Isis Navarro shares her experience in Italy

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We took advantage of the presence of the Brazilian physiotherapist Isis Navarro in Italy, currently working at some ISICO facilities, to get to know her better and have her tell us about her professional experience in collaboration with ISICO.

Would you like to tell us something about yourself on a professional level?
I am a physiotherapist passionate about treating patients with scoliosis.
I completed my undergraduate degree in 2010, my master’s degree in 2018, and my PhD in 2023. In 2017 and 2018, I obtained certification in the SEAS Approach in Brazil with Michele Romano, the physiotherapy director of Isico, and Alessandra Negrini. Since then, I have dedicated my professional life exclusively to treating patients with scoliosis, and currently I am the technical director for the treatment of scoliosis in its entirety at the four units of Clínica Linear in Brazil.

How long have you been collaborating with ISICO and how did this collaboration arise?
Our collaboration began in January 2020 when, during a visit to ISICO in Milan, Michele discussed with me the possibility of offering SEAS Approach certification in Brazil, with myself serving as the local instructor. Unfortunately, shortly after, the pandemic began, and I continued my training with Michele online for two years. In January 2022, we successfully conducted the first SEAS Approach certification course in Brazil in partnership with ISICO. To date, over 200 physiotherapists from all regions of Brazil have been certified in the SEAS Approach, and 14 courses have already been completed.

Why the SEAS Approach? What are its advantages, and how has it influenced your rehabilitation practice?
The SEAS Approach stands out for its remarkable flexibility, adaptability, and its strong foundation in rehabilitation principles, which are consistently applied throughout the treatment process. These qualities made it easy for me to adopt the SEAS method when treating patients with scoliosis. Additionally, its extensive scientific foundation and the wealth of published studies demonstrating the robustness of its results provide me with confidence and reassurance when using the SEAS Approach to treat patients from around the globe.

Now you are in Italy—Why and for how long?
The “icing on the cake” of this partnership is the opportunity to experience ISICO’s routine directly here in Italy! I have moved with my entire family to live in Italy for about a year. The aim is to immerse myself even further in ISICO’s methodology for treating scoliosis and other spinal conditions, given that ISICO is undeniably the global leader in evidence-based scoliosis treatment today.

SEAS Course in Portugal: What can you tell us about this upcoming event?
During this period in Europe, we are seizing the opportunity to expand the reach of SEAS Approach certification. In January, we will launch the first SEAS course in Portugal. This initiative arose from the geographical proximity and the advantage of a shared language, making it a natural step forward. We are excited to bring this certification to new regions and hope this will be the first of many courses offered in Portugal in the future.

The Body

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Chiara Castiello is a psychologist expert in adolescence and social innovation, with a deep passion for photography, writing, and jazz music. Chiara wore a brace for many years, from the age of ten until she was 18. Even today, she continues to care for her back and is one of our adult patients.
Chiara has shared with us her experience as a young girl wearing a brace, but above all, she has offered a reflection as an adult and psychologist on the importance of body perception and both physical and mental health. Thank you!
Below is her text, “The Body” by Chiara Castiello.

“Are you an only child?”
To my astonishment, it was the second time I repeated, “Yes, I am.”
And it couldn’t be otherwise. It was either a blessing or a necessity that I was. At ten years old, the vertebrae in my spine decided not to align perfectly but instead to take on a C-shape, like the initial of my name. An orthopaedic brace, after narrowly avoiding a plaster cast, was the treatment recommended by doctors from a Northern region of Italy. Long and repeated car journeys, endless waiting times, and fittings of this “garment” made of rigid plastic and aluminium, with pressure applied to the hips and behind one shoulder.

At first, it really feels like a tailored outfit, and the sensation is even somewhat pleasant. Standing in a room with your arms resting on two poles that help keep them supported and away from your chest. A tight-fitting gauze in a butter colour is slipped onto you, and then warm plaster strips are applied, shaping your body. In a very short time, the “garment” takes shape, solidifies, and suffocates you. Then scissors cut it under the armpit, opening it like a door, and you emerge, naked and cold.

