Lifenhanced: FEATURED ARTICLE
WCR Shapes the Lives of Young Wearers
During the summer of 2017, Mark Lavallee, MD, CSCS, FACSM, asked Marlies Cabell, CPO, currently with Ability P&O’s office in Frederick, Maryland, if she was aware of the Wood Cheneau Rigo (WCR) scoliosis thoracic lumbar sacral orthotic (TLSO) for treatment of idiopathic scoliosis because he had a patient whose parents had gone to the Align Clinic in San Mateo, California, to have a WCR delivered. Marlies told him that she usually prescribed the Boston brace, which was the only standard orthosis for the treatment and care of scoliosis at Ability.
Marlies has since become certified to provide the WCR spinal brace to correct adolescent idiopathic scoliosis. She is the eighth clinician and the first woman in the country to complete the training and receive certification from Grant Wood, MSc, CO, cofounder of the Align Clinic and creator of the WCR orthosis.
“The difference in the approach [of the WCR and Boston braces] to scoliosis can be explained as comparing apples to bicycles,” Marlies says.
The Boston brace is a symmetrical brace that applies pressure along the body’s entire trunk and provides two-dimensional scoliosis correction. The WCR orthosis is asymmetrical and only applies pressure to the apex of the curves and provides three-dimensional correction. Unlike the Boston brace, which is made of a thicker, heavier plastic, the WCR orthosis is made of thin thermoplastic that has better ventilation and is more cosmetically pleasing, Marlies says.
The expansion areas of the WCR allow the patient to breathe easier, while the pressure of the Boston brace along the trunk makes it more difficult for the patient to breathe. The Boston brace is easy to fit and requires less time and labor to fabricate and fit, according to the Align Clinic. By comparison, the WCR TLSO is hand-modified in-house in California and requires an orthotist with advanced training to evaluate, cast, and fit correctly. WCR bracing treatment employs a multidisciplinary approach using feedback from the patient’s prescribing physician and physical therapist combined with a WCR certified orthotist’s skill. The measurements, X-rays, and clinical photos are used to design and fabricate a custom-made WCR.
Three of Ability P&O’s patients share their stories about how they learned they had scoliosis, how they started using the WCR orthosis, and what wearing the treatment means to them.
The WCR orthosis is asymmetrical and only applies pressure to the apex of the curves and provides three-dimensional correction.
In the summer of 2014, Austin Hoke’s chiropractor discovered the curve in Austin’s spine. The chiropractor gave Austin a heel lift and a pamphlet about scoliosis, says Austin’s mother, Kelly. The family contacted Austin’s pediatrician for a referral to an orthopedic physician, who suggested that Kelly take her son to see Lavallee.
“Dr. Lavallee monitored Austin’s condition from our first appointment with him in October 2014 and recommended Ability P&O when Austin’s curve worsened and a back brace was needed,” says Kelly, a claims assistant for an insurance company.
Austin, 15, received a Boston brace in April 2015 while being treated by a different provider at Ability’s office in York, Pennsylvania. In spring 2016, he began seeing Marlies. Austin’s mother says she was confident in the care they were receiving from Marlies and Ability. “They stated that the benefit of the Boston brace was that, if worn correctly, it would stop his curve from getting worse,” Kelly says. “We understood that it would not correct the curve he already had but would prevent it from getting worse.”
It was Lavallee who told Kelly about the WCR. “He thought Austin would make a good candidate for it,” she says. “He explained that it was the first new brace in 30 years for treating scoliosis, and he was very excited that it was now available to patients in our area. I have complete confidence in Dr. Lavallee’s professional opinion, so I said yes immediately,” she says.
Austin is studying precision metal machining at his technical high school and hopes to work as a machinist with a motorsports team when he is older. He says the WCR is more uncomfortable than the Boston brace because “the WCR is molded more specifically to my body with the goal of untwisting it.” However, he says he likes the WCR brace because it “untwists” his spine and works on correcting the curve.
There is more good news for Austin. Because of his bone maturity, he will start weaning himself out of wearing the WCR over the next six months, Marlies says.
Kelly and her son like the enthusiasm that Marlies has for her profession and the WCR. She says the Ability office works well with Lavallee’s office regarding Austin’s appointments and X-rays. “She is always sure to remind Austin why he is wearing the WCR even if it is not the most comfortable thing for him,” Kelly says. “Marlies is always making improvements to his WCR so that it is not hurting him, and she encourages him at every visit, letting him know the benefit this will be to his future health.”
