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Thread: Bracing in adults to prevent scoliosis progression

  1. #31
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    Sorry jinseeker. We sometimes get caught in these little eddies.

    To pooka - I have seen several references, including on the isico site, on spinecor's muscle-sparing features. If you want to enter some other fact into evidence, just do so. Until then, I will rely on the information in possession.

  2. #32
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    Quote Originally Posted by hdugger View Post
    Sorry jinseeker. We sometimes get caught in these little eddies.
    So, I've now searched on Kevin's posts with the keyword "spinecor" and, when that didn't return anything, the keyword "atrophy" (which returned things, but nothing about bracing). I am using the Kevin_MC user name.

    If you could link to his post about this topic, we'd all be able to make sense of it directly. I'd find that more helpful then relying on a summry - there's always a good deal of depth and meat in Kevin's posts.

  3. #33
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    Quote Originally Posted by hdugger View Post
    So, I've now searched.
    Actually, sorry, I'm going to back out of the atrophy discussion altogether. For some reason I got distracted by that piece and forgot the big picture.

    So, the big picture is that teenagers wear braces (hard braces) for years and, whatever effect that might or not have on their muscles, once they take off their braces, they don't suddenly progress.Whether that's because they exercise while in brace, or wean off them slowly, or for some other reason, the fact remains the same. Wearing a brace does not *increase* progression (at least in kids, where it's mostly studied). It prevents progression while the brace is worn, and the final curve (after weaning) on average stays the same even many years later.

    That is not, at all, to promise that your curve won't progress, with or without a brace. I know the odds increase as curve size increases. But, forgetting the atrophy distraction, there's just nothing in the bracing literature that suggests that braces of any kind (even hard braces) *increase* progression once they are removed.

    Again, sorry for the brief foray into the bowels of bracing literature

    I do have a message out to the ISICO folk for their feedback. I'll let you know what I hear.

  4. #34
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    "The short answers: Yes, bracing causes atrophy of the muscles. Specifically the paraspinal muscles. Exercise can and does help this. Basic concept of muscle physiology is, for muscles - use it or lose it." - Dr. McIntire

    Unless Spinecor is hanging off the patient, it is restricting ROM. How else could it even work in principle if it isn't doing anything?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

  5. #35
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    Quote Originally Posted by Pooka1 View Post
    "The short answers: Yes, bracing causes atrophy of the muscles. Specifically the paraspinal muscles. Exercise can and does help this. Basic concept of muscle physiology is, for muscles - use it or lose it." - Dr. McIntire
    Sorry, could you *link* to the discussion. The quote isn't helping because he seems to just be talking about bracing in general. I'd like to see the whole context of his discussion.

    "Excercise can and does help" is also what I've heard. So, bracing is hard on the muscles, but exercise helps with the weakness caused by bracing. So, that's helpful - Jinseeker is already doing exercise, I'm assuming she would continue that in brace (should she pursue it)

    And, see my post above, in the big picture, this isn't really a concern since even teens in hard braces don't progress after weaning. So, no reason to expect a progression after wearing a soft brace.

  6. #36
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    Oh, never mind, I found the thread. Here it is:

    http://www.scoliosis.org/forum/archi.../t-12149.html?

    Kevin specifically limits his discussion to rigid braces, and mentions that's this the reason they wean kids off braces at the end - so that their muscles will have regained strength by the time they start.

    Here's the remainder of his pariticipation in the discussion:

    "Not a whole lot more to add. There are a handful of studies (although not many) that have looked at paraspinal atrophy during brace wear. I'm not sure specifically what type of brace or if it was varied, but it was definitely looking at the rigid braces."

    This is why seeing the whole discussion is so useful. Now it's clear what type of brace he's talking about (rigid only) and that weaning afterwards counteracts the effects.

  7. #37
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    Quote Originally Posted by hdugger View Post

    Dr. Mehta, unfortunately, is retired. Tonibunny, over in the Scoliosis Support forum in the UK, met with her recently, but I suspect she is not still responding to emails. However, there is a PT clinic in the hospital where she used to work run by Tony Betts, and he has a good deal of knowledge (and is publishing reports) in this area. You might try to reach out to him - since he worked with Dr. Mehta and, likely, has the greatest depth of knowledge in side-shift of anyone practicing in this area.

    As Pooka pointed out, we have only had one adult patient on this forum using the Spinecor, so our knowledge is not very deep on this topic. Here is that same posters discussion about her experience, over on the Scoliosis Support forums - http://www.scoliosis-support.org/showthread.php?t=8948.

