The history of Cheneau 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, credited with the Cheneau  bracing concept.

Christa Lehnert-Schroth & Dr. Marc Moramarco

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 Cheneau orthosis, using bracing concepts that are wholly compatible with Schroth method corrective exercises. Some notable features of Cheneau-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 and should be treated accordingly (2). Cheneau concept scoliosis bracing and Schroth method exercises both focus on correction in the three planes of scoliosis: the coronal, transverse and sagittal planes.

Dr. Hans-Rudolf Weiss & Dr. Marc Moramarco

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 served 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 Cheneau concept eventually spread throughout Europe (2). At the time, Cheneau braces were being fabricated from a mold of a patient’s torso created by casting.

Dr. Weiss went on to develop his ‘Cheneau Light®’ Brace, which is the brace that preceded the current Cheneau Gensingen brace. As medical director of the Katharina Schroth Clinic (later the Asklepios Katharina Schroth Clinic), Dr. Weiss oversaw their in-patient Schroth program fitting thousands of adolescents with Cheneau brace derivatives. The Cheneau Light® Brace had 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 now advanced the Cheneau concept, to an even higher standard with his Cheneau Gensingen Brace (aka GBW) which now boasts a 92.9% success rate.

Cheneau Bracing Evolves with the Gensingen Brace

Bracing design and manufacture evolved with the advent of CAD/CAM more than a decade ago. Dr. Weiss was an early adapter of CAD/CAM design and having amassed an extensive library of curve patterns over his thirty-plus year career treating scoliosis. He now works with bracing exclusively, in accordance with the Christa Lehnert-Schroth Augmented Classification based approach (CBA) (4). His Gensingen Brace library is constantly updated based on feedback from his network of distributors from around the globe. Patients, parents and providers can be assured that each scoliosis brace will be of the designed and delivered to the highest current standards if scoliosis bracing.

An important benefit of computer-aided-design (CAD) for scoliosis bracing is brace standardization. Standardization eliminates the opportunity for error and practitioner interpretation during the brace-making process. Each Cheneau-Gensingen brace is designed and fabricated to have a built-in correction effect according to a patient’s exact individual curve pattern and size. The customized design allows for a more exacting fit that is both effective and comfortable 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 consistently demonstrated excellent in-brace corrections (7). This has been deemed an important aspect of scoliosis bracing success (8).

Today, there are several Cheneau 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 other Cheneau 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, Moramarco K. 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 Cheneau 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.