Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: A preliminary analysis Gozde Gur a, *, Burcu Dilek b , Cigdem Ayhan a , Engin Simsek c , Ozgen Aras d , Songul Aksoy e , Yavuz Yakut a a Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey b Gata Special Education and Rehabilitation Center, Ankara, Turkey c School of Physical Therapy and Rehabilitation, Dokuzeylul University, Izmir, Turkey d Department of Physiotherapy and Rehabilitation, School of Health Sciences, Dumlupinar University, Kutahya, Turkey e Department of Audiology, Voice and Speech Disorders, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey 1. Introduction Various methods of rehabilitation have been utilized for patients with adolescent idiopathic scoliosis (AIS) to decrease curve progression [1–5]. One of these is spinal orthotic treatment [6,7], has been recommended in skeletally immature patients [1] with curvatures ranging from 258 to 458 [8]. Several types of spinal braces are commonly used in patients with AIS [9,10], and differ in impact based on individual design characteristics and underlying mechanisms of preventing curve progression. Most commonly used concepts of spinal braces include Cheneau concept, SPoRT concept and Boston brace systems which have different external corrective force application techniques by using rigid, semi-rigid supports or elastic bands and daily brace wear durations. Cheneau concept braces depend on overcorrection (asymmetrical correction) of three-dimensional scoliotic deformi- ty as lateral deviation on frontal plane, torsion of certain spine parts producing the rib hump or lumbar hump on horizontal plane and deterioration of the thoracic kyphosis and lumbar lordosis on sagittal plane [11]. The SPoRT concept including Sibilla and Gait & Posture xxx (2014) xxx–xxx A R T I C L E I N F O Article history: Received 11 October 2013 Received in revised form 24 July 2014 Accepted 1 September 2014 Keywords: Adolescent idiopathic scoliosis Brace Postural stability Proprioception Cobb angle A B S T R A C T Background: Despite the positive effects of spinal braces on postural stability, they may constrain movement, resulting in poor balance control in patients with adolescent idiopathic scoliosis (AIS). Therefore, assessment of postural dynamics may aid in designing new less-constraining braces. Objectives: The effects of a spinal brace on postural stability and Cobb angle were investigated in this study. Methods: Thirteen pediatric patients (10 females, three males) with AIS were recruited to participate in the study. Cobb angle was assessed by X-ray analyses, and postural stability was tested by computerized dynamic posturography in braced and unbraced conditions. A polyethylene underarm corrective spinal brace was fabricated for the subjects. Results: Thoracic and lumbar curvature decreased to 18.88 Æ 11.738 and 17.70 Æ 10.588, respectively, after bracing (p < 0.05). Lower equilibrium scores were observed in the ‘‘eyes closed’’ condition and higher scores in the ‘‘eyes closed with a swaying support’’ condition; higher composite equilibrium scores were also observed for the sensory organization test (p < 0.05) in the braced condition. Lower scores were observed for the ‘‘toes-up adaptation test’’ in the braced condition (p < 0.05). In the braced condition, the reaction time was slower in the right-backward direction and movement velocity was higher in the right-front direction on the limits of stability test (p < 0.05). Furthermore, lower on-axis velocity during forward/backward dynamic balance control was observed in the braced condition (p < 0.05). Conclusions: Wearing a spinal brace improved postural stability in terms of increased proprioception, equilibrium performance, and rhythmic movement ability in patients with AIS. ß 2014 Elsevier B.V. All rights reserved. * Corresponding author at: Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, 06100 Samanpazari, Ankara, Turkey. Tel.: +90 3123051576. E-mail address: gozde.gur@hacettepe.edu.tr (G. Gur). G Model GAIPOS-4295; No. of Pages 7 Please cite this article in press as: Gur G, et al. Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: A preliminary analysis. Gait Posture (2014), http://dx.doi.org/10.1016/j.gaitpost.2014.09.001 Contents lists available at ScienceDirect Gait & Posture jo u rn al h om ep age: ww w.els evier.c o m/lo c ate/g aitp os t http://dx.doi.org/10.1016/j.gaitpost.2014.09.001 0966-6362/ß 2014 Elsevier B.V. All rights reserved.