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Objective: Spinal orthoses are the most viable conservative treatment for scoliosis, and additive manufacturing techniques have shown huge perspective in producing patient-specific braces, reducing material waste, and production times. This pilot study aimed at determining whether 3D-printed braces could induce advantages or disadvantages compared to conventional braces in terms of mobility and gait, and at quantitatively evaluating the effects of braces on mobility and gait. Methods: Ten participants were included in the study, eight with adolescent idiopathic scoliosis and two with osteogenesis imperfecta. Participants were asked to perform Timed-Up and Go (TUG) tests wearing a triaxial accelerometer under three conditions: unbraced, wearing a conventional (i.e., thermoformed) brace, and wearing a 3D-printed brace. After segmenting each TUG test in sub-phases, metrics quantifying gait and mobility were computed, and Friedman tests among all conditions were performed. Results: No significant differences in scoliotic patients mobility and gait between conventional and 3D-printed brace conditions were found, potentially suggesting that 3D-printed braces are as effective as conventional ones. Conversely, Stand flexion amplitude and Sit extension amplitude were lower in both conventional and 3D-printed brace conditions compared to the unbraced, meaning that braces limited the trunk range of motion. As for gait parameters, no significant differences in Walk Cadence and Walk Velocity among the three conditions were found, indicating that braces did not affect gait, at least during TUG tests. Trial registration: The study was registered at Clinicaltrials.gov (Study ID NCT04282408, Date of Registration February 11th, 2020). Significance: In summary, these preliminary results may help to depict 3D-printed braces as a viable alternative to conventional braces for scoliotic patients. [ABSTRACT FROM AUTHOR]

Background: Orthotic treatment is a well-acknowledged conservative treatment for moderate adolescent idiopathic scoliosis (AIS). The efficacy of this treatment is significantly determined by the forces applied to the bodies of patients. However, there is uncertainty regarding the optimal force levels that should be applied to the patient's torso by spinal orthosis. This study aims to identify reference values for the controlling forces in AIS management. Methods: A comprehensive literature search was performed in five databases (PubMed, Scopus, Cochrane Library, CINAHL, and Web of Science). Only studies written in English and covering the force/pressure measurements of spinal orthosis for the treatment of AIS were included, without publication date restrictions. The methodological index for non-randomized studies (MINORS) was employed for the methodological quality assessment, and force measurements were standardized to pressure in kilopascals (kPa) for comparison. Results: From the initial 10,452 records, 10 studies were admitted for the final analysis. All the included studies reported the interface pressure between the thoracic (T) pad and patient's trunk, and seven studies evaluated the pressure from the thoracolumbar/lumbar (TL/L) pad. These studies used different pressure sensors or transducers with the range from 5.6 to 82.5 kPa for the T pads, and 4.8 to 85.1 kPa for the TL/L pads. Four studies reported strap tensions of 26.8 to 60.4 N. Higher strap tension was correlated with increased interface pressure (r = 0.84). Conclusion: The mean strap tension was 42.5 N, the median interface pressure of the T pads was 8.75 kPa, and the median pressure of TL/L regions was 7.11 kPa without the outliers. The findings provide a baseline value for designing adjustable straps and strategically distributing pressure in orthoses. [ABSTRACT FROM AUTHOR]

