PDA

View Full Version : german bracing


gerbo
10th August 2006, 04:47 PM
The following link http://skoliose-info-forum.de/viewtopic.php?t=957 brings you to a table which I found on a German Scoliosis forum, and shows what kind of initial correction is being achieved there by a certain orthotist there (Rahmouni)

Note that where in younger teenagers 100% correction is often achieved, even in relative "older people" significant improvement seems possible.

Key question obviously are how difficult and painful these braces are, and how cosmetically acceptable.

Even more so, till what extend is the improvement maintained afterwards?

I will try to get a german forum member to comment

tonibunny
10th August 2006, 08:45 PM
That's very interesting Gerbo. I've found some pictures on the net, and the Rahmouni Korsett doesn't appear to be much different to a basic TLSO, at least from the outside (I can't see if it has strategic padding on the inside or not). It's shape is basically the same as the post-op TLSO I was given following my surgery aged 18 in 1994.

They do look very, very tight around the waist - almost like a Victorian lady's corset would! I see from the Rahmouni website that the braces are made from individual casts, but the patient is not put into EDF traction during the casting process; however, the brace works to derotate the spine as well as push it straight. X-rays are taken beforehand in order to work out exactly how flexible the spine is and how much correction is possible, and then the orthotist works towards reproducing the maximum correction with the brace. Sometimes they aim for over-correction. The website says that initially a minimum of 50% correction should be acheived. Later on during treatment, subsequent braces can attain more correction as the patient becomes more able to tolerate it.

The brace should be worn for 23 hours a day and is recommended for curves of 20 degrees and above. They recommend Schroth Therapy in conjunction with the bracing. It appears that the patient is given psychological support to help motivate them in complying with wearing the brace, which sounds good to me.....I think that many teenagers in the UK are just given their brace and told to go away and wear it, so they struggle in doing so. The Rahmouni people have recognised that wearing a brace feels unnatural and can dent a patient's self-confidence.

I think these orthotists sound wonderful!! The key to successful bracing is compliance, and they have addressed the issues surrounding that as well as producing an orthosis that aggressively corrects the curves. I am not surprised that they are having a lot of success :D

gerbo
10th August 2006, 11:25 PM
for info http://www.rahmouni.de/ = link to rahmouni website (in German, I am afraid)

tonibunny
10th August 2006, 11:45 PM
Yes, that's where I took my info from :D

titch
14th August 2006, 05:31 PM
I've had a look on PubMed to see if I could find any referenced studies regarding the Rahmouni brace (PubMed lists studies in German among others), searching for "Rahmouni scoliosis" and "Rahmouni skoliose" - there don't yet appear to be any studies published on it.

The approach does sound fantastic though, the psychological support in particular is surely important.

I do find myself however, with this dreadful suspicion that spinal orthotics is as much art as science - it's purely anecdotal, but I seem to have read of a lot of people finding that there is a noticeable difference between the comfort and fit of braces depending on who made them.

Looking through the photos I was particularly interested by the bottom set here: http://www.rahmouni.de/skoliose/kinderversorgung.htm where the young girl very clearly has congenital scoliosis. It certainly suggests that a blanket approach of refusing to try bracing for congenital curvatures may well miss cases where it could have helped, and given that there is a significant percentage of congenital curvatures which never progress, perhaps there are those for which brace control could avoid the need for surgery at all.