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BACKGROUND:Orthosis is a common and effective treatment for mild to moderate scoliosis,which can delay and inhibit the progression of scoliosis and reduce the incidence of severe deformity.Different types of orthoses have different indications,application characteristics,and efficacies.In recent years,the application of new technology like digital and intelligent has promoted the improvement and development of new orthoses. OBJECTIVE:To classify and compare the commonly used scoliosis orthoses,and describe the application progress of new technologies such as digital and intelligent technology in recent years,so as to provide a reference for the clinical selection of orthoses and the improvement of new orthoses. METHODS:PubMed,Embase,IEEE,CNKI and WanFang databases were searched for relevant literature.Chinese and English search terms were"scoliosis,orthosis,brace,progress,artificial intelligence,digitization".The search time limit was from 2012 to 2022.Finally,56 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)Scoliosis orthosis has a good effect on mild to moderate adolescent idiopathic scoliosis.Through the Hueter-Volkmann law,it can accelerate the growth of the concave spine with a high success rate and has been widely used in this field.(2)The indications,application characteristics and efficacy of different types of orthoses are different,and the clinical selection is targeted.(3)Scoliosis orthosis has been developed in the direction of more humanity,paying attention to the comfort of patients,and the manufacturing process has been transformed from plaster casting to computer-aided manufacturing.It is simple and hygienic,with higher correction accuracy,and patients'compliance has been significantly improved.(4)Scoliosis orthosis is developing in the direction of digitalization and intelligence and has been widely integrated with artificial intelligence,Internet of things and other technologies to monitor the patient's orthopedic force,body temperature,and compliance in real time,so as to provide patients with more accurate treatment.(5)At present,there are still many defects in scoliosis orthosis that cannot be ignored,such as affecting development,decreased muscle strength,and body stiffness,which need further exploration and improvement.
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BACKGROUND:Short-term wearing of cervical brace combined with shoulder and neck muscle exercise can significantly improve the symptoms of early cervical spondylosis.After stopping wearing cervical brace,patients'symptoms are easy to recur,which may be due to the lack of cervical curvature correction function. OBJECTIVE:To analyze the effect of 3D printed personalized cervical orthopedic brace for adjusting cervical curvature in the treatment of early cervical spondylosis. METHODS:From January 2021 to January 2023,30 patients with early cervical spondylosis in the Shanghai Fifth People's Hospital,Fudan University were studied,including 11 males and 19 females,with a mean age of(31.7±6.6)years old.All patients customized and wore 3D printed personalized cervical orthopedic braces for 3 hours a day for continuous 12 weeks.Borden value of cervical curvature,pain threshold of shoulder and neck muscles,cervical dysfunction index,and visual analog scale score in 30 patients were recorded before and 4 and 8 weeks after treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,the difference of Borden value of cervical curvature,right trapezius tenderness threshold,and cervical dysfunction index was not significant in 30 patients after 4 weeks of treatment(P>0.05).Visual analog scale score,left trapezius tenderness threshold,left and right C5C6 tenderness threshold were significantly improved(P<0.05).(2)Compared with before treatment,the cervical curvature Borden value,left and right trapezius tenderness threshold,visual analog scale score,left and right C5C6 tenderness threshold,and cervical dysfunction index of 30 patients were significantly improved after 12 weeks of treatment(P<0.05).(3)Compared with 4 weeks after treatment,the Borden value of cervical curvature,right trapezius tenderness threshold,visual analog scale score,left and right C5C6 tenderness threshold and cervical dysfunction index of 30 patients after 12 weeks of treatment were significantly improved(P<0.05).(4)The results show that short-term wearing of 3D printed personalized cervical orthopedic brace can improve the pain of patients with early cervical spondylosis,while long-term application has certain effect on the recovery of cervical curvature.