Abstract Background Oblique lumbar interbody fusion (OLIF) is an internationally popular minimally invasive technology for the treatment of various lumbar diseases. Since its introduction to China in 2014, OLIF technology has clearly shown its superiority in reconstructing intervertebral stability, restoring intervertebral space height, achieving indirect decompression, and restoring normal lumbar sequence. However, some patients still suffer from persistent symptoms after OLIF, including low back pain and soreness, which indirectly affect the overall surgical efficacy and patient satisfaction. Therefore, some clinicians recommend that patients routinely use spinal orthoses after OLIF to reduce the stress on the lower back muscles and ligaments, thereby relieving or avoiding postoperative residual symptoms or new symptoms. Accordingly, spinal orthosis use after OLIF has emerged as an essential option. However, the role of spinal orthoses in OLIF and their specific impact on postoperative patient clinical outcomes have remained unclear, and there is a lack of strong clinical evidence to indirectly or directly support the role of spinal orthoses in OLIF and demonstrate their impact on patient clinical outcomes. This study aims to investigate the role of spinal orthoses in OLIF by grouping patients based on the use or nonuse of spinal orthosis after OLIF, thus providing a better basis for the majority of patients and physicians. Methods/design We plan to conduct a 1-year randomized controlled trial involving 60 subjects. The subjects will be randomized into two groups: group A (those wearing spinal orthoses after surgery) and group B (those not wearing spinal orthoses after surgery). The clinical outcomes of these patients will be evaluated using the Oswestry disability index, visual analog scale, and Brantigan, Steffee, Fraser 1 day before surgery and 2 weeks and 1, 6, and 12 months after surgery. Discussion This randomized controlled trial aims to provide a reference for further comprehensive trial design. The findings of this study will provide a better and more scientific basis for the choice of postoperative rehabilitation and treatment for patients undergoing such a procedure. Trial registration This study has been registered in the Chinese Clinical Trial Registry (Registration No.: ChiCTR2200059000). Registration date: April 22, 2022. Registration website: http://www.chictr.org.cn/showproj.aspx?proj=166310

Background: Oblique lumbar interbody fusion (OLIF) is an internationally popular minimally invasive technology for the treatment of various lumbar diseases. Since its introduction to China in 2014, OLIF technology has clearly shown its superiority in reconstructing intervertebral stability, restoring intervertebral space height, achieving indirect decompression, and restoring normal lumbar sequence. However, some patients still suffer from persistent symptoms after OLIF, including low back pain and soreness, which indirectly affect the overall surgical efficacy and patient satisfaction. Therefore, some clinicians recommend that patients routinely use spinal orthoses after OLIF to reduce the stress on the lower back muscles and ligaments, thereby relieving or avoiding postoperative residual symptoms or new symptoms. Accordingly, spinal orthosis use after OLIF has emerged as an essential option. However, the role of spinal orthoses in OLIF and their specific impact on postoperative patient clinical outcomes have remained unclear, and there is a lack of strong clinical evidence to indirectly or directly support the role of spinal orthoses in OLIF and demonstrate their impact on patient clinical outcomes. This study aims to investigate the role of spinal orthoses in OLIF by grouping patients based on the use or nonuse of spinal orthosis after OLIF, thus providing a better basis for the majority of patients and physicians. Methods/design: We plan to conduct a 1-year randomized controlled trial involving 60 subjects. The subjects will be randomized into two groups: group A (those wearing spinal orthoses after surgery) and group B (those not wearing spinal orthoses after surgery). The clinical outcomes of these patients will be evaluated using the Oswestry disability index, visual analog scale, and Brantigan, Steffee, Fraser 1 day before surgery and 2 weeks and 1, 6, and 12 months after surgery. Discussion: This randomized controlled trial aims to provide a reference for further comprehensive trial design. The findings of this study will provide a better and more scientific basis for the choice of postoperative rehabilitation and treatment for patients undergoing such a procedure. Trial registration: This study has been registered in the Chinese Clinical Trial Registry (Registration No.: ChiCTR2200059000). Registration date: April 22, 2022. Registration website: http://www.chictr.org.cn/showproj.aspx?proj=166310 [ABSTRACT FROM AUTHOR]

