do enough to assess quality of the included studies? | 1 | 1 | (Karimi, Rabczuk and Kavyani, 2018): used 26 articles which 7 articles bias and 6 articles confounding. We think it will increase risk of bias (Karimi and Rabczuk, 2019): author did enough assess the quality, but they use more than 10 year published studies |
| Q5 | If the results of the review have been combined, was it reasonable to do so? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): the result of all the study clearly displayed and has similar result which cheanu able to reduce the cobb angle progression(Karimi and Rabczuk, 2019): the result of all the study clearly displayed and has similar result which cheanu able to reduce the cobb angle progression |
| Q6 | What are the overall results of the review? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): the result explained clearly (Karimi and Rabczuk, 2019): the result explained clearly |
| Q7 | How precise are the results? | 1 | 1 | (Karimi, Rabczuk and Kavyani, 2018): confidence interval not stated(Karimi and Rabczuk, 2019): confidence interval not stated |
| Q8 | Can the results be applied to the local population? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): cheneau brace treatment is applicable in Indonesia(Karimi and Rabczuk, 2019): Boston brace treatment is applicable in Indonesia |
| Q9 | Were all important outcomes considered? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): all important outcome and information we seek are covered(Karimi and Rabczuk, 2019): all important outcome and information we seek are covered |
| Q10 | Are the benefits worth the harms and costs? | 2 | 2 | (Karimi, Rabczuk and Kavyani, 2018): efficacy of cheanu worth the harms & costs(Karimi and Rabczuk, 2019): efficacy of Boston worth the harms & costs |
| TOTAL | 18 | 18 | ||
Table 4. Clinical Appraisal of Cohort Category
| NO | QUESTION | ANSWER | COMMENT | |||
| (Pasquini et al., 2016) | (Minsk et al., 2017) | (Xu et al., 2019) | (Weniger et al., 2019) | |||
| Q1 | Did the review address a clearly focused question? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): population, intervention, outcome considered clearly explained(Minsk et al., 2017): population, intervention, outcome considered clearly explained(Xu et al., 2019): population, intervention, outcome considered clearly explained(Weniger et al., 2019): population, intervention, outcome considered clearly explained |
| Q2 | Was the cohort recruited in an acceptable way? | 2 | 2 | 2 | 0 | (Pasquini et al., 2016): grouping by loc of curve, degree of magnitude, and riser sign(Minsk et al., 2017): grouping by brace types(Xu et al., 2019): grouping by initial and final visit(Weniger et al., 2019): not stated how the way grouping, there’s no table to make it clear as well |
| Q3 | Was the exposure accurately measured to minimize bias? | 2 | 2 | 2 | 1 | (Pasquini et al., 2016): used objective measurements, same procedure to all groups(Minsk et al., 2017): the wear time in brace for both groups different(Xu et al., 2019): used objective measurements, same procedure to all groups(Weniger et al., 2019): uncleared grouping participants |
| Q4 | Was the outcome accurately measured to minimized bias? | 2 | 1 | 2 | 2 | (Pasquini et al., 2016): used objective measurements (cheneau brace), same procedure to all groups(Minsk et al., 2017): the wear of time in brace for both groups different(Xu et al., 2019): used objective measurements (Boston brace), same procedure to all groups(Weniger et al., 2019): used objective measurements (Boston brace) |
| Q5 | (a) Have the authors identified all important confounding factors? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): all important factors were covered(Minsk et al., 2017): all important factors were covered(Xu et al., 2019): all important factors were covered(Weniger et al., 2019): all important factors were covered |
| (b) Have they taken account of the confounding factors in the design and/or analysis? | 2 | 1 | 2 | 1 | (Pasquini et al., 2016): confounding factors not founded(Minsk et al., 2017): different time in brace for both groups(Xu et al., 2019): confounding factors not founded(Weniger et al., 2019): how the way grouping? | |
| Q6 | (a) Was the follow up of subjects complete enough? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): 2 years follow up, authors excluded subject that lost to follow up(Minsk et al., 2017): followed up until skeletal maturity or progression of surgery(Xu et al., 2019): min 1 year follow up after complete brace treatment(Weniger et al., 2019): 2 years follow up |
| (b) Was the follow up of subjects long enough? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): 2 years follow up(Minsk et al., 2017): followed up until skeletal maturity (start with riser sign 0-2)(Xu et al., 2019): min 1 year follow up after complete brace treatment(Weniger et al., 2019): 2 years follow up | |
| Q7 | What are the results of this study? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): 80% of participants “improved” and “unchanged”(Minsk et al., 2017): Patients with RCOs had lower mean and percent major curve progression (5 & 38%) versus those with TLSOs (47 & 49%).(Xu et al., 2019): 37.8% of patient were successfully treated(Weniger et al., 2019): Cobb angle with a progression of ≤ 5 ° was achieved for 136 of the patients (85.5%). |
| Q8 | How precise are the results? | 2 | 1 | 2 | 2 | (Pasquini et al., 2016): 95% of confidence intervals(Minsk et al., 2017): confidence intervals not stated(Xu et al., 2019): 95% of confidence intervals(Weniger et al., 2019): 95% of confidence intervals |
| Q9 | Do you believe the results? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): the procedure and follow up are reliable (Minsk et al., 2017): the procedure and follow up are reliable(Xu et al., 2019): the procedure and follow up are reliable(Weniger et al., 2019): the procedure and follow up are reliable |
