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From measurement to meaning: ISICO’s Award-Nominated research at SOSORT 2026

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When the international scoliosis community gathers in Turin, Italy, from 29 April to 2 May 2026 for the SOSORT International Congress, ISICO will be present with a rich and multifaceted scientific contribution.

Alongside the abstracts previously announced, an additional study —“A 3D Surface Topography-Derived Method for the Aesthetic Evaluation of Trunk Asymmetry in AIS” — has also been accepted for poster presentation, further expanding ISICO’s contribution to the congress (a total of 23 abstracts: 19 oral presentations and 4 poster presentations).

Among this body of work, two studies have been selected to compete for the prestigious SOSORT Award. Both focus on a theme that lies at the heart of conservative treatment for adolescent idiopathic scoliosis (AIS): aesthetic outcome. Not only how we measure it. But how patients experience it.

TRACE2: bringing precision to clinical aesthetic evaluation

The SOSORT Award nominee “TRACE2 (Trunk Aesthetic Clinical Evaluation, Version 2). The New Rasch-Compatible Scale to Enhance Aesthetic Evaluation in Clinical Practice and Research” represents a significant methodological evolution, aligning clinical observation with psychometric robustness. Aesthetic improvement is formally recognized by SOSORT as a primary goal of rehabilitation in adolescent idiopathic scoliosis (AIS). Yet, measuring aesthetics in a reliable and reproducible way has always been challenging.

TRACE has long been part of everyday clinical practice. With TRACE2, ISICO takes a decisive step forward. Developed through an international Delphi process and validated using Rasch analysis — the gold standard in modern psychometrics — TRACE2 expands the original 4-item scale to 13 items while preserving clinical practicality.
The new version increases measurement sensitivity and reliability, allowing clinicians to discriminate trunk asymmetry more precisely and to compare outcomes across patients and populations with greater confidence.

TRACE2 does not complicate practice. It strengthens it. As Stefano Negrini, ISICO Scientific Director and first author of the study, explains: “We have always known that aesthetics matter deeply to our patients. TRACE2 allows us to measure trunk asymmetry with the rigor required by modern psychometrics, without losing the simplicity needed in daily clinical work”.
Watch the short video in which Stefano Negrini presents TRACE2. 

When improvement is visible — but not yet felt

The second SOSORT Award nominee, “Early Clinical Improvement, Delayed Patient Perception: Divergent Aesthetic Outcomes During Brace Treatment for Adolescent Idiopathic Scoliosis” explores a crucial and often overlooked dimension of conservative treatment: the relationship between measurable improvement and patient perception.

In a large cohort of 1,004 adolescents treated with rigid and very rigid “push-up” braces, clinician-assessed trunk aesthetics (TRACE) improved significantly within the first four months of treatment. Objective changes were clear, early, and statistically robust.

Patients, however, did not perceive a comparable improvement until the end of treatment, as reflected in the SRS-22 self-image domain.

This temporal divergence between objective aesthetic correction and subjective self-perception highlights an important clinical reality: physical changes and psychological adaptation do not necessarily evolve in parallel.
The findings suggest that clinicians should not assume that measurable improvement automatically translates into perceived benefit. Instead, actively sharing objective results during treatment may enhance patient awareness, motivation, and possibly adherence.

As Francesco Negrini, rehabilitation physician at ISICO reflects: “We often assume that when the body improves, the patient immediately feels better. Our data show that this is not necessarily the case. Recognizing and addressing this gap may help us improve communication and support patients more effectively throughout treatment”.

This study deepens our understanding of the patient experience during bracing and reinforces the importance of integrating objective assessment with patient-reported outcomes in everyday clinical care.

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.