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Objective The biomechanical model for the musculoskeletal system of a human knee joint was established using a numerical simulation method.The kinematic and dynamic information captured during jumping motion simulated by the human dynamic model was used as driven data of the knee biomechanical model,followed by further analysis of the stress field distribution characteristics of the meniscus under different thermal-force coupling knee brace conditions.Methods Based on computed tomography and magnetic resonance imaging of the subject,a realistic human knee model,including bone,articular cartilage,meniscus,ligaments and peripheral soft tissues of the knee joint,was constructed.Furthermore,two gaits,namely taking-off and landing-on,of jumping motion with an increased risk of meniscus injuries were selected according to mechanical features in full-cycle jumping motion.Subsequently,the stress field characteristics of the knee meniscus under four different thermal-force coupling knee braces were analyzed,the changes of the peak stress of the meniscus and its stress concentration area were discussed,and the protective efficacy and mechanical basis of meniscal injuries and wearing knee braces were explored.Results The anterior part of the medial knee meniscus was a vulnerable area under concentrated stress.Under the knee brace thermal-force coupling condition,the stress concentration area of the medial meniscus was transferred from its narrow and weak anterior part to its wide and thick middle part,and the peak stress was also significantly reduced.The peak stress on the medial meniscus and that on the lateral meniscus were similar,indicating that the two parts of the meniscus bore the external load evenly,and the meniscus stress concentration area decreased.Conclusions Thermal-force coupling knee braces have good protective effects against knee meniscus injury.The numerical simulation provides theoretical support and technical guidance for the design of multifunctional thermal knee braces.
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Objectives:To analyze the functional movement characteristics after brace treatment for patients with adolescent idiopathic scoliosis(AIS),and to develop and validate a nomogram model to predict the risk of poor outcome.Methods:AIS patients who were treated with braces at our institution from March 2020 to March 2022 were collected as a training set,and were tested for functional movement before treatment,at initial follow-up and after treatment.The same criteria were used to collect AIS patients who underwent brace treatment in our hospital from April 2022 to August 2022 as the validation set.On the basis of whether the degree of scoliosis progression was＞5° after 1 year of treatment,the patients in the training set were divided into stable(≤5°)and progressive(＞5°)groups.Comparison of data was made between groups.Spearman corre-lation analysis was used to analyze the correlation between variables.Logistic regression model was used to screen the risk factors for poor outcomes.R software was applied to develop a nomogram prediction model.Area under curve(AUC)of receiver operating characteristic(ROC)curve and calibration curve were applied to evaluate the discrimination and accuracy of the model.Internal validation was performed with the model predicted risk values before and after training set Bootstrap self-sampling as the test variables and the actual prognosis of patients as the state variable;External validation of the model was performed after randomization of the validation set Bootstrap self-sampling.Results:A total of 102 patients with AIS were included in the training set.There were 73 cases in the stable group and 29 cases in the progressive group(range of degrees of progression:8° to 27°).The median follow-up time was 15.4 months.Both thoracic and lumbar Cobb angles decreased significantly after treatment(P＜0.05).Rotational stability and push-ups were higher at initial follow-up than before treatment,and scores on bow-step squat,hurdle striding,rotational stability,and push-ups improved after treatment(P＜0.05).There was no significant correlation between functional movement characteristics and Cobb angle(P＞0.05).Pre-treatment Cobb angle≥35°,Risser's sign≥3°,apex rotation≥degree Ⅲ,and spinal length gain≥20mm/year were independent risk factors for scoliosis progression.Lumbar spine bone density≥0.8g/cm2 and spinal flexibility≥50%were protective factors.The total value of the risk of scoliosis progression after brace treatment predicted by the nomogram model was 0.93.The AUCs before and after training set self-sampling were 0.928(95%CI:0.858-0.998)and 0.926(95%CI:0.854-0.997),respectively.The validation set included 37 patients.The external validation AUC for validation set was 0.891(95%CI:0.857-0.998).The calibration curves all showed good degree of fitting.Conclusions:Patients with AIS have poor movement patterns due to spinal restrictions.Brace treatment improves trunk stability and rotational stability,which has good corrective effects on the movement pattern.AIS patients with Cobb angle≥35°,Risser's sign≥3°,apex rotation≥degree Ⅲ,spinal length gain≥20mm/year,lumbar spine bone mineral density＜0.8g/cm2,and spinal flexibility＜50%before treatment who underwent bracing are prone to scoliosis progression.Timely warning shall be made based on the nomogram model and postural correction needs to be supplemented at appropriate time to improve the prognosis of AIS brace treatment.
