The BrAIST Study (Bracing in Adolescent Idiopathic Scoliosis Trial) stands as the gold-standard research proving how effective bracing is for Adolescent Idiopathic Scoliosis (AIS). This landmark study shows clearly that consistent brace wear dramatically lowers the risk of curve progression in growing adolescents.
Bracing plays a major role in AIS treatment, especially for kids and teens who still have significant growth remaining. AIS refers to scoliosis that appears in adolescents without a known cause. Providers typically recommend bracing for spinal curves between 25–45 degrees because proper brace wear can prevent the curve from worsening and often reduces the need for surgery.
For years, clinicians debated how many hours per day a patient should wear a brace to get the best results. The BrAIST Study set out to answer this question. Dr. Stuart Weinstein led the trial, published in 2013, to directly measure how well back braces control scoliosis progression.
Between 2007 and 2013, the research team enrolled more than 200 adolescents, ages 10–15, with AIS and Cobb angles between 20 and 40 degrees. They randomly assigned participants to one of two groups:
Bracing group: Patients wore a scoliosis brace 18 hours per day. A built-in sensor tracked real usage time.
Observation group: Patients did not wear a brace and received no additional scoliosis treatment.
The researchers evaluated each patient at two clear endpoints:
Treatment success: The patient reached skeletal maturity without their curve reaching 50 degrees.
Treatment failure: The curve progressed to 50 degrees, which typically triggers surgical consideration.
The BrAIST Study provided strong, real-world evidence that consistent brace wear, especially at 18 hours per day or more, offers powerful protection against scoliosis progression.
The results of the study showed that the number of hours that a brace is worn each day has a significant effect on the progression of scoliosis. Participants who wore the brace for at least 18 hours per day had a significantly lower chance of needing surgery to correct their scoliosis than those who wore the brace for less than 18 hours per day or those in the observation group.
Interestingly, the study also found that wearing the brace for more than 18 hours per day did not provide any additional benefit. This means that wearing a brace for the recommended amount of time is crucial for its effectiveness in treating scoliosis, but wearing it for longer than necessary may not provide any additional benefit.
The reason why wearing a brace for a significant portion of the day is so important is that it helps to correct the curvature of the spine by applying pressure to the affected areas. This pressure can hold the curve in place and can prevent the curve from getting worse, and may even help to gradually reduce the degree of curvature over time.
In summary, the BRAIST study found that wearing a brace for at least 18 hours per day is an effective way to treat adolescent idiopathic scoliosis and prevent the need for surgery. The study also showed that wearing a brace for more than 18 hours per day does not provide any additional benefit.
It’s worth noting that the BRAIST study actually ended early because the results were so conclusive. The researchers felt that it was unethical to continue assigning participants to the no-treatment group since it was clear that wearing a brace was the more effective option.
Overall, the BRAIST study provides important insight into the best practices for treating scoliosis with a back brace. If you or a loved one has been diagnosed with scoliosis, it’s important to talk to your doctor about the best treatment options for your specific case. Wearing a brace for the recommended amount of time can be an effective way to correct the curvature of the spine and prevent the need for surgery in the future.