To investigate the effect of a semi-rigid backpack type thoracolumbar orthosis (TLO) on thoracic kyphosis angle (TKA) and potentially contributing factors of hyperkyphosis, including position sense and back muscle strength and endurance. This randomized, controlled trial was conducted on 48 older adults with hyperkyphosis, randomly allocated to an experimental or control group. The experimental group wore a semi-rigid TLO for 3 consecutive months. The control group received no external support or exercise. Thoracic kyphosis angle (TKA), joint position sense, back muscle strength and endurance were evaluated at the baseline and at the end of week 6 and week 12. The two-way (group × time) interactions were significant in terms of TKA (F = 37.88, p ≤ 0.001, ηp2 = 0.45), muscle strength (F = 26.005, p ≤ 0.001, ηp2 = 0.36), muscle endurance measured via load cell (F = 3.417, p = 0.039, ηp2 = 0.06), and endurance holding time of Ito test (F = 3.629, p = 0.045, ηp2 = 0.07). A further analysis using one-way repeated measures of ANOVA showed that TKA, muscle strength and endurance were significantly improved in the experimental group. Also, two-way interactions were significant for absolute error and variable error of trunk neutral repositioning test from a trunk flexed and/or extended position for global components and horizontal components trunk repositioning test. Wearing a semi-rigid backpack type TLO even from an unknown brand for short periods during the day (e.g., 2–4 h) over 3 months not only modifies kyphotic posture but also can enhance back muscle performance in older adults with hyperkyphosis. Prescription of a semi-rigid backpack type thoracolumbar orthosis for older adults has no adverse effects such as muscle weakness if it is applied for short periods during the day. A semi-rigid backpack thoracolumbar orthosis can prevent position sense degradation in older adults with hyperkyphosis. A semi-rigid backpack type thoracolumbar orthosis may counteract trunk flexion and kyphotic posture by applying the biomechanical principles of the three-point pressure system. Improvement in spinal alignment resulting from wearing thoracolumbar orthosis should not occur in exchange for muscle deconditioning. [ABSTRACT FROM AUTHOR]

Spinal orthoses were designed to correct poor posture; however, they may restrict trunk movements at all times, making daily activities difficult. Detecting trunk movements can provide instructions for adjusting the stiffness of the spinal orthosis. This study evaluated the feasibility of identifying movements based on surface electromyography (sEMG) signals. Ten participants were tested for different movements with two different modalities: motion without the spinal orthosis (Normal) and with the spinal orthosis (Spinal orthosis). The sEMG signals were collected from eight muscles using surface electrodes during four movements [flexion-extension, lateral bending, axial rotation, and stand to sit to stand]. Four time domain features were extracted, with a total of 32 feature vectors. The principal component analysis (PCA) method was adopted to feature selection, and it was found that eight feature dimensions can make cumulative explained variance exceed 95%. The results showed that machine learning algorithms could not only identify Normal and Spinal orthosis movement modalities, but also distinguish four daily movements. Moreover, the classification performance of Random Forest (RF), k-Nearest Neighbor (k-NN), and Support Vector Machine (SVM) algorithms were also compared. The results showed that all three machine algorithms have high classification accuracy. The machine learning methods can accurately identify movement patterns by considering sEMG signals, which may provide instructions for adjusting the stiffness of the spinal orthosis. In the future, the spinal orthosis with adjustable stiffness controlled by sEMG signals could help correct poor posture, and permit the wearer to achieve free movement when needed.

Copyright of Rehabilitation / Rehabilitacija is the property of University Rehabilitation Institute, Republic of Slovenia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Aging is associated with progressive loss of musculoskeletal performance. Exercise interventions can improve physical function in the elderly but there is a paucity of comparative assessments in order to understand what specific goals can be achieved particularly with less demanding exercise interventions readily accessible for untrained men. Methods: Prospective randomized, controlled, single center exploratory trial to compare four distinct exercise interventions, i.e. Resistance Training (RT), Whole Body Vibration Exercise (WBV), Qi Gong (QG) and wearing a Spinal orthosis (SO) for 6 months in men at risk for osteoporosis aged 65–90 years. Primary endpoint was change in isometric one repetition maximum force trunk strength for extension (TSE) and flexion (TSF) compared to baseline, secondary endpoints covered key parameters of geriatric functional assessment, including Handgrip Strength (HS), Chair-Rise-Test (CRT), Usual Gait Speed (UGS) and Timed-Up-and-Go (TUG). Results: Altogether 47 men (mean age 77 ±6.1 years) were randomized to RT, (n = 11) WBV (n = 13), QG (n = 10) and SO(n = 13). RT, defined as reference exercise intervention, lead to significant improvements for TSE (p = 0.009) and TSF (p = 0.013) and was significantly superior in the between-group analysis for TSE (p = 0.038). Vibration exercise caused sign. Improvements in TSE (p = 0.014) and CRT (p = 0.005), the Spinal orthosis improved CRT (p = 0.003) and Gait Speed (p = 0.027), while the QG intervention did not attain any sig. Developments.Subgroup analyses revealed most pronounced musculoskeletal progress in vulnerable patients (age ≥ 80 years, pre-sarcopenia, multimorbidity ≥3chronic diseases). Irrespective of the type of exercise, participants ≥80 years experienced significant gains in TSE (p = 0.029) and CRT (p = 0.017). Presarcopenic subjects (Skeletal muscle Index (SMI) ≤10.75 kg/m2) improved in TSE (p = 0.003), CRT (p = 0.001) and UGS (p = 0.016). Multimorbid participants achieved sig. Gains in TSE (p

