Effectiveness of Bracing in Preventing Scoliosis in Children With Spinal Cord Injury
Recruitment status was Active, not recruiting
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Purpose
The purpose of this study is to determine whether full-time high dose prophylactic bracing (23 hours or more per day) is more effective than low dose bracing (12 hours or less per day) in preventing or delaying spinal curve progression in children with scoliosis after spinal cord injury.
| Condition | Intervention |
|---|---|
|
Scoliosis |
Device: Thoraco-Lumbar-Sacral-Orthoses (TLSO) / Flex-Foam |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Effectiveness of Full-Time Prophylactic Bracing at Preventing or Delaying Curve Progression in Paralytic Scoliosis Secondary to Spinal Cord Injury in the Growing Child: Randomized Trial |
- X-rays (at the time of consent and every 6 months for 5 years) to determine degree of scoliosis. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Timed Motor Assessment (at the time of consent and once a year for 5 years) to measure functional ability in daily life activities including putting on sweat pants, T-Shirt, transferring from wheelchair to bed, etc. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Reachable Workspace Assessment (at the time of consent and once a year for 5 years): performing functional tasks including reaching for the floor, overhead, and every 20-degree radius in between. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Global Measures (at the time of consent and every 6 months for 5 years): Four different questionnaires to monitor function, satisfaction, and quality of life. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 88 |
| Study Start Date: | June 2005 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | December 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
High-dose Thoraco-Lumbar-Sacral Orthoses wear (>23hrs/day) will be compared to low-dose Thoraco-Lumbar-Sacral Orthoses wear (12hrs/day)
|
Device: Thoraco-Lumbar-Sacral-Orthoses (TLSO) / Flex-Foam
TLSO back brace, Flex-Foam (Posterior Opening)
|
|
Active Comparator: 2
Low-dose Thoraco-Lumbar-Sacral-Orthoses wear (12hrs/day)
|
Device: Thoraco-Lumbar-Sacral-Orthoses (TLSO) / Flex-Foam
TLSO back brace, Flex-Foam (Posterior Opening)
|
Detailed Description:
This is a randomized control trial to determine the effectiveness of high dose bracing (≥ 23 hours per day) and low dose bracing (≤ 12 hours per day) in skeletally immature children with Spinal Cord Injury. Subjects will be randomized into either a prophylactic high dose-bracing group (≥ 23 hours per day) or low dose-bracing group (≤ 12 hours per day). Subjects will be stratified by age (younger than age 10 and older than age 10), and curve severity (< 20 degrees and 20-40 degrees) using a matching random blocks design.
Eligibility| Ages Eligible for Study: | 5 Years to 16 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Children with C5 to L2 SCI.
- ASIA impairment levels A, B, or C.
- Age greater than 5 up to one year before end of growth (14 in girls, 16 in boys)
- A single structural curve <40 degrees or a double curve <40 degrees where the largest compensatory curve is <25 degrees on bending film.
- Children at risk for Paralytic Scoliosis
- Ability to follow simple instructions.
Exclusion Criteria:
- Curve magnitude >40 degrees, pressure sores over the trunk.
- Inability to tolerate TLSO wears.
- Structural compensatory curves of 25 degrees or greater (double structural curves).
- Severe Traumatic Brain Injury, TBI (8 and below on Glasgow Coma Scale).
- Cognitive Impairment
- Less than 6 months from date of injury
Contacts and Locations| United States, California | |
| Shriners Hospital for Children - Northern California | |
| Sacramento, California, United States, 95817 | |
| United States, Illinois | |
| Shriners Hospital for Children - Chicago | |
| Chicago, Illinois, United States, 60707 | |
| United States, Pennsylvania | |
| Shriners Hospital for Children - Philadelphia | |
| Philadelphia, Pennsylvania, United States, 19140 | |
| Principal Investigator: | Craig M McDonald, MD | Shriners Hospital for Children, Northern California |
| Principal Investigator: | Randal R Betz, MD | Shriners Hospital for Children, Philadelphia |
| Principal Investigator: | Lawrence Vogel, MD | Shriners Hospital for Children, Chicago |
More Information
Additional Information:
Publications:
| Responsible Party: | Craig McDonald, MD, principal investigator, Shriners Hospital for Children |
| ClinicalTrials.gov Identifier: | NCT00256672 History of Changes |
| Other Study ID Numbers: | 9155-200513332 |
| Study First Received: | November 16, 2005 |
| Last Updated: | June 11, 2008 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Shriners Hospitals for Children:
|
Spinal Cord Injury TLSO brace Spine curvature Child Effectiveness of bracing |
Additional relevant MeSH terms:
|
Scoliosis Spinal Cord Injuries Spinal Curvatures Spinal Diseases Bone Diseases Musculoskeletal Diseases |
Spinal Cord Diseases Central Nervous System Diseases Nervous System Diseases Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on May 23, 2013