Jacquelyn Kouma was 12 years old in 2016 when she and her parents were told she had scoliosis, a diagnosis that was confirmed a year later when Jacquelyn participated in Pennsylvania’s mandated scoliosis screenings for sixth- and seventh-grade students. However, when Jacquelyn went to her family physician in the summer of 2017, she was told that it was nothing to worry about and would likely not cause future problems.
That fall, however, when the rib hump on her right side was noticeable and the skin around it was red and sore, Jacquelyn’s parents took her to an urgent care clinic. “There we happened to meet Dr. Lavallee, who prescribed a back brace for me pretty much on the spot,” Jacquelyn says. “It was the only action we’ve ever taken in treatment, and the curves were not severe enough for surgery to be necessary, but we had to push to get the brace quickly because of insurance coverage.”
It was Lavallee who introduced Jacquelyn and her parents to Marlies and Ability, where Jacquelyn has been going for treatment for the last year. She says her family decided to try the WCR as they learned about the differences between it and the Boston brace. Jacquelyn says her family appreciated that the WCR orthosis is designed to correct the spinal curve rather than just keeping it from progressing.
Jacquelyn, a freshman at York Suburban High School, York, Pennsylvania, has been swimming competitively since she was in the sixth grade. For the best results, Jacquelyn says she only removes the orthosis when she swims or has band practice. “I began taking [the orthosis] off for all physical activities, performances, and later for band practice and certain social activities.”
Though her swimming season has stalled because of medical complications, Jacquelyn says she plans to run on her high school’s track team when preseason begins. “This system allows me the confidence that I usually get to wear it about 20 hours a day every day rather than trying to wear it for a certain number of hours and working around that goal.”
Jacquelyn says she loves the care she receives from Ability and Marlies. “She’s the nicest person I’ve ever met,” Jacquelyn says.
Hannah and Jennah Finneyfrock
Six-year-old Hannah Finneyfrock is eight seconds older than her identical twin sister, Jennah. Since it is not unusual for identical twins to have much in common, it likely came as no surprise to their parents that if one of their twins had scoliosis, the other would as well.
The twins’ early onset scoliosis was discovered about two years ago by their physician during a routine physical exam, says their father, Damion, who has lived in Fairfield, Pennsylvania, for 14 years. “Their doctor noticed something irregular with their backs when they bent over,” he says.
After the twins’ initial diagnosis, their parents, Damion and Lacey (who passed away in July), took Hannah and Jennah to a specialist. Almost immediately, the twins’ parents were unhappy with the specialist’s recommendation for surgery. They didn’t believe that he had the best interest of the twins at heart, says Damion, a construction fiber slicer for Verizon, where he has worked for 23 years. “The doctor was not on board with the brace and wanted to operate,” he says. “My wife and I believed that we should not try to operate right away, and give this new brace a try. An operation seems like it should be the last resort. I think money was on his mind and not the welfare of my daughters.”
After a handful of frustrating appointments with different specialists, Damion says they learned about Marlies and Ability P&O. The WCR is the only spinal brace the twins have worn, their father says. “This [orthosis] seemed like it was the best choice to help the children live their most comfortable lives possible,” he says. “It seems like it gets the job done, which ultimately is the goal, without terribly disturbing the social life or sporting activities of my girls,” Damion says of the twins, who both play soccer and are taking Taekwondo lessons.
Twins Hannah and Jennah Finneyfrock have not let scoliosis deter their love of sports.
The WCR is the best option for an orthotic TLSO to correct the girls’ scoliosis, Marlies says. “Both Jennah and Hannah are wearing the WCR, and they are very compliant with their wear times,” she says. “[This] will satisfy [those who] think this correctional type of scoliosis TLSO should only be applied to teens—not the case. The derotation principles [or unwinding of the spine] is not age-dependent. Honestly, whenever a curve is progressing, then the most effective scoliosis TLSO should be applied to that spine.”
Damion believes that most of the time his daughters don’t mind wearing their orthoses. “They don’t even know it’s on,” he says. When they do find it too restrictive, he explains to them that the brace is better than the alternative, which is surgery. “Saying that, my girls make sure that not a day goes by that Daddy does not forget that they do get a short break from wearing the brace,” he says.
The twins will be in the WCR until they reach bone maturity between 16 and 18 years old, Marlies says. Damion says he is hopeful the WCR will work. “Do I know if it is going to work? No,” he says. “I just pray this is the best solution.”