The orthopaedic brace teaches you endurance. It teaches you to sleep on your back on the hard surface of the plastic, to bear the cold touch of the aluminium in winter. To appreciate shade and cool places in the summer. It teaches you discipline; in my case, for a long time, I could only remove it for one hour a day. It teaches you not to scratch mosquito bites, as they are unreachable, locked inside your “box”! It instils moderation, as it compresses your stomach if you eat too much.
It teaches you to cover yourself for fear of being found out. Not to follow fashion, because you can’t; to button the collars of the polo shirts you wear and buy them a size larger. To pick up things from the floor with your feet so you don’t have to bend too often. To quickly dart through security gates at museum entrances to avoid setting off alarms. To dodge hugs from boys, while secretly yearning for them.

It denies you comparison with others because they are healthy, normal, and free. It deludes you into always feeling like a child and prevents you from thinking about your body, which is there but invisible. Artificially supported, it grows under compression. Its development, except for the worsening of the spine, remains imperceptible. And when the “garment” becomes tight, you rush back north to get a new one.

During these endless visits, my parents and I transported by car for 620 kilometers, my body and its black-and-white photographs: the X-rays on which doctors, in white goans with rulers and red pencils, recorded numbers and the degrees of curvature, marking the positive or negative progress of my condition. This body-object, so medicalised, observed, and adjusted, was a stranger to me. It grew, changed, betrayed me, worsened without my control and, after great effort and many years, healed.

As a patient and adolescent (now an adult) with scoliosis, I wish to shed light on the importance of working in parallel on one’s perception of body image. To perceive: to become aware of oneself. I am my body; it belongs to me, and I relate to the world through it. Despite the plastic “box,” I can live, connect, and experience this non-object outside its cage.
And there is more. The “Self” cannot be put on hold while waiting for the body to heal because the two are not separate entities. Put differently, it is essential not to neglect the wholeness of a person as the union of body and psyche. The well-being or suffering of both travels in the same carriage of the same train; they are interdependent. Sartre wrote that the “body is the ultimate psychical object, the only psychical object” (1943, p.429).

If this was understood, one wouldn’t feel so unprepared at the end of treatment, so afraid, fragile, defenceless, fragmented. Medicalising and isolating the body is a mistake still too often made in care practices, but the body lives and breathes as part of its whole being. We are our history, our experiences, from birth onwards; we are unique and, as such, deserve to be welcomed.
Only in this way can we truly consider ourselves healed and free.

Is Life Turning You Kyphotic? Here’s How to Prevent It

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The spine supports the torso and allows the head to stay upright, keeping the gaze towards the horizon. Proper alignment in the sagittal plane helps maintain the torso in the correct position with minimal energy expenditure and optimal load distribution along the spine.

Over time, particularly in older adults, a forward imbalance tends to develop, causing the torso to lean forward. Researchers have identified the age range of 50 to 60 as the period when this imbalance typically begins to manifest, progressively worsening with age. Compensatory mechanisms then come into play, creating a vicious cycle involving the pelvis and the entire spine, leading to specific degenerative changes.
The pelvis tilts backward, lumbar lordosis decreases, and the upper torso bends forward. In some cases, these changes in sagittal alignment occur rapidly and progressively, developing into pathological conditions.
Certain factors may exacerbate this, such as the presence of scoliosis, disc disorders leading to reduced lordosis, or stiffness in the spine. Severe kyphosis or kyphosis resulting from vertebral fractures also contribute to forward collapse, as does weakness in the spinal extensor muscles, leading to forward lean.

Now, let’s consider our daily activities.
Most of what we do involves looking downward or at least keeping the head tilted forward. For example, how much strain is placed on the cervical vertebrae when the head is tilted forward at 30 degrees? (Keep in mind that when we look at our phones, we usually tilt our heads much more than 30 degrees.)

At this angle, the discs experience 400% more stress compared to when the head is upright and looking forward. The natural tendency towards forward collapse, combined with daily activities that increasingly involve static, flexed postures and potential degenerative spinal conditions, accelerates the forward tilt of the torso. This forward imbalance results in pain, reduced spinal functionality, fatigue, aesthetic concerns, and, most importantly, a decline in quality of life.

What Can We Do?