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ObjectiveTo investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability (CAI). MethodsA total of 52 patients with unilateral chronic ankle instability (CAI) in Beijing Rehabilitation Hospital from February, 2021 to January, 2023 were randomly divided into control group (n = 26) and experimental group (n = 26). Both groups underwent an eight-week exercise training program. The control group wore placebo brace during daily activities, while the experimental group wore soft ankle brace. Plantar dynamic parameters were measured using a pressure plate system during walking, including peak plantar pressure and plantar impulse before and after intervention. ResultsSix participants dropped out in the control group and five in the experimental group, resulting in a final inclusion of 41 participants. After intervention, there was no significant difference in peak plantar pressure and impulse on the affected side in the control group among different areas (P > 0.05). In the experimental group, the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas increased (|t| > 4.192, P < 0.001), while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased (t > 2.984, P < 0.05); the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas were higher in the experimental group than in the control group (|t| > 2.126, P < 0.05), and the peak pressure and impulse were lower in the midfoot and forefoot lateral areas (t > 2.133, P < 0.05). ConclusionWearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plantar impulse on the affected side in patients with CAI, which may prevent recurrence of sprains.
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Objective: To study the protective effect of parachute ankle brace on ankle joint during simulated parachuting landing. Methods: In August 2021, 30 male paratroopers were selected as the test subjects by simple random sampling method. They jumped from the 1.5 m and 2.0 m height platforms respectively with and without parachute ankle brace, and landed on the sandy ground in a semi-squat parachute landing position. The experiment was divided into 1.5 m experimental group and control group and 2.0 m experimental group and control group. Angle sensor and surface electromyograph were used to measure and analyze the coronal tilt range of the ankle joint and the percentage of maximal voluntary contraction (MVE%) of the muscles around the ankle joint, respectively, to evaluate the protective effect of the parachute ankle brace. Results: At the same height, the tilt range of coronal plane of ankle in experimental group was significantly reduced compared with control group, and the difference was statistically significant (P<0.05). Under the same protection state, the tilt range of the coronal plane of the ankle in the 1.5 m group was significantly reduced compared with that in the 2.0 m group, and the difference was statistically significant (P<0.05). The coronal plane inclination range of the ankle in 2 m experimental group was significantly lower than that in 1.5 m control group, and the difference was statistically significant (P<0.05). Compared with 1.5 m control group, MVE% of right tibialis anterior muscle and bilateral lateral gastrocnemius decreased in 1.5 m experimental group, while MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle and right lateral gastrocnemius decreased in 2.0 m experimental group, while the MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). The MVE% of bilateral tibialis anterior muscle, bilateral lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m experimental group decreased compared with 2.0 m experimental group, and the differences were statistically significant (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle, right lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m control group decreased, and the differences were statistically significant (P<0.05) . Conclusion: Wearing parachute ankle brace can effectively limit the coronal plane inclination range of ankle joint, improve the stability of ankle joint and reduce the load on the muscles around ankle joint by landing. Reducing the height of the jumping platform can reduce the coronal plane incline range of the ankle and the muscle load around the ankle during landing.
