Does bracing affect bone health in women with adolescent idiopathic scoliosis?
OBJECTIVE
Adolescent idiopathic scoliosis (AIS) is often associated with low bone mineral content and density (BMC, BMD). Bracing, used to manage spine curvature, may interfere with the growth-related BMC accrual, resulting in reduced bone strength into adulthood. The purpose of this study was to assess the effects of brace treatment on BMC in adult women, diagnosed with AIS and braced in early adolescence.


METHODS
Participants included women with AIS who: (i) underwent brace treatment (AIS-B, n = 15, 25.6 ± 5.8 yrs), (ii) underwent no treatment (AIS, n = 15, 24.0 ± 4.0 yrs), and (iii) a healthy comparison group (CON, n = 19, 23.5 ± 3.8 yrs). BMC and body composition were assessed using dual-energy X-ray absorptiometry. Differences between groups were examined using a oneway ANOVA or ANCOVA, as appropriate.


RESULTS
AIS-B underwent brace treatment 27.9 ± 21.6 months, for 18.0 ± 5.4 h/d. Femoral neck BMC was lower (p = 0.06) in AIS-B (4.54 ± 0.10 g) compared with AIS (4.89 ± 0.61 g) and CON (5.07 ± 0.58 g). Controlling for lean body mass, calcium and vitamin D daily intake, and strenuous physical activity, femoral neck BMC was statistically different (p = 0.02) between groups. A similar pattern was observed at other lower extremity sites (p < 0.05), but not in the spine or upper extremities. BMC and BMD did not correlate with duration of brace treatment, duration of daily brace wear, or overall physical activity.


CONCLUSIONS
Young women with AIS, especially those who were treated with a brace, have significantly lower BMC in their lower limbs compared to women without AIS. However, the lack of a relationship between brace treatment duration during adolescence and BMC during young adulthood, suggests that the brace treatment is not the likely mechanism of the low BMC.
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
Nasreen
N
Akseer
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
Kimberly
K
Kish
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
W Alan
WA
Rigby
Michael G. DeGroote School of Medicine, Niagara Regional Campus, McMaster University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
Matthew
M
Greenway
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada ; Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
Panagiota
P
Klentrou
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada ; Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada ; Behavioral Health Sciences Research Lab, Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada.
Philip M
PM
Wilson
Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada ; Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON L2S 3A1, Canada.
Bareket
B
Falk
Adolescence; Adulthood; Bone; Brace; DXA; Exercise; Female; Growth; Maturation; Nutrition; Physical activity