  1. Resist Gravity: Throughout the day, whether standing or sitting, make an effort to sit or stand up straight and hold this position for a few seconds.
  2. Engage in Regular Physical Activity: Any type of exercise is beneficial, but activities that engage the trunk extensor muscles are especially helpful. Don’t stop moving! It’s also a good idea to vary your exercises over time, which will benefit your back as well.
  3. Seek Medical Advice: If you notice yourself leaning forward when tired, especially in the evening, or if those around you point out that you’re becoming more stooped, it’s time to seek a medical evaluation.

…And if life pushes us forward? Let’s straighten it out!

Artificial Intelligence: A Revolution in Rehabilitation?

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Artificial Intelligence (AI) is transforming how medical professionals approach rehabilitation, offering innovative tools that enhance the quality of treatment. At ISICO, we are increasingly committed to exploring how AI can support daily clinical work and contribute to highly personalised therapeutic decisions.

We discussed this with Francesco Negrini, a specialist physiatrist at ISICO and the author of a groundbreaking 2023 study on AI and rehabilitation. This study, “Developing a new tool for scoliosis screening in a tertiary specialist setting using artificial intelligence: a retrospective study on 10,813 patients,” won the prestigious SOSORT Award in 2023.

Dr Negrini recently presented another paper exploring the use of AI in rehabilitation projects, particularly in stroke recovery.

What Are the Key Areas Where AI Can Be Used in Rehabilitation?
Artificial Intelligence (AI) is incredibly versatile and can be applied at various stages of the medical process. It can range from diagnosis, using automated analysis of X-ray or MRI images to identify pathologies with greater precision, to prognosis, with predictions on treatment outcomes, and on to the personalisation of treatments, determining the most effective therapeutic pathway based on patient data. AI also enables continuous monitoring, allowing real-time patient progress evaluation to adapt the treatment accordingly.
At ISICO, we are exploring, for example, how AI can support personalised treatment approaches. This technology could analyse a patient’s natural history and the likelihood of success when using one type of brace over another, providing physicians with more accurate decision-making tools.

Can you give a concrete example of how ISICO is using AI?
A significant example is the research that won the SOSORT Award 2023, recently published (link). The study demonstrated how analysing clinical data using advanced techniques can enhance our understanding of scoliosis and its treatments.

Another potential application involves the diagnosis of low back pain, where AI can analyse radiographic images to identify aetiologies that the human eye might otherwise miss. This approach takes advantage of today’s enhanced computational power, enabling the rapid and accurate processing of large volumes of data.

How Could AI Transform the Management of Spinal Disorders in the Future?
There are three key areas where we see tremendous potential. The first is screening and early diagnosis, which involves early detection of scoliosis or other conditions to improve treatment outcomes. The second area is the customisation of braces, using data collected from clinical centres to predict which type of brace will be most effective for a specific patient. Lastly, monitoring outcomes plays a crucial role, as it allows for tracking the progress of therapy and adapting it based on observed improvements, thereby enhancing the overall effectiveness of treatment.

What Makes AI Such a Valuable Ally for Clinicians?
AI amplifies a clinician’s capabilities, providing more detailed information and helping them make data-driven decisions. However, as we always emphasise at ISICO, the doctor-patient relationship remains central. AI does not replace a clinician’s experience and empathy; instead, it offers tools that enhance human expertise.

What is the Future of AI in Rehabilitation Medicine?
I believe we will see an increasingly close integration of AI in clinical practice. At ISICO, we are moving in this direction, exploring how AI can improve therapeutic outcomes and make rehabilitation more targeted. We are just at the beginning, but the possibilities are immense, especially if we can combine the best of technology with the invaluable expertise of healthcare professionals.

SEAS Therapy: 20 Minutes of Daily Exercises at Home – Too Much or Too Little?

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The International Society for Conservative Scoliosis Treatment (SOSORT) recommends exercises based on self-correction, which involves movement aimed at counteracting spinal curves, stabilising this position, and integrating it into daily life【1.

