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Adolescent Idiopathic ScoliosisBrAISTNCT00448448

Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST)

A study testing Brace and Observation in people with Adolescent Idiopathic Scoliosis, run by Stuart L. Weinstein, MD at 25 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 10 to 15 years
Conditions the study is for
Adolescent Idiopathic Scoliosis
What is being tested?
Brace and Observation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
383 participants
Where
25 sitesin 2 countries
Study dates
Feb 2007to Sep 2013
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 to 15 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • 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

Who cannot join

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

Trial locations and contacts

25 sites in 2 countries.

25 sites in 2 countries

United States22 sites
  • Carrie Tingley Hospital

    Albuquerque, New Mexico, 87102-1715

  • Children's Healthcare of Atlanta

    Atlanta, Georgia, 30342-4755

  • Children's Hospital Boston

    Boston, Massachusetts, 02115

  • University of Virginia Health System

    Charlottesville, Virginia, 22908-0232

  • Shriner's Hospital for Children

    Chicago, Illinois, 60707

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • University of Iowa Children's Hospital

    Iowa City, Iowa, 52242

  • Children's Mercy Hospitals and Clinics.

    Kansas City, Missouri, 64108

  • Shriners Hospitals for Children - Lexington

    Lexington, Kentucky, 40502

  • Children's Hospital Central California

    Madera, California, 93638

  • Shriners Hospitals for Children - Minneapolis

    Minneapolis, Minnesota, 55414

  • Hospital for Special Surgery

    New York, New York, 10021

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Children's Hospital of Pittsburgh

    Pittsburgh, Pennsylvania, 15213

  • University of Rochester Medical Center

    Rochester, New York, 14642

  • Shriners Hospital of Northern California

    Sacramento, California, 95817

  • Shriners Hospitals for Children - Salt Lake City

    Salt Lake City, Utah, 84103

  • Rady Childrens Hospital

    San Diego, California, 92123

  • Children's Hospital and Regional Medical Center

    Seattle, Washington, 98105

  • St. Louis Children's Hospital

    St Louis, Missouri, 63110

  • Shriners Hospitals for Children - St. Louis

    St Louis, Missouri, 63131

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

    Wilmington, Delaware, 19899

Other trials in United States

Canada3 sites
  • Shriner's Hospital for Children

    Montreal, Quebec

  • Hospital for Sick Children

    Toronto, Ontario, M5G 1X8

  • BC Children's Hospital

    Vancouver, British Columbia, V6H 3V4

Other trials in Canada

About this study

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.

Read the detailed description

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.

Being tested
Brace, Observation
Keywords
adolescent idiopathic scoliosis, orthotics, bracing, partially randomized preference design

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BraceDevice

    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.

  • ObservationOther

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

Study groups in NCT00448448
Study groupRoleWhat they receive
BraceActive comparatorThis 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.
Receives: Device: Brace
ObservationActive comparatorObservation. Observed subjects are followed every six months with radiography, clinical exam and self-reported evaluations of health and functioning.
Receives: Other: Observation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Skeletal Maturity With a Cobb Angle of <50 Degrees (Successful Outcome)

    Measured: Skeletal maturity and the Cobb angle were measured at baseline and at each 6-month follow-up. Subjects were followed until they reached criteria for either success or failure. The average duration of follow-up was 23.67 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2007 (estimated)
  2. Study startFeb 2007
  3. Primary completionSep 2013
  4. Study completionSep 2013

Why it stopped: Stopped for efficacy

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
383 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00448448
Sponsor's protocol ID
200108052
Other IDs
R01AR052113
Acronym
BrAIST
Status last verified
Feb 2026
First submitted
14 Mar 2007
Last updated
2 Mar 2026
Data monitoring committee
Yes

Publications

  • 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.

    PubMed 24026162
  • Amaral JZ, Kallur A, Dolan LA, Nguyen AQ, Schultz RJ, Martin BM, Coello P, Scioscia JP, Chhabra BN, Hanson DS, Gerow FT, Smith BG. Bracing Outcomes and Risk of Curve Progression in Adolescents with Idiopathic Scoliosis and Autism Spectrum Disorder. J Bone Joint Surg Am. 2026 Apr 1;108(7):499-506. doi: 10.2106/JBJS.25.00668. Epub 2025 Dec 3.

    PubMed 41337495
  • Sullivan TB, Bastrom TP, Bartley CE, Dolan LA, Weinstein SL, Newton PO. More severe thoracic idiopathic scoliosis is associated with a greater three-dimensional loss of thoracic kyphosis. Spine Deform. 2020 Dec;8(6):1205-1211. doi: 10.1007/s43390-020-00149-7. Epub 2020 Jun 2.

    PubMed 32488764
  • Troy MJ, Miller PE, Price N, Talwalkar V, Zaina F, Donzelli S, Negrini S, Hresko MT. The "Risser+" grade: a new grading system to classify skeletal maturity in idiopathic scoliosis. Eur Spine J. 2019 Mar;28(3):559-566. doi: 10.1007/s00586-018-5821-8. Epub 2018 Nov 16.

    PubMed 30446865
  • 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.

    PubMed 26555827
  • 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.

    PubMed 32205704
  • 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.

    PubMed 37994691
  • 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.

    PubMed 24047455
  • 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.

    PubMed 26886460
  • Taylor TN, Ratnasamy PP, Lee TM, Tuason D, Li DT, Cooperman DR, Dolan LA, Smith BG. The Proximal Humerus Ossification System Predicts Surgical Curve Progression in Unbraced Patients With Adolescent Idiopathic Scoliosis. J Pediatr Orthop. 2026 Apr 1;46(4):249-254. doi: 10.1097/BPO.0000000000003195. Epub 2025 Dec 11.

    PubMed 41379077
  • Dolan LA, Weinstein SL, Abel MF, Bosch PP, Dobbs MB, Farber TO, Halsey MF, Hresko MT, Krengel WF, Mehlman CT, Sanders JO, Schwend RM, Shah SA, Verma K. Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST): Development and Validation of a Prognostic Model in Untreated Adolescent Idiopathic Scoliosis Using the Simplified Skeletal Maturity System. Spine Deform. 2019 Nov;7(6):890-898.e4. doi: 10.1016/j.jspd.2019.01.011.

    PubMed 31731999

Questions about this trial

What is this clinical trial studying?

A study testing Brace and Observation in people with Adolescent Idiopathic Scoliosis, run by Stuart L. Weinstein, MD at 25 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 2 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 25 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 23 Jul 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Skeletal Maturity With a Cobb Angle of <50 Degrees (Successful Outcome) (time frame: Skeletal maturity and the Cobb angle were measured at baseline and at each 6-month follow-up. Subjects were followed until they reached criteria for either success or failure. The average duration of follow-up was 23.67 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00448448, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2026.

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