Posture supporting garment (soft exosuit) development for spinal deformities

The spine is an important part and fundamental axis of the skeleton that keeps people erect. Congenital or acquired changes in this structure cause different postural disorders from mild to severe. Adolescent Idiopathic Scoliosis (AIS), common in adolescence, is a three-dimensional spinal deformity of unknown cause. Rigid braces (rigid orthoses) are used to control the curvature in the early period of AIS. The rigid structure and cosmetic unsuitability of these corsets cause psychosocial problems and reluctance to use corsets in adolescents. This affects the treatment negatively, reduces the success of the treatment, and causes progression in scoliosis due to its not being used regularly. Although soft corsets are more accepted by the user, their effectiveness in controlling scoliosis is as controversial as rigid corsets. In this study, two different Posture-supporting Soft Exosuits were developed for spinal deformities. Its design aspect and its effect on scoliosis control were investigated with trials on the case. The case constituting the research sample in which the experimental research method was used; A 14-year-old adolescent girl with a scoliosis Cobb angle of 29o, who received a rigid orthosis indication by the subject specialist physician, did not accept the use of a rigid corset. Soft Exosuit prototypes were prepared with a user-centered iterative design approach and tested on the body segments of the case affected by scoliosis. The data collected with the form and scale decided in the research method; Before using Soft Exosuit, the examination at the 3rd, 6th, and 15th months of the treatment were analyzed in terms of effectiveness with radiological and quality of life evaluations. Before the pretotype and prototype design, preliminary preparations and tests were made for material and pattern construction. Technical analyzes have been carried out to determine which material will provide the best posture support and in what form. Statistical analyzes were used in the interpretation of the obtained numerical data. In the evaluations of the design, the opinions of the relevant field experts and users were considered. All phases were carried out with a multidisciplinary approach from both clinical and design perspectives. The developed Soft Exosuit prototypes were used full time by a patient for 15 months. In control performed for the termination of the treatment, both cosmetic and radiological scoliosis Cobb angle evaluations were made. Soft Exosuit provided body cosmetic control of the case, and CSL stabilized it in the midline. It was observed that the Cobb angle showed an improvement at a rate of 29.3% with a decrease of 8.50o compared to the baseline, and posture stabilization was supported. The patient found the Soft Exsuit easy and comfortable to use, compatible with the body, and comfortable. In the expert evaluation, Soft Exosuit prototypes were found to be successful in terms of posture support. The rigid structure of corsets, which is an important option in the conservative treatment of scoliosis, causes compliance problems in adolescents. Soft corset models that can wear easily are more comfortable for the user and effective in controlling scoliosis are a good alternative for patients with the cooperation of fashion design and health professionals. This research is the first in our country in the field of Soft Exosuit application in scoliosis. It constitutes innovation and a basis for designing Soft Exosuit development studies to control spinal deformities.