Providence Nocturnal Scoliosis® Orthosis Protocol: A Suggestion for Best Practices

Initial fitting

At the initial fitting, we recommend the practitioner draw lines on the straps to make it easier for the patient to gradually tighten their brace. The goal should be for the patient to have adjusted the straps to the tightest point within the first 2-3 weeks of wearing the brace, or before their follow up appointment and initial in-brace x-ray. Over time, the patient can progressively tighten the brace to its appropriate fit.

After initial fitting of the brace, there is a “break-in period.” A loose fit is recommended until the patient can tolerate wearing the brace throughout the night. Then, progressive tightening should begin.

Initial “In-Brace X-ray” Protocol

Research shows there is a strong correlation between “best” or “initial” in-brace correction and follow up correction. The Providence® brace is a recumbent position orthosis. It is vital that the orthotist instruct the patient and care takers the proper donning of the brace to insure the best outcome for the “initial in-brace x-ray.”

In-Brace X-rays

All In-Brace X-rays must be taken with the patient in the supine position. The Providence Nocturnal Scoliosis® Orthosis is a recumbent brace.

Follow up appointments

At the 1st follow up appointment, the practitioner should check for any fitting issues the patient may be experiencing. Return visits should be every 3 months. The brace may need new straps after 6 months if the orthosis is being worn for the recommended time.

Please keep in mind, it is recommended you follow the patients orthopedic surgeon’s “protocol.” If applicable, it is best to schedule your patients visit around the surgeons scheduled visits to limit the amount of inconvenience for the patient and family.

Benefits of the Providence® Orthosis:

The Providence® brace was designed to correct both single and multiple scoliotic curvatures while in the recumbent position. When considering lumbar correction in the Providence® brace, the pelvic area on the convex side of the curve is not enclosed in the brace which allows increased pad pressure and progressive lumbar correction as the patient’s pelvis widens with growth. Another design benefit is the large void areas opposing the convex side of curve/curves. These void areas allow for derotation of the spine, expansion of the lungs for proper breathing, and overall comfort for the patient.

Brace Spacer:

The Providence® brace is shipped with one (1) spacer (attached to the opening). This is to maintain the shape of the brace during shipping and handling as well as to limit unwanted effects of the brace opening and curling. We recommend providing the spacer for the patient to use when the brace is not being worn.

Wear Time Success

Studies have shown there is a direct correlation between the hours of brace wear and the rate of correction in Scoliosis patients.

stTracker®

We developed the stTracker® to help doctors, orthotists, parents and patients share the common goal of compliance.

Patient Recommendations

As the Providence® brace is a nighttime orthosis, we recommend patients and parents take advantage of additional opportunities to extend wear time when possible. Encouraging the child to lie down in a recumbent position for extended periods of time will aid in achieving more compliance. Suggested ways to accomplish this include the use of a bean bag chair while lying supine and watching TV, reading a book, or hanging out with friends.