Objective: To assess the duration of benefits on back pain and back extensor strength in women with osteoporosis who had previously participated in a randomized controlled trial (RCT) involving either exercise or wearing a spinal orthosis. Design: A 6-month postintervention follow-up of women who were involved in the interventions in the RCT. Setting: The study was conducted in a primary health care center in Stockholm, Sweden. Participants: In this follow-up study 31 women participated in the spinal orthosis group, and 31 women participated in the exercise group, with a median age of 76 years in both groups (N=62). All women were diagnosed as having osteoporosis, had back pain with or without vertebral fracture, and were 60 years or older, which were the inclusion criteria in the RCT. Interventions: The participants received no controlled supervision. The spinal orthosis group was asked to wear the orthosis, and the training group was asked to follow an exercise program for another 6 months voluntarily. Main Outcome Measures: Back extensor strength was measured with a computerized device; back pain was estimated by the visual analog scale and by Borg CR-10. Results: After 6 months there were no significant differences between the groups in back extensor strength or back pain. Analyses within the groups showed that achieved results during 6 months intervention in the RCT were maintained after 6 months of voluntary use of the spinal orthosis and training. In the spinal orthosis group, back extensor strength mean was 81.7 N, and back pain median was 3 mm. In the training group back extensor strength mean was 72.8 N, and back pain median was 3 mm. There were no changes for any other measurements performed. Conclusions: Voluntary use of the spinal orthosis or exercise during a 6-month follow-up period maintained the increase in back extensor muscle strength obtained during the RCT. Estimation of back pain was not influenced. This indicates that the women had continued to use the spinal orthosis and exercise.

Background and purpose: Osteoporotic hyperkyphosis is associated with adverse outcomes, such as fatigue, back pain, or reduced back extensor strength, with a negative impact on functionality and quality of life. The purpose of this review is to assess the effectiveness of spinal orthosis on these adverse effects. Methods: A systematic review following the PRISMA guidelines was performed. Inclusion criteria were (1) women with osteoporosis; (2) randomized controlled trials only; and (3) type of intervention: spinal bracing. Exclusion criteria were (1) article not written in English; (2) full-text not available; and (3) no kyphosis assessment. Quality-of-life variables such as back pain, functional variables such as back extensor strength, and osteoporotic-related variables such as lumbar spine bone mineral density were extracted and recorded before and after the intervention. The characteristics of the intervention programs were also extracted and recorded. The characteristics of studies, interventions, and participants are summarized in a table. Then, the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the quality of the studies. Results and Discussion: Four randomized controlled trials with a low risk of bias were included (n = 326 women with osteoporosis, aged 51–93 years). Interventions consisting of wearing a dynamic hyperextension orthosis for at least two hours per day for six months improved functionality, mobility, back extensor strength, respiratory function, and reduced the thoracic kyphosis angle. Conclusions: Spinal orthosis, especially dynamic hyperextension braces, seems effective in improving the adverse outcomes of osteoporotic hyperkyphosis. It does not seem necessary to wear the orthosis during all daily activities.

This paper is about defining a different novel concept of a simple machine for producing spinal orthosis moulds. Should such a machine be developed, the required functionality with a special emphasis on low price is to be achieved. The paper considers the issues regarding the kinematics and feasibility confirmation as related to the concept. A CAD model made for the purpose of simulation and activities related to the software development for generating tool trajectories along with the belonging kinematics and trajectory visualization were carried out.