At ISICO, we have developed and use the SEAS approach. These exercises involve actively achieving the self-corrected position and working to maintain it despite various challenges. The exercises are designed to test the stability of the correction, requiring the patient to stabilise their spine and recover the correction if control is lost【2.
Gradually, as therapy progresses and through continuous practice, patients become more adept at incorporating self-correction into their daily lives—for example, while eating, walking, or doing homework.

How much time should be dedicated to practising the exercises each day?
Typically, 20 minutes daily is a significant commitment, especially as this therapy can last for a long time—sometimes several years. Patients are given one rest day per week, making the total weekly commitment about two hours.

Some parents, particularly at the beginning, ask whether more than the prescribed amount can be done. We usually respond that it is important to train without overwhelming the patient. For example, consider marathon training: a young person should not exhaust all their energy at the start and then abandon therapy, but instead maintain endurance and continue until skeletal maturity. At this point, we can say that the risk of scoliosis progression has decreased.
Conversely, reducing the duration would result in an insufficient period of practice. When we think about how much time young people spend on their phones daily, 20 minutes is not much.

How much time is needed for exercises in other scoliosis treatment approaches?
According to current data, the other most widely used approach globally is the Schroth therapy, developed in Germany.
This method involves hospitalisation in a specialised clinic for 3–4 weeks, during which patients undergo daily two-hour sessions to learn the exercises properly. After the training period, patients are instructed to continue the exercises at home and visit the clinic one to four times a month to ensure proper execution【3.
Alternatively, patients can learn the exercises through closely spaced individual sessions with a therapist, lasting 60–90 minutes, followed by weekly group sessions of 60 minutes, combined with a daily home exercise programme lasting 30–45 minutes【4.
This represents a significantly greater commitment than the 20 minutes required for SEAS therapy.

1. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. doi: 10.1186/s13013-017-0145-8. PMID: 29435499; PMCID: PMC5795289.

2. Romano M, Negrini A, Parzini S, Tavernaro M, Zaina F, Donzelli S, Negrini S. SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises. Scoliosis. 2015 Feb 5;10:3. doi: 10.1186/s13013-014-0027-2. PMID: 25729406; PMCID: PMC4344739.

3. Rigo M, Reiter C, Weiss H-R. Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil. 2003;6(3–4):209–14.

4. Burger M, Coetzee W, du Plessis LZ, Geldenhuys L, Joubert F, Myburgh E, van Rooyen C, Vermeulen N. The effectiveness of Schroth exercises in adolescents with idiopathic scoliosis: A systematic review and meta-analysis. S Afr J Physiother. 2019 Jun 3;75(1):904. doi: 10.4102/sajp.v75i1.904. PMID: 31206094; PMCID: PMC6556933.

How to Write a Winning Abstract: 10 Key Tips for SOSORT 2025

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The deadline for SOSORT abstract submissions is fast approaching! December 7th is just around the corner, and with the conference scheduled for April 23-26, 2025, in Dubrovnik, it’s time to refine your submissions.
To assist those still working on their abstracts, ISICO has prepared a practical pocket guide with tips. These are based on SOSORT’s guidelines, provided by the Scientific Committee. For more detailed insights, a SOSORT webinar on the topic is also available. Additionally, we’ve included a special tip from our researchers, offering a glimpse into the unique approach we follow at our institute.
ISICO’s approach emphasises the direct link between research and clinical applications, reinforcing the idea that addressing existing clinical challenges can lead to advancements in understanding and rehabilitation therapies.

SOSORT Guidelines for Presenting an Effective Abstract

  1. Craft a Clear and Specific Title
    • Keep the title concise but informative. Focus on the essence of the work, using terms that reflect your main objectives and findings. The title word count is not included in the abstract text but should be condensed and not exceed 300 characters.
  2. Highlight Key Objectives and Results
    • Define the primary goal of the study and the hypothesis tested. Summarize your findings briefly, emphasising data that strongly support your conclusions.
  3. Follow the Required Structure
    • Organize your abstract according to the conference’s format: introduction, methods, results, and conclusions. This makes your abstract easier to read and aligns with reviewers’ expectations.
  4. Be Compact and Precise
    • Avoid unnecessary details and focus on delivering the most essential information. Each sentence should add value to the abstract and enhance overall clarity. The body of the abstract text must NOT exceed 450 words and must include the following sections: title, authors, background, objectives, study design, method, result, clinical significance, and level of evidence. 
  5. Avoid Brand Names and Commercial References
    • Maintain a neutral tone by using generic terms instead of brand names, enhancing scientific objectivity.
  6. Use Tables or Graphs Strategically
    • If allowed to include one table or figure, choose the data that best summarizes a key aspect of your work. Make sure it’s clear and enhances understanding.
  7. Check Ethical Compliance
    • For studies involving human subjects, ensure you have the necessary approvals, as you’ll be required to confirm this during submission.
  8. Request Feedback and Mentorship
    • If pre-submission mentorship is available, use it to get feedback on impact, clarity, and quality.
  9. Review Additional Writing Resources

