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Study Design: Clinical pilot study. Purpose: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. Overview of Literature: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. Methods: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects’ disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. Results: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). Conclusions: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain. [ABSTRACT FROM AUTHOR]

Study Design: In this prospective study, we measured the pad pressures of the Milwaukee brace in adolescent hyperkyphosis treatment. Purpose: We evaluated the skin-brace interface forces exerted by the main pads of the Milwaukee brace. Overview of Literature: A fundamental factor associated with brace effectiveness in spinal deformity is pad force adjustment. However, few studies have evaluated the in-brace force magnitude and its effect on curve correction. Methods: Interface forces at four pads of the Milwaukee brace were measured in 73 patients withround back deformity (mean age,14.04±1.97 years [range, 10-18]; mean initial Cobb angle,67.70°±9.23° [range, 50°-86°]). We used a modified aneroid sphygmomanometer to measure the shoulder and kyphosis pad pressures. Each patient underwent measurement in the standing and sitting positions during inhalation/exhalation. Results: The mean pad pressures were significantly higher in the standing than in thesitting position, and significantly higher pressures were observed during inhalation compared toexhalation (p =0.001).There were no statistically significant differences between right and left shoulder pad pressures (p >0.05); however, the pressure differences between the right and left kyphosis pads were statistically significant (p <0.05). In a comparison of corrective forces with bracing for less or more than 6 months, corrective force was larger with bracing for less than 6 months (p =0.02). In the standing position, there were no statistically significant correlations between pad pressures and kyphosis curve correction. Conclusions: In the sitting position, there was a trend toward lower forces at the skin-brace interface; therefore, brace adjustment in the standing position may be useful and more effective. There was no significant correlation between the magnitude of the pad pressures and the degree of in-brace curve correction. [ABSTRACT FROM AUTHOR]