Spinal orthosis applications are preferred for conservative treatment of adolescent idiopathic scoliosis, and holistic biomechanical approaches are recommended. This was single-blind, prospective, randomized, controlled study. It included 42 patients (29 females/13 males) aged 10–18 years with adolescent idiopathic scoliosis, Cobb angle of 20°–45°, who were deemed suitable for spinal orthosis use. Patients were randomly divided into two groups: control, spinal orthosis group (n = 21), and insoles and spinal orthosis group (n = 21). All participants used spinal orthoses for 3 months. This study evaluated the functional capacities, quality of life, balance, and plantar pressures of the participants. The evaluations were repeated after 1 week, and 3 months following spinal orthosis application. Statistically significant difference and positive effect were observed in Cobb angle (p = 0.008; p = 0.878, respectively), right total (p = 0.037; p = 0.193, respectively), left total (p = 0.037; p = 0.193, respectively), left rearfoot (p = 0.002; p = 0.708, respectively), and right forefoot plantar pressure (p = 0.001; p = 0.739, respectively) in participants in insoles and spinal orthosis group compared with those in the control group. Statistically significant differences and positive effects were observed in swing length (p = 0.001; p = 0.053, respectively) and functional capacity (p = 0.005; p = 0.220, respectively), which are parameters related to postural balance. No change was found in quality of life of either group (p > 0.05). Insoles may have positive impact on functional capacity, balance, and plantar pressure during long-term follow-up in individuals with scoliosis. Therefore, the evaluation of foot plantar pressure in individuals with scoliosis is recommended, and personalized insoles may be a beneficial option. • Spine and foot biomechanics can affect body posture. • Plantar pressure may be negatively affected in individuals with scoliosis. • Insoles may be preferred conservative treatment after foot evaluation in scoliosis. • Spinal orthosis and insoles can support body posture in individuals with scoliosis. [ABSTRACT FROM AUTHOR]

The biomechanical principles of orthotic design assist in promoting control, correction, stabilization, or dynamic movement. All orthotic designs are based on three relatively simple principles pressure, equilibrium, and the lever arm principle. The following principles provide the foundation for all orthotic designs keeping in mind that the more complicated the orthotic application, the more confounded the various principles become. The drawbacks of the spinal orthosis cause discomfort, osteopenia (Low BMD), skin breakdown, nerve compression, poor patient compliance etc,. Without a good design implementation and strategy, the deficiency from using this spinal orthosis to the spinal patients might not be solved. Therefore, the previously developed spinal orthosis should be reviewed thoroughly in order to analyse the problem relating to the orthosis development. In addition, we were also able to classify an on-going research in this rehabilitation spinal orthosis field. According to the literature review analysis, it shows that none have tried to control the spinal motion of the vertebrae of the cervical, thoracic, and lumbar curves extensively using a multiple joint spinal orthosis, which will be the main focuses in this article review analysis. [ABSTRACT FROM AUTHOR]

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Background : Falls in the elderly are common and are associated with appreciable morbidity and mortality. Hyperkyphosis is a risk factor for balance impairment and postural instability. Increased forward curvature of the spine displaces the center of mass anteriorly towards the limits of stability, and thus increases the likelihood of loss of balance and predisposes persons to fall. The orthoses are an option for decreasing the risk of falling in elderly population however, the quantitative evidence to support their application is not convincing. The purpose of this study is to analysis the effects of spinomed orthosis on risk of falling of elderly people with spinal hyperkyphosis. Materials & Methods : 18 elderly people with mean age 65.96 ± 4.4 who had thoracic kyphosis of ≥ 50 (cobb angle) were enrolled in the study. Subjects were randomly allocated into either spinomed orthosis or control group. Patients were randomly subjected to computerized dynamic posturography, which contained sensory organization tests and limits of stability. The tests for each person were conducted in two conditions: while wearing and not wearing the orthosis and the order of testing within a patient was randomized. Results : Wearing spinomed orthosis significantly increased balance score (p