ISICO’s Insightful Tip

  1. Identify Clinical Needs or New Insights in the Field
  • Stefano Negrini, ISICO Scientific Director: “When it comes to research, start from a clinical need. Focus on something that has already been explored to some degree or choose a topic highlighted by recent articles in the field. This approach adds value, ensures relevance to clinical practice, and drives improvements in the therapies themselves.”
  • Fabio Zaina, physiatrist: “By following these guidelines, you can ensure your abstract aligns with SOSORT’s standards, effectively communicates your research, and contributes to advancing evidence-based scoliosis care and conservative treatment practices. Additionally, ensure the title is clear, focused, and engaging, as this will help attract attention to the research.”

Gym workouts and scoliosis: can the two go hand in hand?

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In recent years, fitness has become a booming industry, driven by a growing interest among young people and on social media. This trend has resulted in the emergence of better-qualified fitness professionals, triggering a virtuous circle in terms of improving the quality and safety of training.

From our perspective, it is worth remembering that physical activity, if performed correctly, can have a protective role in the management of scoliosis.
We are often asked whether patients with scoliosis, particularly those undergoing bracing treatment, can work out in the gym.
Before answering this question, let’s make two things clear:

● the literature contains nothing specific on this topic;

● “working out in the gym” means more than one thing (i.e., not all training is the same).

The importance of goals
Before embarking on a training programme, it is crucial to establish your personal goals. Among adolescents, the main reasons for working out are often the desire to build muscle (boys) or tone up (girls). However, in adolescence, learning the correct training techniques and improving your physical abilities, such as coordination, balance, strength, and resistance, are more important than immediately seeking to bulk up your muscles.
Young people will find that efforts to gain muscle mass give more gratifying results once they have finished growing (i.e. after reaching 16-18 years of age).
The best approach, then, is to try to focus on what you actually do in the gym, striving to do it better and more effectively and thinking less about what you see in the mirror.

The benefits of training in the gym

Training in the gym offers you the chance to monitor your body and safely regulate training stimuli, unlike when practising many competitive sports, during which you are more likely to sustain an injury. Several studies show that the gym is associated with a lower injury rate than other sports.

Advice for those with scoliosis

We should first point out that young people with scoliosis (boys and girls) are, in most cases, no different from their peers who do not have scoliosis. Having said this, we do have some advice.

  1. Find a professional. A properly qualified trainer can help you do the exercises correctly and adapt the training programme to your individual requirements. It might also be a good idea to put your doctor/physiotherapist and trainer in contact with each other, so that the training programme can be refined and any doubts addressed.
  2. Don’t be in a hurry. Targeted warm-up exercises can improve flexibility and reduce stiffness in the spine.
  3. Choose your exercises. It is important to start with simple and controlled exercises, then gradually increase the difficulty level.
  4. Take care with axial loads. Axial loading exercises must be performed carefully to avoid sudden or compensatory movements. When it comes to the squat, for example, the goblet squat may be the best option as it is performed with the weight (dumbbell/plate/kettlebell) held in your hands, at chest height, in front of you. By facilitating load management, this version guarantees greater stability and makes it easier to control the movement.
  5. Learn to “dose” self-correction. When you are working out in the gym, the amount of self-correction you apply (i.e., the extent to which you adopt the position designed to counteract the scoliotic curves and therefore keep your spine more aligned) will depend on the type of exercise you are doing and the level of fatigue you are experiencing. The objective of exercises done in the gym differs from that of the specific exercises taught you by your physiotherapist, where self-correction is the key element, and determines how the exercises are performed. When you are using weights, the priority is to focus on the specific training stimulus, while at the same time trying to keep your spine properly supported.

