In the United States, over seven million people are affected by scoliosis (1). This abnormal curvature of the spine is often diagnosed during childhood or early adolescence. Each year, an estimated 30,000 children are put in spinal braces and about 38,000 patients go through surgery (2). Adolescent idiopathic scoliosis (AIS) is the most common case of scoliosis (3). This condition frequently appears during puberty, forcing the spine into an “S” shape instead of growing straight (3). Wearing spinal orthoses has been effective in improving deformity (4); however, wearing a rigid brace for most hours of the day can negatively impact young children. Due to the unappealing appearance of wearing a brace, adolescent patients might be unaccepting of it (4). Biofeedback wearable devices are being tested out for effectiveness to provide real-time alerts and to decrease the need for rigid and unappealing braces.  

In a 2001 study, a new postural training device was tested for its effectiveness on children with idiopathic scoliosis (4). This device used audio-biofeedback to alert young patients of incorrect posture during real-time. The study included AIS patients from the ages of 10-14 and with a  cobb’s angle of 25°-35°. The training device produces a low audible tone for 20 seconds, only heard by the patient when it sensors an incorrect position. If the incorrect posture is held longer, the tone increases in the volume until a correct posture is maintained. Patients were told to wear the device for 23 hours and went for a routine check-up every 6-8 weeks. Out of 13 patients, 9 patients’ spine curvature remained stable (change within + 5° Cobb’s angle). 5 out of 13 patients completed skeletal maturity after wearing the device and no longer had to take prevention. Physicians were also able to measure compliance by downloading the device’s data at each visit and seeing the wear length. As for the patients’ acceptance, all 13 patients preferred using the training device to a rigid orthosis due to the better appearance and smaller size.

Another recent device tested in 2011 was the SKOL-AS biofeedback method, which also targeted adolescent scoliosis patients. The device was tested on 28 low-grade scoliosis patients from ages 5 to 16. This device used manometry-guided biofeedback to visualize the direction of spine correction and applied external corrective force. Patients also used deep muscle exercises to help with spine elongation, and with 24 sessions in 3 months of training, significant positive changes in the patient’s height and trunk rotation were observed (5). 

These non-invasive treatments and therapies provide patients the choice of avoiding surgery, which can be costly and cause undesirable side effects (6). Biofeedback therapies are a great way for younger patients to learn correct posture on their own and provide long-term stable outcomes. Esurgi’s product, the Biostabilizer, is also a digital pressure biofeedback unit. This product uses graphical readings and audio input to give the best amount of feedback during sessions.

What are your experiences in using biofeedback with scoliosis patients?

Citations

  1. Scoliosis. (n.d.). Retrieved September 03, 2020, from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis
  2. National Scoliosis Foundation. (n.d.). Retrieved September 03, 2020, from https://www.scoliosis.org/info.php
  3. Adolescent idiopathic scoliosis – Genetics Home Reference – NIH. (2020, August 17). Retrieved September 04, 2020, from https://ghr.nlm.nih.gov/condition/adolescent-idiopathic-scoliosis
  4. Wong, M., Mak, A., Luk, K., Evans, J., & Brown, B. (2001). Effectiveness of audio-biofeedback in postural training for adolescent idiopathic scoliosis patients. Prosthetics and Orthotics International, 25(1), 60-70. doi:10.1080/03093640108726570
  5. Kamelska-Sadowska, A. M., Protasiewicz-Fałdowska, H., Zakrzewska, L., Zaborowska-Sapeta, K., Nowakowski, J. J., & Kowalski, I. M. (2019). The Effect of an Innovative Biofeedback SKOL-AS® Treatment on the Body Posture and Trunk Rotation in Children with Idiopathic Scoliosis—Preliminary Study. Medicina, 55(6), 254. doi:10.3390/medicina55060254
  6. Scoliosis Surgery: Things to Consider – OrthoInfo – AAOS. (n.d.). Retrieved September 03, 2020, from https://orthoinfo.aaos.org/en/treatment/scoliosis-surgery-things-to-consider/
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