Background and aim: The objective of this study was to assess the effect of thoracolumbosacral orthoses (TLSOs) on antero-posterior (AP) sway, medio-lateral (ML) sway and displacement of the center of pressure (COP) during a longitudinal study in patients with adolescent idiopathic scoliosis (AIS).Methods: Eight females aged between 12 and 14.5 years participated in this study. Evaluations were performed prior to the TLSO intervention as a baseline condition, after 1 month, and after 4 months of orthosis use by assessing balance when standing statically on different surfaces.Results: When standing on both lower limbs on a solid surface there were significant differences in ML sway with the eyes both open and closed, and also in A/P sway but only when standing on a solid surface with the eyes open and also when standing on a foam surface with the eyes closed with TLSO use. When standing on the dominant leg, ML sway significantly improved, but AP sway only improved with a foam base surface with the eyes open.Conclusion: This study demonstrated positive effects of wearing a TLSO in improving quiet standing balance and standing on the dominant lower extremity in subjects with AIS after 4 months of brace use.Implications for RehabilitationDue to a change in body shape such as that caused by scoliosis, human posture changes and spinal deformities affect the position of the center of support, and thus balance ability may change.AIS subjects have poor standing stability compared to a healthy matched control group.Brace wearing had positive effect in improving quiet standing balance and standing on the dominant lower extremity in subjects with AIS undergoing brace treatment after 4 months of TLSO use. [ABSTRACT FROM PUBLISHER]

Study Design. A prospective study; 2-group design. Objective. This study aims to assess the time response of scoliotic spines to orthotic intervention using clinical ultrasound. Summary of Background Data. Patients with moderate adolescent idiopathic scoliosis are generally advised orthotic treatment. However, the time to reach maximum correction after donning spinal orthosis or the time to return to pretreatment curvature after doffing spinal orthosis is not fully understood. Method. Subjects were divided into 2 groups, the don-orthosis group and the doff-orthosis group where the time reaching maximum correction and the time returning to pretreatment curvature were investigated accordingly. To avoid excessive radiation exposure via obtaining repeated radiographs, a validated method of estimating Cobb angle using radiation-free clinical ultrasound was applied at an interval of every 30 minutes up to 180 minutes. The spinal flexibility (estimated from supine radiographs) and body mass index were collected from the subjects for analyses. Result. Nine female patients with adolescent idiopathic scoliosis were recruited. There was no immediate change in the Cobb angles. A change of more than 5° could be observed in both groups only after 30 minutes and maximum change was found at/after 120 minutes. In the doff-orthosis group, the subject with the lowest body mass index took the longest time to increase more than 5° after doffing spinal orthosis. In the don-orthosis group, the subject with the highest body mass index took the longest time to achieve curve correction more than 5°. Conclusion. This investigation demonstrated that there is a time lag between application of spinal orthosis and its effect on scoliotic curvature.This is likely due to the low-stiff and viscoelastic properties of the spine. The clinical relevance of this study is that for patients with scoliosis undergoing orthotic treatment, radiograph should not be obtained within 2 hours of putting on or taking off spinal orthosis because it may not show the maximum effect. [ABSTRACT FROM AUTHOR]

Force sensors have been reported to be reliable for monitoring spinal orthosis compliance in the treatment of scoliosis. However, the current force sensor used for these compliance monitors has certain limitations and drawbacks. A lower cost force sensor with a 55% larger operating force range was chosen for this application, with modifications required to increase its contact surface, improve comfort, and reduce the manufacturing time. Different designs have been considered and described in this paper. A final prototype using a rubberlike material housing with a stiff nub over the sensing area of the original sensor produced a linear, highly sensitive, large surface area, reliable, and robust sensor. It has a sensitivity of 315 mV/N, accuracy 1.9%, repeatability 0.6%, linearity 0.7%, hysteresis 0.8%, dead band 0.0%, point drift 0.5%, temperature drift 2.2% for the temperature range 25^\circC– 35 ^\circC, and reproducibility 1.3%. These properties are adequate for measuring forces in a spinal orthosis. The total cost of the sensor with housing is $46 when ordered in quantities of 1000, which reduces the price of the existing sensor by 34%. The manufacturing time of the new sensor was reduced and a preliminary subject trial demonstrated that the new sensor did not have significant temperature effect. This will make force systems more affordable and adaptable for the effective treatment of scoliosis. [ABSTRACT FROM PUBLISHER]