Should a brace be worn in the gym?

Individuals who are being treated with a brace can consider doing their physical activity during their brace-on hours, so as to take full advantage of the support provided by the brace itself. However, if they prefer to train during their brace-off window, they should make sure they do a longer warm up, so as to prepare their back for the training session.

So, finally

Working out in the gym is possible for those with scoliosis and can indeed be beneficial if the necessary precautions are taken. Be sure to find a professional trainer, keep your doctor in the loop, and listen to your body because these are the keys to safe and effective training.

Luca Selmi comments on SEAS course in Egypt

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A few weeks ago, our physiotherapist Luca Selmi held a SEAS course in Cairo, Egypt. We took the opportunity to ask him about his experience, as it was the first time he had conducted an international course on his own. 

We also remember that the local organiser, Essam Rashad, physiotherapist and owner of the “Scoliofix” centre in Cairo (pictured with Selmi), was one of the first partners of ISICO Alliance.

● Was it the first time you held a SEAS course?

No, I started working as a SEAS trainer in both national and international contexts about 2 years ago, initially alongside our Head of Physiotherapy, Michele Romano, and later independently. However, this was my first course as the sole instructor at the international level.

● And in Cairo, was it your first time?

Yes, I had never been to Egypt, although in some way, I didn’t feel it was so far away since I have a close friend with Egyptian roots.

● How did it go?

Very well, I’d say even better than expected. I was confident about doing a good job, but in these situations, teaching success is closely tied to participant feedback. Fortunately, the feedback was very positive. Additionally, on the day of departure, I was lucky enough to spend a few hours as a tourist, and the grandeur of the Pyramids left me speechless!

● How many participants?

There were 21, all physiotherapists.

● What were they most interested in?

The academic path to a physiotherapy degree differs in Egypt compared to Italy. It lasts six years, and a medical prescription does not bind the physiotherapist. They can work independently, prescribe X-rays, and, in the case of patients with scoliosis, even braces. I sensed great interest in the comprehensive management of patients, with obviously more focus on the physiotherapy approach, as it was their first exposure to SEAS. Only a few had experience with scoliosis patients, but they used other treatment methods. So, it was an excellent opportunity for exchange and mutual learning.

● What kind of questions did they ask?

I’d say I’ve never received so many questions in the courses I’ve held before. Since it was a very practical course, I sensed a strong desire for “one-on-one” interaction on how to teach corrective movements. They even practiced directly with their hands on my torso, as if I were the patient, so I could give them feedback.

● What would you focus on in future courses?

From what I’ve seen, there’s a lot of interest in high-quality information and training. I was told that the first option for patients in the region is “wait and see,” possibly leading to surgery. Conservative treatment has not yet offered a sufficient alternative, from the medical personnel’s perspective.

In the coming years, having a growing number of therapists trained and updated based on the latest scientific evidence, and therefore able to offer patients an alternative to just hoping things don’t get much worse, while also being a valuable team ally for doctors, will be a great achievement.

● What are your next appointments?

My next course will be in Italy in early November, and I will return to Cairo in early April 2025.

Your brace, an “accessory” that makes you unique

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Every era has its own fashion corset, you might say, if you think of the various ways, in which this particular garment has been used over the years.

First created in the sixteenth century, it has always been intended to enhance the female silhouette by the aesthetic canons of the times. Worn under clothes, it modified the shape of the body. It has undergone a continuous process of evolution to the point of becoming, nowadays, an actual item of clothing—a fashion garment that, again for aesthetic reasons, is deliberately left visible.

The well-known TV series Bridgerton, which features women in Regency-style corsets, has brought them back into vogue, so much so that, in the name of gender equality, male models are now even wearing them on catwalks. And, as we saw on the red carpet at the Oscars, corsets appeal both to Gen Z and over-60s celebrities, with Halle Bailey and Jamie Lee Curtis both appearing in Dolce & Gabbana ones.

