Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST)

NCT ID: NCT00448448

Last Updated: 2025-11-04

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

383 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-02-28

Study Completion Date

2013-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Adolescent idiopathic scoliosis (AIS) is a structural curve of the spine with no clear underlying cause. Bracing is currently the standard of care for preventing curve progression and treating AIS. However, the effectiveness of bracing remains unclear. The purpose of this study is to compare the risk of curve progression in adolescents with AIS who wear a brace versus those who do not and to determine whether there are reliable factors that can predict the usefulness of bracing for a particular individual with AIS.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

AIS is characterized by a lateral curvature of the spine greater than 10 degrees plus rotation of the spinal vertebrae. AIS is found in adolescents between the age of 10 and time of skeletal maturity. Progression of a spinal curve to 50 degrees suggests a high risk for continued curve progression throughout adulthood and usually indicates the need for spinal fusion surgery. Only about 10 percent of adolescents with AIS end up having curves that progress and require surgical intervention. While certain risk factors for curve progression have been identified, there is no reliable way of estimating the likelihood of needing surgery. Bracing is currently the standard of care for treating AIS. However, the effectiveness of bracing remains unclear, and it is unknown which adolescents in particular may benefit from bracing. Therefore, adolescents undergo bracing without knowing their likelihood of avoiding surgery. The purpose of this study is to compare the risk of curve progression in adolescents with AIS who wear a brace versus those who do not and to determine whether there are reliable factors that can predict the usefulness of bracing for a particular individual with AIS. The study will also evaluate the best dosing and duration schedule and how bracing affects quality of life, functioning, and psychosocial adjustment among participants.

Participation in this study will last until a participant reaches skeletal maturity or their spinal curve progresses to 50 degrees, after which usual care will continue. Participants will either be 1)randomly assigned to a treatment or 2) may decline randomization and choose their own treatment arm. Study visits will occur every 6 months at an orthopaedic surgeon's office and will include x-rays, a clinical exam, and questionnaires. Participants assigned to braces will be instructed to wear the brace at least 18 hours per day. Temperature monitors placed in the brace will be used to determine the actual wear time by each participant.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Adolescent Idiopathic Scoliosis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The outcomes assessor(s) are blinded to the treatment assignment.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Brace

This study involves full-time, rigid TLSO's only. Braced subjects are followed every six months with radiography, clinical exam and self-reported evaluations of health and functioning. Orthotic evaluations are conducted every 6 months as as necessary to maintain brace fit and function.

Group Type ACTIVE_COMPARATOR

Brace

Intervention Type DEVICE

Brace (TLSO) applied for at least 18 hours per day. Wear time measured using a temperature monitor. Clinical, radiographic, and self-report follow-up every 6 months.

Observation

Observation. Observed subjects are followed every six months with radiography, clinical exam and self-reported evaluations of health and functioning.

Group Type ACTIVE_COMPARATOR

Observation

Intervention Type OTHER

Clinical, radiographic, and self-report follow-up every 6 months.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Brace

Brace (TLSO) applied for at least 18 hours per day. Wear time measured using a temperature monitor. Clinical, radiographic, and self-report follow-up every 6 months.

Intervention Type DEVICE

Observation

Clinical, radiographic, and self-report follow-up every 6 months.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Diagnosis of AIS
* Skeletally immature (Risser grade 0, 1, or 2)
* Pre-menarchal or post-menarchal by no more than 1 year
* Primary Cobb angle between 20 and 40 degrees
* Curve apex caudal to T7 vertebrae
* Physical and mental ability to adhere to bracing protocol
* Ability to read and understand English, Spanish, or French
* Documented insurance coverage and/or personal willingness to pay for treatment

Exclusion Criteria

* Diagnosis of other musculoskeletal or developmental illness that might be responsible for the spinal curvature
* History of previous surgical or orthotic treatment for AIS
Minimum Eligible Age

10 Years

Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

NIH

Sponsor Role collaborator

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

Shriners Hospitals for Children

OTHER

Sponsor Role collaborator

Children's Mercy Hospital Kansas City

OTHER

Sponsor Role collaborator

University of Rochester

OTHER

Sponsor Role collaborator

Stuart L. Weinstein, MD

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Stuart L. Weinstein, MD

Professor of Orthopaedics and Rehabilitation

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Stuart L. Weinstein, MD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa

Lori A. Dolan, PhD

Role: STUDY_DIRECTOR

University of Iowa

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Children's Hospital Central California

