The moderating effect of dietary fiber and protein on the relationship between symptoms of depression and anxiety and cognitive decline.

Adolescent idiopathic scoliosis is a 3-dimensional spinal deformity characterized by lateral deviation in the frontal plane, vertebral rotation in the transverse plane, and a loss of normal thoracic kyphosis in the sagittal plane []. Various treatment methods for scoliosis include physical therapy and exercise, bracing, and surgery. Of these, studies indicate that bracing plays an important role in the nonsurgical treatment of adolescents with idiopathic scoliosis measuring 15 to 60 degrees [], with the goal of preventing curve progression during the growth spurt []. The selection of a brace for treating adolescent idiopathic scoliosis includes the use of thoracolumbosacral orthoses and the Milwaukee brace, which is determined by the location of the curve apex []. The Milwaukee brace is indicated for thoracic and double major curves with an apex at or above the T7/T8 vertebrae, whereas thoracolumbosacral orthoses are prescribed for single or double lumbar and thoracic curves with an apex below T7/T8 []. Although scoliosis affects the spine in all 3 planes of movement, most braces provide correction primarily in the frontal plane [] and the greatest improvement in the Cobb angle does not always align with the greatest correction of vertebral rotation [,]. The Chêneau brace is one of the few designed to simultaneously correct deformities in all 3 planes []. Its design as a thoracolumbosacral orthosis for treating idiopathic scoliosis utilizes pressure zones and expansion areas to achieve comprehensive 3-dimensional correction [,]. However, despite the effectiveness of this brace in correcting scoliosis across all 3 planes, expert consensus and specialized guidelines are based on the assumption that this brace, along with other thoracolumbosacral orthoses, should only be used for thoracic curves with an apex below T7/T8 [, , ]. Although the Milwaukee brace has long been considered the preferred orthotic design for thoracic curves with an apex above T7/T8 [], limited supporting data is available regarding its comparative effectiveness in relation to lower profile TLSOs, particularly the Chêneau brace, in adolescents with idiopathic scoliosis. Additionally, studies comparing the Milwaukee and Chêneau braces for high thoracic curves are lacking. Therefore, assessing whether the Chêneau brace can obtain corrective outcomes comparable to those of the Milwaukee brace in scoliosis curves with an apex above T7/T8 appears warranted. This belief originates from the argument that the trimlines of the TLSOs such as the Chêneau brace are designed in a way that it cannot apply corrective forces to curves above T7/T8 []. It is important to note that the efficacy of the Milwaukee brace for treating higher thoracic curves is not well-established and no studies have specifically investigated this issue. Also, numerous studies comparing the Milwaukee brace with TLSOs have reported that the use of TLSOs has a less negative impact on adolescents’ overall quality-of-life scores, particularly with respect to their psychosocial functioning and body image [,]. Therefore, considering the reported adverse effects associated with the Milwaukee brace and the lack of studies investigating the efficacy of this brace—particularly the Chêneau brace—for curves with an apex above T7/T8, conducting a study on this subject appears essential. Given the effectiveness of the Chêneau brace and its upper trim line extending to the level of the fifth thoracic vertebra, we hypothesize that this brace may also be effective for curves with an apex above the T7/T8 vertebrae. Therefore, the present study aims to compare the short-term effects of Milwaukee and Chêneau braces on adolescent idiopathic scoliosis curves above the T7/T8 vertebrae.