| Q10 | Can the results be applied to the local population? | 2 | 2 | 1 | 2 | (Pasquini et al., 2016): 2 year follow up with cheneau brace is applicable in Indonesia(Minsk et al., 2017): both of boston & cheneau brace are applicable in Indonesia(Xu et al., 2019): lack of evidence in Indonesia to treat large curve with brace but worth to try(Weniger et al., 2019): 2 year follow up with cheneau brace is applicable in Indonesia |
| Q11 | Do the results of this study fit with other available evidence? | 2 | 1 | 2 | 2 | (Pasquini et al., 2016): the efficacy result of chenau brace on this paper similar with other published study(Minsk et al., 2017): there’s a little published study that comparing boston and cheneau(Xu et al., 2019): similar result done by Aulisa et al., and Negrini et al.(Weniger et al., 2019): the efficacy result of chenau brace on this paper similar with other published study |
| Q12 | What are the implications of this study for practice? | 2 | 2 | 2 | 2 | (Pasquini et al., 2016): used supportive evidence from other published study(Minsk et al., 2017): used supportive evidence from other published study(Xu et al., 2019): used supportive evidence from other published study(Weniger et al., 2019): used supportive evidence from other published study |
| TOTAL | 28 | 23 | 27 | 24 | ||
Appendix 2. Data Extraction
Table 5. Data Extraction to Continue Full Text Review
| No | Year | Titles | Review types | Article types | Participants | Aim | Method/PO interventions | Outcome |
| 1 | 2016 | The outcome of modified version of the Cheneau brace in Adolescent Idiopathic Scoliosis (AIS) based on SRS and SOSORT criteria: | effectiveness of cheneau | retrospective study cohort | 67 | To assess the outcomes of a modified version of the Cheneau brace, (“Cheneau-P”) in patients with AIS, based on SRS and SOSORT criteria. | cheneau bracing | This study shows that in patients with AIS the treatment with the “Cheneau-P” brace is associated with a remarkably high rate of successful outcomes, both in the whole sample and in the subgroup of patients completely fulfilling the SRS criteria. |
| 2 | 2017 | Effectiveness of the Rigo Chêneau versus Boston-style orthoses for adolescent idiopathic scoliosis: a retrospective study | effectiveness of cheneau vs boston brace | retrospective study cohort | 108 | compared outcomes of AIS patients treated with cheneau or boston | comparing cheneau vs boston | Patients treated with RCOs also had smaller mean change and smaller percent increase in major curves from treatment initiation through follow-up. |
| 3 | 2018 | Evaluation of the efficiency of the Chêneau brace on scoliosis deformity | effectiveness of cheneau | systematic review | 26 studies | determine the efficiency of the Chêneau brace to control scoliotic curve progression | cheneau bracing | the Chêneau brace and its modifications could control the progression of the scoliotic curve and also influence the natural history of scoliosis. |
| 4 | 2019 | Brace Treatment in Adolescent Idiopathic Scoliosis Patients with Curve Between 40 and 45 | effectiveness and relative factors | journal article cohort | 90 | To investigate effectiveness of brace treatment in patients with adolescent idiopathic scoliosis with factors associated with bracing outcome. | boston brace | Curved was improved in 37.8% patients and stabilized in 13.3% patients. |
| 5 | 2019 | Evaluation of the efficiency of Boston brace on scoliotic curve control: A review of literature | efffectiveness of boston | literature review | 18 studies | efficiency of Boston brace to control the progression of the curve based on the available literature. | boston brace | The results of most of the studies support the efficiency of this brace to control the progression of scoliotic curve, especially for the curve between T6 and L2. |
| 6 | 2019 | Long-term Results of Conservative Therapy of Adolescent Idiopathic Scoliosis Using the Cheneau Brace | effectiveness of cheneau | retrospective study cohort | 159 | to examine the effectiveness of the Cheneau brace in treating adolescent scoliosis. | cheneau bracing | The Cheneau brace treatment constitutes an effective treatment at curvature angles between 20–40°. The risk of progression can be reduced by a timely and correct identification. |
Appendix 3. PICO worksheet and Search Strategy Protocols
PICO Worksheet and Search Strategy Protocol
1. Define your question using PICO by identifying: Patient/Problem, Intervention, Comparison group and Outcome:
Patient/Problem: Adolescent Idiopathic Scoliosis / lateral curvature > 10⁰
Intervention: Cheneau Brace
Comparison: Boston Brace
Outcome: Decreased in Cobb angle, control the curve progression
Write out your question:
Which brace treatment between Cheneau and Boston brace more effectively for Adolescent Idiopathic Scoliosis Patient ?
2. Type of question/problem:
Circle one:Therapy / Prevention / Diagnosis / Etiology / Prognosis
3. Type of studies/publications to include in the search:
Check all that apply:
□ Meta-analysis
✔ Systematic review
□ Clinical practice guidelines
□ Randomized controlled trial
✔Research studies or articles
□ Case report or series
□ Research report or other grey literature
4. List main topics and alternate terms from your PICO question that can be used for your search:
Effectiveness
Adolescent Idiopathic Scoliosis
Cheneau Brace
Boston Brace
Factors influence treatment
Bracing treatment
5. Write out your search strategy:
Effectiveness
Adolescent Idiopathic Scoliosis
Cheneau Brace
Boston Brace
Bracing treatment
6. List any limits that may apply to your search:
Gender: Male
Age: ≤ 18
Year(s) of publication: 2015-2020
Parameters: Cobb angle decreased
Total sources: 6
Language(s): English
7. List the databases you will search:
Google Scholar, PubMed, ScienceDirect.
This form is adapted from: Miller, S.A. (2001). PICO worksheet and search strategy. US National Center for Dental Hygiene Research.