A traditional spinal orthosis in conjunction with a hip-knee-ankle-foot orthosis (HKAFO) improves posture in persons with paraplegia during standing and walking. It also limits the wearer's range of motion when worn during other activities, such as vehicle transfer or sitting and reaching for objects. In order to regain full torso flexibility the user would need to remove the spinal orthosis which can be arduous and time consuming. A Convertible Spinal Orthosis (CSO) that allows the user to switch between Locked rigid torso support and Unlocked free motion has been designed, fabricated and tested. It shows promise for increasing functionality, wear time and subject comfort. Analysis of movement has been performed with an able-bodied and a paraplegic subject wearing a rigid spinal orthosis, the CSO in both states, and without any bracing. Configuration state had the most impact on lateral bending. Mean values for the paraplegic subject of 27°, 38°, 48°, and 48° and for the able-bodied subject of 22°, 26°, 48°, and 45° were found for lateral bending of the upper torso relative to the thighs in the Rigid, Locked, Unlocked, and No-Brace states, respectively. [ABSTRACT FROM AUTHOR]

Copyright of Rehabilitation / Rehabilitacija is the property of University Rehabilitation Institute, Republic of Slovenia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Scoliosis is a spinal deformity that affects millions of adolescents in the United States. Bracing is the most common non-surgical treatment method for scoliosis, but the biomechanics of such treatment is unclear. The objective of this study is to develop and validate a force logging system that can record forces at multiple locations inside a brace, as well as brace strap tension, and correlate these forces with different body positions. The force logging system can be used to investigate the biomechanics function of a brace to treat scoliosis during the treatment period. Two phases were completed in this study: design phase, involving custom development and calibration of strap tension transducers and modifications of in-brace force transducers; and validation phase, including preliminary testing on a subject with different postures. In-brace force load cell and tension transducer were tested and validated. Their sensitivities were 193.5±4.9mV/N and 35.5±0.2mV/N, respectively, with both linear correlation coefficients were 0.99, reflecting high repeatability and linearity. Qualitative validation was also completed, allowing general relationships to be found between subject posture and force distribution. This study shows an excellent functionality and utility of the developed system. [Copyright &y& Elsevier]

Patient with moderate AIS is usually prescribed with spinal orthosis aiming to mechanically support and prevent the spine from further deterioration. In the conventional fitting method, pre-brace X-ray is the main reference, thus, the pressure pad of spinal orthosis may not be accurately located to the strategic areas because the spinal deformities could change 3-dimensionally once pressure pad is applied. A high correlation (r > 0.98) between Cobb's angle and spinous process angle (SPA) was found in the recent studies. With the advancements of 3D clinical ultrasound (3D CUS), tracing SPA along a scoliotic spine becomes possible and this can be used to estimate Cobb's angle. This study aimed to evaluate the effect of pressure pad location of spinal orthosis in the treatment of AIS and 3D CUS was used to trace SPA for estimation of Cobb's angle. The in-brace X-rays were assessed for confirmation of treatment effectiveness. The subjects were divided into ultrasound-guided fitting group A (n=21) and conventional fitting group B (n=22). In the group A, pressure pads were tested at 5 locations - the prescribed location as in the conventional fitting (referred to the pre-brace X-ray), and 1 cm and 2 cm above and below the prescribed location, and 3D CUS was applied to trace the SPA in these 5 pad locations, and the pad location with the lowest estimated Cobb's angle was selected in the final fitting. The assessments of in-brace X-rays showed that the mean Cobb's angle of group A decreased from 28.9° (pre-brace) to 18.6° (immediate in-brace) while the mean Cobb's angle of group B decreased from 27.1° (pre-brace) to 22.5° (immediate in-brace). There was a significant difference (p < 0.05) in the correction of Cobb's angle between the two groups. The results showed that accurate pressure pad location does play an important role in the reduction of Cobb's angle and 3D CUS can be considered as a non-invasive and effective assessment tool to improve orthotic treatment of AIS. [ABSTRACT FROM AUTHOR]

The article presents a study focusing on the effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis. The study shows that the use of an orthoses increases trunk muscle strength and thus improves posture in patients with vertebral fracture caused by osteoporosis. It concludes that thus a better quality of life is achieved by pain reduction, decreased limitations of daily living, and improved well-being.

