The history of Chêneau bracing dates back to the work of Dr. E.G. Abbott of Portland, Maine in the early twentieth century (1907). Dr. Abbott used plaster jackets in an attempt to affect derotation in scoliosis patients (1). His work influenced Dr. Jacques Chêneau of France, who began the Chêneau concept of scoliosis bracing.

In his quest to advance and improve scoliosis bracing, Dr. Chêneau traveled to Sobernheim, Germany (now Bad Sobernheim) in the 1970s to visit the scoliosis clinic of Katharina Schroth and Christa Lehnert-Schroth, PT. Dr. Chêneau wanted to learn more about Schroth corrective breathing and Christa Lehnert-Schroth’s Classification System (2).

In 1979, Dr. Chêneau developed the first Chêneau orthosis, using bracing concepts that are wholly compatible with Schroth corrective exercises. Some notable features of Chêneau-style braces are openings positioned at the spinal concavities and corrective pressure points according to Schroth’s curve-pattern classifications.

Dr. Chêneau was the first brace developer to recognize that idiopathic scoliosis generally involves thoracic lordosis, which should be treated accordingly (2). Chêneau bracing and Schroth method exercises both focus on correction in the three planes of scoliosis: the coronal, transverse and sagittal planes.

In the 1990s, Dr. Hans-Rudolf Weiss (3rd generation Schroth family member) hosted courses at the Katharina Schroth clinic (named for his grandmother). At the time, Dr. Weiss was serving as the medical director and invited Dr. Chêneau to the clinic to demonstrate his bracing concepts to other European practitioners, including Dr. Manuel Rigo of Barcelona, Spain. Dr. Weiss went on to train and work with Dr. Rigo. The two eventually parted ways and Rigo adopted his own classification system. The Chêneau concept eventually spread throughout Europe (2). At the time, Chêneau braces were being fabricated from a mold of a patient’s torso created by casting.

Dr. Weiss went on to develop his ‘Chêneau Light®’ Brace. As medical director at the Katharina Schroth Clinic, Dr. Weiss oversaw the in-patient Schroth program and fit thousands of adolescents with the Cheneau-derived brace. The Chêneau Light®’ Brace has a record of improved patient satisfaction and favorable outcomes, reducing the need for scoliosis surgery (3). With the advent of CAD/CAM technology, Dr. Weiss has been able to advance the Chêneau concept even more, leading to the newest model – the Gensingen Brace® (GBW).

Chêneau Bracing Evolves with the Gensingen Brace®

Bracing design and manufacture evolved to a higher standard with the advent of CAD/CAM. Dr. Weiss was an early adapter of CAD/CAM design. Over his thirty-plus year career treating scoliosis, Dr. Weiss has amassed an extensive library of curve patterns, in accordance with the Christa Lehnert-Schroth Augmented Classification based approach (CBA) (4). Each Gensingen Brace® is custom-designed from that extensive library, which is constantly updated for delivery of the best possible brace.

An important benefit of CAD is brace standardization. Standardization eliminates the opportunity for error and practitioner interpretation during the Chêneau brace-making process. Each brace is designed and fabricated to have a built-in correction effect according a patient’s individual curve pattern. The customized design allows for a more exacting fit, that is both effective and tolerable for the patient, contributing to improved corrections (5).

This asymmetric 3D brace is suitable for patients with mild, moderate and severe curves (6). The GBW aims to overcorrect the spine, positively influence vertebral rotation, and improve posture in scoliosis patients. The Gensingen Brace® has been shown to offer excellent in-brace corrections (7), which has been deemed an important aspect for the success of scoliosis bracing (8).

Today, there are several Chêneau derivates but very few have documented their bracing advancements to the extent that Dr. Weiss has with respect to in-brace results, nor does any Chêneau concept brace have as widespread usage internationally.

References

  1. The New England Journal of Medicine, Volume 167. Massachusetts Medical Society, 1912. 196. Google Books.
  2. Weiss HR, Lehnert-Schroth C and Moramarco, M. Schroth Therapy: Advancements in Conservative Scoliosis Treatment. LAP Lambert Academic Publishing. 2015.
  3. Weiss HR, Werkmann, M. Rate of Surgery in a Sample of Patients fulfilling the SRS Inclusion Criteria treated with a Chêneau Brace of Actual Standard. St. Heal T 2012; 176:407-10.
  4. Weiss, Kleban. Development of CAD/CAM Based Brace Models for the Treatment of Patients with Scoliosis-Classification Based Approach versus Finite Element Modelling.
  5. Weiss HR, Seibel S, Moramarco M, Kleban A. Bracing scoliosis: the evolution to CAD/CAM for improved in-brace corrections. Hard Tissue.
  6. Weiss HR, Moramarco M. Remodelling of trunk and backshape deformities in patients with scoliosis using standardized asymmetric computer-aided design/computer-aided manufacturing braces. Hard Tissue 2013 Feb 26;2(2):14.
  7. Ng SY, Borysov M, Moramarco M, Nan XF, Weiss HR. Bracing Scoliosis – State of the Art. Curr Pediatr Rev.  2016;12(1):36-42.
  8. Landauer F, Wimmer C, Behensky H. Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up. Pediatr Rehabil 2003;6:201–207.