Madera, California, United States

Site Status

Shriners Hospital of Northern California

Sacramento, California, United States

Site Status

Rady Childrens Hospital

San Diego, California, United States

Site Status

Alfred I. duPont Hospital for Children and Nemours Children's Clinic

Wilmington, Delaware, United States

Site Status

Children's Healthcare of Atlanta

Atlanta, Georgia, United States

Site Status

Shriner's Hospital for Children

Chicago, Illinois, United States

Site Status

University of Iowa Children's Hospital

Iowa City, Iowa, United States

Site Status

Shriners Hospitals for Children - Lexington

Lexington, Kentucky, United States

Site Status

Children's Hospital Boston

Boston, Massachusetts, United States

Site Status

Shriners Hospitals for Children - Minneapolis

Minneapolis, Minnesota, United States

Site Status

Children's Mercy Hospitals and Clinics.

Kansas City, Missouri, United States

Site Status

St. Louis Children's Hospital

St Louis, Missouri, United States

Site Status

Shriners Hospitals for Children - St. Louis

St Louis, Missouri, United States

Site Status

Carrie Tingley Hospital

Albuquerque, New Mexico, United States

Site Status

Hospital for Special Surgery

New York, New York, United States

Site Status

University of Rochester Medical Center

Rochester, New York, United States

Site Status

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Shriners Hospitals for Children - Salt Lake City

Salt Lake City, Utah, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Children's Hospital and Regional Medical Center

Seattle, Washington, United States

Site Status

BC Children's Hospital

Vancouver, British Columbia, Canada

Site Status

Hospital for Sick Children

Toronto, Ontario, Canada

Site Status

Shriner's Hospital for Children

Montreal, Quebec, Canada

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Canada

References

Explore related publications, articles, or registry entries linked to this study.

Dolan LA, Weinstein SL, Dobbs MB, Flynn JMJ, Green DW, Halsey MF, Hresko MT, Krengel WF 3rd, Mehlman CT, Milbrandt TA, Newton PO, Price N, Sanders JO, Schmitz ML, Schwend RM, Shah SA, Song K, Talwalkar V. BrAIST-Calc: Prediction of Individualized Benefit From Bracing for Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976). 2024 Feb 1;49(3):147-156. doi: 10.1097/BRS.0000000000004879. Epub 2023 Nov 23.

Reference Type RESULT
PMID: 37994691 (View on PubMed)

Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Design of the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST). Spine (Phila Pa 1976). 2013 Oct 1;38(21):1832-41. doi: 10.1097/01.brs.0000435048.23726.3e.

Reference Type BACKGROUND
PMID: 24026162 (View on PubMed)

Dolan LA, Donzelli S, Zaina F, Weinstein SL, Negrini S. Adolescent Idiopathic Scoliosis Bracing Success Is Influenced by Time in Brace: Comparative Effectiveness Analysis of BrAIST and ISICO Cohorts. Spine (Phila Pa 1976). 2020 Sep 1;45(17):1193-1199. doi: 10.1097/BRS.0000000000003506.

Reference Type RESULT
PMID: 32205704 (View on PubMed)

Schwieger T, Campo S, Weinstein SL, Dolan LA, Ashida S, Steuber KR. Body Image and Quality-of-Life in Untreated Versus Brace-Treated Females With Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976). 2016 Feb;41(4):311-9. doi: 10.1097/BRS.0000000000001210.

Reference Type RESULT
PMID: 26555827 (View on PubMed)

Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med. 2013 Oct 17;369(16):1512-21. doi: 10.1056/NEJMoa1307337. Epub 2013 Sep 19.

Reference Type RESULT
PMID: 24047455 (View on PubMed)

Schwieger T, Campo S, Weinstein SL, Dolan LA, Ashida S, Steuber KR. Body Image and Quality of Life and Brace Wear Adherence in Females With Adolescent Idiopathic Scoliosis. J Pediatr Orthop. 2017 Dec;37(8):e519-e523. doi: 10.1097/BPO.0000000000000734.

Reference Type RESULT
PMID: 26886460 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://braistcalc.com

BrAIST-Calc is an online aid for patients with Adolescent Idiopathic Scoliosis who want to estimate their personal risk of scoliosis surgery with and without bracing treatment.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

R01AR052113

Identifier Type: NIH

Identifier Source: secondary_id

View Link

200108052

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.