Although the orthopaedic braces used in the rehabilitation treatment of scoliosis are created with a completely different function in mind, they, too, are worn to achieve a better silhouette. Indeed, one of their purposes is undoubtedly to improve the appearance of the patient’s back, as well as its health, of course.

Whenever we mention corrective braces, the initial response is always one of fear and dismay because the first image that springs to mind is that of some object that is impossible to disguise under clothes. We might think, for example, of the Milwaukee brace (now hardly ever used anywhere in the world), which even has a kind of chin rest that clearly can’t be concealed under clothing. However, thanks to research and continuous efforts to develop treatments that are the least invasive possible, the braces being produced nowadays are not only more and more effective as corrective devices, but also increasingly close-fitting and therefore impossible to see under clothes. One example is the Sforzesco brace, developed by ISICO, which is just as effective as casting.

Familiarity with these somewhat “awkward accessories” has grown in recent years as people are encouraged to regard them (whatever type they are) as objects that are just a part of everyday life and don’t need to be covered up. Actually, plastic braces now even exist that can be customized with different Thermo adhesive designs.

It’s a bit like the situation with glasses: frames have increasingly evolved, following fashion, and today the variety available is so great that there is something for all tastes, particularly eccentric styles. In this way, a person’s glasses are now a fundamental part of their style and identity. Their purely medical function has been combined with a strong aesthetic component, turning them into true accessories.

Similarly, dental braces have become increasingly customisable, and limb prosthetics, in part thanks to athletes, are now part of everyday life too. Indeed, many of those who wear them are happy to show them off as they are part of what makes them unique.

All these are examples of “awkward accessories” that are now a part of everyday life. And why shouldn’t this also be true of the corrective braces worn by young scoliosis patients?  

My next comments are aimed directly at those who wear braces or are about to start doing so.

Just like glasses, dental braces or limb prosthetics, a scoliosis brace should be seen, and treated, as something that sets you apart, but in a positive way, as something that is peculiar to you — something that makes you special, stronger and more self-confident, while also caring for your back. Although this might initially sound impossible, over time you really will come to see it as a strength.

You might think, “it’s easy for the physiotherapist to talk. They haven’t actually gone through this. We patients are the ones who have to wear these things, and only we can really know what it feels like.” 

Well, this is where, as a physiotherapist, I am able to draw on my own experience as a former patient. I lived with a brace for 7 years, wearing it full-time to begin with. And on the basis of that experience, I feel compelled to urge all youngsters who are embarking on, or about to embark on, this journey to use their brace and see it as a distinguishing feature, something to joke about with friends, something that makes you unique and will help you in your adult life (even though I realise that when you’re young it’s hard to think that far ahead).

Erica, former ISICO patient and now ISICO therapist

Isico Alliance, excellence in spine

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Isico’s goal has always been to promote the best therapies for the treatment of scoliosis in the world, and it is precisely from this idea and to give proper answers to the requests we periodically receive that we founded the Isico Alliance.

“ISICO stands alongside the ISICO Alliance Centres to support applying proper braces, organising new activities, and providing better care to their patients—explains Fabio Zaina, physiatrist and one of the project coordinators — taking advantage of the experience and ongoing innovations ISICO realises day by day. In fact, ISICO services mean excellent care for patients and an excellent approach for the centre.” 

There are several advantages from which an Isico Alliance centre can choose, from brace delivery, ISICO takes care of the entire production cycle of the prescribed brace in the workshops in Italy, to brace design, ISICO gives its assistance in designing the brace that will be produced on-site, from the training of a local orthotist to equip them with the skills necessary to manage the entire process of SPoRT (Symmetric, Patient-oriented, Rigid, Three-dimensional, active) braces production, to the opportunity to organise periodically SEAS courses in the local area, up to the use of the best technology for best care thanks to ScoliosisManager, the software developed by ISICO providing a uniform data collection protocol. Other optional services available are the ISICO iOS-Android app featuring specific functions for patients and ISICO practitioners, and Telemedicine services delivered to local patients directly by ISICO for complex or particular cases.

Do you wish to join the Alliance, or do you want to ask for more information? Please visit the website: https://isicoalliance.com