Nighttime Bracing or Scoliosis-Specific Exercise for Moderate Adolescent Idiopathic Scoliosis: Findings From a Multicenter Randomized Trial

Physical therapists and physical therapist assistants who see adolescents with idiopathic scoliosis in outpatient orthopedic, pediatric, or school-based settings, and who field questions from families about bracing schedules and scoliosis-specific exercise programs.

Physical therapists and physical therapist assistants in outpatient orthopedic, pediatric, and school-based practice; clinicians who co-manage adolescent idiopathic scoliosis with orthopedic surgeons and orthotists.

Intended audience

Physical Therapy

Level

Introductory

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of a single randomized clinical trial. All figures, definitions, and conclusions presented here are drawn from that report.

Charalampidis A, Diarbakerli E, Dufvenberg M, Jalalpour K, Ohlin A, Ahl AA, Möller H, Abbott A, Gerdhem P; CONTRAIS Study Group. Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(1):e2352492. doi:10.1001/jamanetworkopen.2023.52492. PMID: 38285447; PMCID: PMC10825714.

Trial registration: ClinicalTrials.gov Identifier NCT01761305.

Scope note

This is an evidence appraisal course, not a technique course. It does not teach brace fitting, brace fabrication, or any specific scoliosis-specific exercise method, and it does not issue practice recommendations beyond what the trial authors themselves concluded.

After completing this course, you will be able to:

1. Describe the population, the three treatment groups, and the success threshold used in the CONTRAIS randomized clinical trial of moderate-grade adolescent idiopathic scoliosis.
2. State what the trial found for nighttime bracing and for scoliosis-specific exercise compared with self-mediated physical activity alone, including what happened to surgery rates over the following two years.
3. Explain the limitations the authors identified, including how adherence was measured and how allowing transition to full-time bracing after treatment failure may have shaped the longer-term results.

1. Start Here: how this course works and what the source is
2. Podcast: Nighttime Bracing, Exercise, or Activity Alone? (about eight minutes)
3. Moderate Adolescent Idiopathic Scoliosis and the Bracing Question
4. Inside CONTRAIS: Six Swedish Hospitals, Three Groups, One Outcome
5. What the Trial Found: Curve Progression, Surgery, and Adverse Events
6. Where the Trial Is Uncertain: Adherence, Crossover, and Exercise Content
7. Bringing the Findings Into Conversations With Families and Referral Partners
8. Key Takeaways
9. Post-test and course evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports the findings of a single randomized clinical trial. All figures, definitions, and conclusions presented here are drawn from that report.
2. Charalampidis A, Diarbakerli E, Dufvenberg M, Jalalpour K, Ohlin A, Ahl AA, Möller H, Abbott A, Gerdhem P; CONTRAIS Study Group. Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(1):e2352492. doi:10.1001/jamanetworkopen.2023.52492. PMID: 38285447; PMCID: PMC10825714.
3. Trial registration: ClinicalTrials.gov Identifier NCT01761305.
4. Scope note
5. This is an evidence appraisal course, not a technique course. It does not teach brace fitting, brace fabrication, or any specific scoliosis-specific exercise method, and it does not issue practice recommendations beyond what the trial authors themselves concluded.