The article provides a study that determines the validity of three commercially available at recording thoracic-lumbar-sacral orthosis (TLSO) wearing time of children with spinal cord injury (SCI). It also assesses each monitor's function during daily activities. It is said that fifteen children with SCI who wore a TLSO for paralytic scoliosis were observed for four days during their rehabilitation stay. It is inferred that compliance to prescribed wearing schedule has been a barrier to studying TLSO efficacy.

Spinal orthoses are commonly prescribed to patients with moderate AIS for prevention of further deterioration. In a conventional manufacturing method, plaster bandages are used to get patient's body contour and plaster cast is rectified manually. With the introduction of CAD/CAM system, a series of automated processes from body scanning to digital rectification and milling of positive model can be performed in a fast and accurate fashion. This project is to study the impact of CAD/CAM method as compared with the conventional method. In assessing the 147 recruited subjects fitted with spinal orthoses (43 subjects using conventional method and 104 subjects using CAD/CAM method), significant decreases (p<0.05) were found in the Cobb angles when comparing the pre-intervention data with that of the first year of intervention. Regarding the learning curve, Orthotists are getting more competent with the CAD/CAM technique in four years time. The mean productivity of the CAD/CAM method is 2.75 times higher than that of the conventional method. The CAD/CAM method could achieve similar clinical outcomes and with its high efficiency, could be considered as substitute for conventional methods in fabricating spinal orthoses for patients with AIS. [ABSTRACT FROM AUTHOR]

Osteoporotic spine fractures (OSF) are common sequelae of osteoporosis. OSF are directly correlated with increasing age and incidence of osteoporosis. OSF are treated conservatively or surgically. Associated acute pain, chronic disabilities, and progressive deformities are well documented. Conservative measures include a combination of initial bed rest, analgesia, early physiotherapy, and a spinal brace (orthosis), with the aim for early rehabilitation to prevent complications of immobile state. Spinal bracing is commonly used for symptomatic management of OSF. While traditional spinal braces aim to maintain the neutral spinal alignment and reduce the axial loading on the fractured vertebrae, they are well known for complications including discomfort with reduced compliance, atrophy of paraspinal muscles, and restriction of chest expansion leading to chest infections. Exoskeletons have been developed to passively assist and actively augment human movements with different types of actuators. Flexible, versatile spinal exoskeletons are designed to better support the spine. As new technologies enable the development of motorized wearable exoskeletons, several types have been introduced into the medical field application. We have provided a thorough review of the current spinal robotic technologies in this paper. The shortcomings in the current spinal exoskeletons were identified. Their limitations on the use for patients with OSF with potential improvement strategies were discussed. With our current knowledge of spinal orthosis for conservatively managed OSF, a semi-rigid backpack style thoracolumbar spinal robotic orthosis will reduce spinal bone stress and improve back muscle support. This will lead to back pain reduction, improved posture, and overall mobility. Early mobilization is an important part of management of patients with OSF as it reduces the chance of developing complications related to their immobile state for patients with OSF, which will be helpful for their recovery. [ABSTRACT FROM AUTHOR]

Introduction: Thoracolumbar braces are used to treat Adolescent Idiopathic Scoliosis. The objective of this study was to design and validate a mechanical analog model of the spine to simulate a thoracolumbar, single-curve, scoliotic deformity in order to quantify brace structural properties and corrective force response on the spine., Methods: The Scoliosis Analog Model used a linkage-based system to replicate 3D kinematics of spinal correction observed in the clinic. The Scoliosis Analog Model is used with a robotic testing platform and programmed to simulate Cobb angle and axial rotation correction while equipped with a brace. The 3D force and moment responses generated by the brace in reaction to the simulated deformity were measured by six-axis load cells., Results: Validation of the model's force transmission showed less than 6% loss in the force analysis due to assembly friction. During simulation of 10° Cobb angle and 5° axial rotation correction, the brace applied 101 N upwards and 67 N inwards to the apical connector of the model. Brace stiffness properties were 0.5-0.6 N/° (anteroposterior), 0.5-2.3 N/° (mediolateral), 23.3-26.5 N/° (superoinferior), and 0.6 Nm/° (axial rotational)., Conclusions: The Scoliosis Analog Model was developed to provide first time measures of the multidirectional forces applied to the spine by a thoracolumbar brace. This test assembly could be used as a future design and testing tool for scoliosis brace technology., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.