DMO postural scoliosis suit

New approach to treatment could help patients avoid radical surgery & ‘free them’ from rigid bracing.

Peer reviewed research, published in “Scoliosis and Spinal Disorders Journal1 (201611:14), is providing GPs, paediatricians musculoskeletal consultants with exciting new evidence into the positive effects of the Dynamic Movement Fabric Orthoses (DEFO) for the management of scoliosis in children – designed and developed by a team of medical innovators based in South West England.2

The research paper is the first substantial clinical study to document the effectiveness of orthotic devices (including Postural and Structural Scoliosis Suits) in relation to neuropathic onset scoliosis, which accounts for around 10% of the cases in patients who are affected by spinal curvature of a neuromuscular condition, such as muscular dystrophy, developmental delay or cerebral palsy.

Overall, Scoliosis affects around 42,000 young people (aged 15 and under) in the UK, leading to 3 to 4 children per 1,000 needing specialist supervision. In most cases the cause is unknown (idiopathic).

The new study showed that the use of a DEFO greatly improved the chances of patient compliance with an orthotics device with a staggering 98% of patients willing to wear them (high compliance).

The data also highlighted that 42% of children who had been diagnosed with scoliosis and prescribed a DEFO, saw their condition improve or not progress further. 12% of scoliosis patients were found to no longer need any intervention after an average period of 18 months.

38% of the cases included in the study who underwent corrective surgery experienced complications such as; spinal rod breakage, excessive movement of fixations, infection and reduced head control. 36% of patients who underwent surgical intervention also experienced curve progression after surgery.

Only a third of cases who were prescribed rigid bracing continued to use this form of orthosis with 11% converting to using a DEFO.

And, early intervention using DEFO’s could also have a positive financial benefit to the NHS and privately funded healthcare. The cost of surgical intervention for neuromuscular scoliosis is estimated to be US $50,096 (£32,000 approx.) By contrast DEFO’s, cost a fraction of this price.3

Scoliosis is the abnormal twisting and curvature of the spine that affects a person’s appearance by deforming the ribcage causing a lump to form on the back. Other possible signs of scoliosis are a shoulder blade that sticks out or an uneven waist.

The spine can curve to the left or the right and can occur in different parts of the spine. Sometimes there are two curves and the spine may look like an S shape from behind. This is called a ‘double curvature’. When the curve is S-shaped a person’s spine can appear quite straight because the two curves cancel each other out.

Spotting and treating a curve early may allow patients to try non-operative treatment like bracing. If curves are discovered late, when they are already severe, treatment can be more difficult and less effective.

This study looked at the clinical notes of 180 patients collated over 10 years from 5 separate paediatric physiotherapy departments within the NHS, which were audited independently by researchers at Plymouth University, Devon.

The patients were divided into three categories:

  1. Those diagnosed with scoliosis
  2. Those with a developing spinal curve
  3. Those not diagnosed with scoliosis (involving children with neuro-muscular conditions such as cerebral palsy which would have the potential to develop into scoliosis)

Of the 180 individual cases 121 were prescribed a Dynamic Movement Fabric Orthosis (DEFO), 18 were prescribed some form of rigid bracing and 41 were not prescribed an orthosis. Not strictly true as only 120 were DMOs!

Lead author and Managing Director of DM Orthotics, Martin Matthews, comments:

“There is little doubt that our study has produced some very interesting results, putting forward good evidence for the wider use of DEFO’s in the management and prevention of neuropathic onset scoliosis in children and as a positive alternative to rigid bracing and invasive surgery.

“It is also interesting to note that the use of DEFO’s has been shown to have many other positive outcomes. The audit indicated that DEFO suits may improve spatial awareness provided by compression to the spine, combined with downward compression on the shoulders and control around the pelvis to provide postural stability. The suits not only provide postural support and stability but also encourages muscle use, necessary to promote isometric movement and balanced spinal muscle tone.”

The study concluded that DEFO’s could be an effective form of management of mild to moderate scoliosis in a range of neuromuscular conditions and that Cobb angle (used to quantify the magnitude of spinal deformities) progression was typically minimal in those children using a DEFO.

It is hoped the results also provide some evidence for the potential for DEFO’s to be used in the future management of children at risk of developing and presenting with neuropathic onset scoliosis.

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