    Best of luck, and do let us know how everything turns out.

    As Hudugger suspects, unfortunately Dr Mehta is very frail and elderly now and is not able to correspond with scoliosis patients anymore. However, when I met her a few months ago she told me how much she approved of the ISICO group's work, and she demonstrated how she uses the Side-Shifting technique that she devised in order to relieve the pain of her own (very severe) scoliosis.

    Tony Betts is head physio at the Royal National Orthopaedic Hospital, which is one of the largest centres for the treatment of scoliosis here in the UK - as Hudugger says, this is where Ms Mehta was based. The RNOH is an NHS hospital, but Mr Betts also has a private clinic so it would be much easier for you to contact him there. Here's a link:

    http://www.tonybettsphysio.co.uk/

  8. #38
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    How do you think Spinecor maintains the corrected spine if they don't restrict motion? Magic?

    It's an oxymoron.

    I can't find the thread where I asked him about Mamamax's continued claims she repeated from Spinecor. I bet it was erased due to dissension.

    I included Spinecor and then he made that quote.

    Either it's a brace or it isn't. Is Spinecor holding the curve or isn't it? The radiographs suggest it is. Any brace that is claimed to build muscle is an oxymoron.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #39
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    Quote Originally Posted by hdugger View Post
    This is why seeing the whole discussion is so useful. Now it's clear what type of brace he's talking about (rigid only) and that weaning afterwards counteracts the effects.
    The research he quoted concerned hard bracing. His comment I quoted was not so restricted.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  10. #40
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    Quote Originally Posted by Pooka1 View Post
    The research he quoted concerned hard bracing..
    Yes, exactly.

    But no reason to continue this digression. If muscle atrophy has no effect on progression in bracing patients, it's no more than an academic point.

    Thanks so much for the link, Toni, and for Dr mehta's feedback on the isico group. I'm holding out some hope for their providing clarity to this area.

  11. #41
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    Sorry, I realize I'm continuing the digression, but I used to be a technical writer and these little details just nag at me.

    Your summary of the discussion which I just linked to appears to get the order wrong.

    Correct order:

    BalletMom starts a discussion about bracing and muscle atrophy (her child is in a hard brace)

    several posts - none from Kevin or Pooka

    Kevin enters the discussion and says the first quote "bracing causes atrophy of muscles" (said in a discussion which, up until this point, has been about hard braces)

    *then* you extend his assertion to Spinecor in the next post, saying "Including Spinecor, their claims otherwise notwithstanding." This is the first time that the Spinecor brace is mentioned in the discussion, and it happens *after* Kevin's comment about bracing causing atrophy. Not before.

    then several posts - none from Kevin or Pooka

    Then, kevin enters again and says that thing about "but it [the studies he's seen] was definitely looking at the rigid braces"

    That's why I ask for a link to the source - because people reach different conclusions of what they've read. When I read this, it seems clear to me that Kevin is *correcting* your assertion that Spincor causes atrophy when he says that the only studies he's seen are "definitely looking at the rigid braces."

    Sorry again, but I just wanted to get those details straight. It's not a huge deal (atrophy does not equal progression) but it's useful to have the evidence down clearly in case someone else, considering spinecor and worried about muscle atrophy, thinks that our resident scientist has said that the two are linked.

  12. #42
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    But in searching through the discussions I did find one thing of interest. The adult patient on this forum who used spinecor said that, six months after weaning off the brace, her curve was (slightly) smaller then when she started wearing the brace. She's not suggesting that spinecor decreased her curve - but it doesn't seem (from our sample of one) that her curve increased out of brace. She was also doing schroth exercises.

  13. #43
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    Quote Originally Posted by hdugger View Post
    I have seen these kinds of misstatements about surgery being corrected, but my experience is that it is (mostly) us participants and not the moderator making the correction.

    The thing is that there are *a lot* of people with personal experience/knowledge about surgery. But, with the exception of (I think) me, there is no one else on the forum with a lot of knowledge about exercise in adult patients (and, even that, second-hand, since it's my son doing the exercise). And, with the exception of Mamamax (who, I believe, is no longer participating here) there is no one at all with knowledge about bracing in adult patients.

