The effect of spinal bracing on sitting function in children with neuromuscular scoliosis.

Background:: Scoliosis is common in children with neuromuscular deficits. It is often associated with an asymmetric sitting position and with poor balance. Many children with neuromuscular scoliosis spend most of their day sitting.

Objectives:: To describe how sitting function is affected by treatment with a modified custom-moulded Boston brace in children with neuromuscular scoliosis.

Study Design:: Retrospective review of medical records.

Methods:: A review of medical records from children fitted with scoliosis braces, including analysis of sitting, using a pressure-mapping system.

Results:: A total of 106 children with a median age of 11.3 (1.7-17.7) years were included. The most frequent diagnoses were cerebral palsy ( n = 33) and myelomeningocele ( n = 17). Around 56 children could sit without support and 24 children were independent walkers. The Cobb angle was between 19° and 126°. Sitting function as noted in medical records improved in 73/105 children and deteriorated in five. The pressure mapping showed that symmetry was improved in 44/86 children, while three deteriorated. Stability improved in 20/40 children and seven decreased.

Conclusion:: Bracing had a positive effect on sitting function in children with neuromuscular scoliosis.

Clinical Relevance: Bracing can reduce the need for support in sitting. Children with severe scoliosis can get a better sitting function with a brace. Sitting analysis with pressure mapping can identify sitting problems needing correction of the brace and adaptations of the chair.