Free Pelvis Brace works: this is demonstrated by the study presented at Sosort

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At the latest Sosort international conference, held a few months ago, Isico presented the study Increasing Brace Comfort, Durability and Sagittal Balance through Semi-rigid Pelvis Material does not change Short-Term Very-Rigid Sforzesco Brace Results.
For years, Isico has replaced plaster cast with the Sforzesco brace, a particular type of very rigid brace for the most demanding scoliotic curves: developed in the Institute itself in 2004, it obtained results equal to casting, highlighted in several published studies.
The Sforzesco brace is a way to avoid casting for severe curves, because of the significant costs involved both at the individual (side effects including cast syndrome, skin problems, significant psychological impact, inability to shower for months, etc.) and social (repeated inpatient treatments) levels.
“In recent years, thanks to the experience with the Sforzesco brace, we have worked to improve our brace – explains dr Francesco Negrini, physiatrist, and one of the authors of the research presented at Sosort – We have therefore recently introduced a particular innovation, the system “Free Pelvis”, which consists of releasing the pelvis corset using a less rigid material at that level, increasing comfort while wearing. The “Free Pelvis” system is a very important innovation, a potentially big step forward in conservative treatment of scoliosis”.
The study presented compared the Sforzesco brace classical version (VRB) versus the Free Pelvis one (FPB): “The results obtained showed us that the Sforzesco “Free Pelvis” has no inferior results to the classic Sforzesco – concludes dr Negrini – furthermore it reassures the effectiveness of the Sforzesco “Free Pelvis”, and allows us to continue with greater confidence and conviction in the process of introducing this new and revolutionary instrument into our regular clinical practice”.

Scoliosis: is aesthetics measurable?

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When it comes to scoliosis therapy, aesthetics is one of the goals along with a healthy back.

Aesthetic deformity due to scoliosis and its impact on the patient is considered by the members of SOSORT (International Society On Scoliosis Orthopaedic and Rehabilitation Treatment) as the most important reason for treating AIS; unfortunately, only a few of scoliosis studies were found in PubMed on this topic. 

But can a goal, apparently so subjective, be measurable in a repeatable way to become objective? Yes,according to the data collected by the study Reliability, repeatability and comparison to normal of a set of new stereophotogrammetric parameters to detect trunk asymmetries, recently published by the Journal of BIOLOGICAL REGULATORS & Homeostatic Agents. 

“Aesthetic impairment is a crucial issue in Adolescent Idiopathic Scoliosis (AIS), but to date no objective measurements are available – states Dr Francesco Negrini, Isico physiatrist – for our research, we used the Formetric®, which we usually use to measure sagittal planes. We have established parameters for evaluating symmetries in patients, such as those of the shoulder blades or hips, to obtain objective data related to the aesthetic aspect. In order to validate this instrument for clinical practice, the first step and aim of this study are to evaluate the repeatability of the parameters measured by surface topography in a group of AIS subjects and to test if they can distinguish healthy subjects from AIS patients to develop an objective tool for deformity evaluation of the trunk in AIS patients. For our evaluations, we used a device for surface topography based on the principles of rasterstereography. This device (Formetric®, Diers Biomedical Solutions) can reconstruct digitally in three dimensions the back of any person”.

The study evaluated 15 selected parameters that could be good predictors of scoliosis’ impact on the patients’ trunk.
“We analysed short-term (30 seconds, 38 subjects) and medium-term (90 minutes, 14 subjects) repeatability of surface topography measures and their diagnostic validity in AIS (74 subjects, 33 AIS patients and 41 healthy subjects) – proceeds Dr Negrini – All examined parameters were highly correlated as far as short, and medium-term repeatability is concerned”. 

When it comes to aesthetics we cannot stop at Cobb degrees alone, believing that there is no objective measure: “Symmetries can be measured repetitively, as we did in our study – concludes Dr Negrini – so we can offer an objective measurement of aesthetics in patients with idiopathic scoliosis. The surface topography showed good repeatability. Moreover, some of its parameters are correlated with scoliosis, showing that it could very well evaluate deformity due to this pathology. Thanks to these findings, it will be possible to develop a tool that can objectively evaluate aesthetics in AIS patients.”.