    So, because we just have so few people with knowledge in these areas, it's just far, far more likely that there will be (uncorrected) misstatements made. If someone like Foofer were regularly participating here, instead of participating only on the private forum, we'd all benefit from her experience, and she could also correct misstatements. But, because she and Mamamax and other people like them are no longer on this forum, it sort of *is* my job to make sure that info about exercise and bracing is as correct as possible. If not me, I'm not sure who else here can do it.

    I'd love to have Jinseeker stick around, or for Foofer and others to return, so that we could have the best info possible on how to address adult curves conservatively.
    In fact without non surgical defamers there would not be any problem here.
    And certainly it would be great to have have again many adults interested in non surgical options. This was never a friendly place for that people.

  14. #44
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    Quote Originally Posted by Pooka1 View Post
    How do you think Spinecor maintains the corrected spine if they don't restrict motion? Magic?

    It's an oxymoron.
    Quote Originally Posted by Pooka1 View Post
    "The short answers: Yes, bracing causes atrophy of the muscles. Specifically the paraspinal muscles. Exercise can and does help this. Basic concept of muscle physiology is, for muscles - use it or lose it." - Dr. McIntire

    Unless Spinecor is hanging off the patient, it is restricting ROM. How else could it even work in principle if it isn't doing anything?
    Quote Originally Posted by Pooka1 View Post
    *IF* she as progressing she would continue to progress because there is no reason related to brace wear that it would stop when taken off.

    Quote Originally Posted by Pooka1 View Post
    Even if it did halt progression, you only wear it two years, yes? You would continue progressing when you take it off and perhaps at a faster rate since you won't have any muscle tone from being supported for two years in a brace.
    Quote Originally Posted by Pooka1 View Post
    Either it's a brace or it isn't. Is Spinecor holding the curve or isn't it? The radiographs suggest it is. Any brace that is claimed to build muscle is an oxymoron. ????????????????
    Is incredible in a new thread all what you may say according your irrational thinking.

    Certainly it would not be needed to be a scientist (as you are saying you are), to realize that only someone with not a good background and training in logics may claims something of all of that.

    If you don’t know about some case you say ‘there is no evidence’, if you don’t know why something works you say it cannot works, if you have not idea about something, you talk as if you know about it and if certainly there are reasons to think that may works, you say that there are not and only may works if it would be magic.
    If this forum would be moderate in a serious way, you could not be in non surgical sections.

    Do you know what is a brace, how it works? Why are effectives in stopping and even reducing curves in kids/teens? Do you know what is the Spinecor? Do you know how it works? What do you know about physiology? What do you know about something in order to say what you are saying here? It seems that absolutely nothing of course!
    Last edited by flerc; 01-08-2014 at 11:49 PM.

  15. #45
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    Quote Originally Posted by Jinseeker View Post
    People think i am overacting when they see me and sometimes i question myself is any of what i am really doing working at all, or am i just needlessly anxious about it. Whichever the case, the confusion and ambiguity never leaves me.
    Okay I looked at some of your other threads. I also notice you are on my "Friends" list. I don't have so many but you are on it! :-)

    I think you are in an unusual spot... a large curve that is just hanging there near the surgical range. There are a few other players here over the years who were in a similar situation but only a few. I think you stated you got two opinions, one to operate and one to wait. I once thought you would have a hard time finding a surgeon to fuse you but Linda disagreed. So I now think your situation is just going to be chock full of opposing professional opinions which is a very tough thing to deal with.

    As to what you are doing "working", it isn't crazy to use PT to control pain. It's better than surgery. And given you are not progressing maybe PT is even controlling progression. Who knows.

    I did see in one past thread that you needed to do more and more just to hold ground on the pain. I forget what PT you are doing (Schroth?) but maybe a new opinion and doing different PT would help more. Did you try the ISICO stuff? Maybe Torso rotation would work for you and you could get away with far less per week.

    I guess if I were you, I would not want to be blind-sided about the surgical window. So over the years, besides monitoring your curves, I would be asking questions about bone quality as it affects fusion success (if osteoporosis runs in your family) and the length of the fusion and if it would change if you wait as discussed in previous threads of yours. Maybe it would help you to to be less anxious to have more information if you don't have this type of information already.

    They say scoliosis not an emergency situation. You are the poster boy for that. :-) But that can be a double-edged sword. This whole scoliosis thing has dogged you most of your life it seems and you are still young! I just hope people similarly situated to you will respond except there are not so many people with large non-progressive curves around.

    Good luck.
    Last edited by Pooka1; 01-09-2014 at 08:43 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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