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Humans , Male , Ankle , Ankle Joint/physiology , Lower Extremity/physiology , Muscle, Skeletal/physiology , ElectromyographyABSTRACT
Objectives:To analyze the clinical efficacy of Cheneau brace in adolescent idiopathic scoliosis(AIS)patients and to discuss the changes of curve type during the treatment.Methods:75 patients with AIS treated with Cheneau brace from October 2016 to November 2021 were included.There were 69 females and 6 males,averaged 11.9±1.0 years old when starting to wear the brace,with a mean initial main curve Cobb angle of 29.8°±8.5° and an initial Risser's sign ≤2.Clinical and imaging data were collected,including age,gender,menarche age,time of daily wear,and full-length radiographs of the spine before initial treatment and at the final follow-up.All the patients were followed up for 1 year after finishing brace treatment.The curve types of the patients were counted using the main curve type and the modified Lenke classification system(mLenke),and changes in curve types and the efficacy of bracing in patients with different curve types were analyzed.Results:After 25.7±10.8 months of brace treatment,the patients averaged 14.2±1.2 years old when finishing brace treatment,and the mean main Cobb angle was 27.6°±12.0°.Among the patients,scoliosis was controlled in 63 while progressed in 12,and 23 patients were treated surgically.The rates of success of brace and control of curve were higher in patients with main lumbar curve than those in patients with main thoracic curve(P=0.043,P=0.003).There was a difference in the rate of brace success and control of curve in patients with each mLenke classification(P＜0.001,P=0.005).The highest rates of brace success and control of curve were found in patients of mLenke type Ⅴ,while mLenke type Ⅳ patients had the lowest success rate of brace treatment success and mLenke type Ⅱ patients had the lowest rate of control of curve.Before and after brace treatment,there was a difference in the proportion of patients with each main curve type(P=0.019),and the proportion of patients with each mLenke classification had no statistical difference(P=0.071).There were differences in the rate of change of curve type in each main curve type and each mLenke classification both(P＜0.001,P=0.020).No significant differences were seen in the rates of success of brace treatment and control of curve between patients with and without change in curve type under the two curve type classifications.Conclusions:The efficacy of Cheneau brace varies among AIS patients with different curve types.Patients with a main thoracic curve tend to have a poor response to bracing compared with patients of main lumbar curve;During the treatment with Cheneau brace,the patient's curve types may change,and the overall trend of curve type change is upward shifting of the main curve.The rate and outcome of curve type changes vary among patients with different curve types,and curve type changes may also occur in curve controlled or corrected patients.
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Background: Nail braces are reportedly effective for treating both acute inflamed and chronic dystrophic type ingrown toenails. Aims: In this study, risk factors for poorly controlled and recurrence-prone ingrown toenails treated with nail braces were identified. Methods: We performed a retrospective study on patients with ingrown toenails between June 1, 2015, and May 31, 2018. The last follow-up date was January 31, 2019. Multivariate logistic regression was performed to evaluate the possible factors associated with poorly controlled status (ongoing paronychia during treatment) and recurrence. Results: There were 120 (244 sides) and 118 patients (167 sides) with chronic dystrophic and acute inflamed type ingrown toenails, respectively. The mean treatment duration and follow-up period were 161.2 ± 98.3 days and 432.7 ± 320.9 days, respectively. Poor control and recurrence were seen in 7.3% (17/232) and 12.2% (27/221) of the patients, respectively. In the multivariate analysis, acute inflamed ingrown toenails, previous nail avulsion, proximal nail fold hypertrophy and more than one affected side remained significantly associated with poorly controlled ingrown toenails. Foot bone deformity was significantly associated with recurrence. Limitations: This study was a retrospective study so that confounding factors such as comorbidities, body mass index, accompanying nail changes and lifestyle could not be evaluated. Conclusion: Several risk factors related to poor control and recurrence were identified. Patients could therefore benefit from more suitable treatment plans with reasonable expectation.
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ObjectiveTo investigate the immediate effect of wearing a soft ankle brace on dynamic and static balance function and biomechanics of affected lower limbs during walking in chronic ankle instability (CAI) patients. MethodsFrom January to August, 2021, 40 CAI patients from Musculoskeletal Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University were measured dynamic and static balance indexes with Zebris FDM-System and Y balance test, before and after wearing a soft ankle brace; while the kinetics indexes and surface electromyography of the affected lower extremities during walking were collected with Zebris FDM-System and a surface electromyography telemeter simultaneously. ResultsThe velocity and area of center of pressure reduced in both open and closed eye modes (|t| > 2.876, P < 0.01), the Y-balance scores increased in all the directions (|t| > 21.212, P < 0.001) after wearing brace; while the peak pressures and impulses increased in the midfoot and medial forefoot regions (|t| > 2.057, P < 0.05), and decreased in the lateral heel, lateral forefoot and toe regions (|t| > 2.464, P < 0.05), and the root mean square of surface electromyography increased in the tibialis anterior and lateral gastrocnemius (|t| > 2.159, P < 0.05) during walking. ConclusionWearing soft brace can immediately improve dynamic and static balance of CAI patients, and optimize plantar kinetic distribution and enhance activation of the anterior tibial and the lateral head of gastrocnemius of the affected limb during walking, to improve motor control of CAI patients.
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Objective To examine the effects of ankle brace on biomechanics of the lower extremity during landing, so as to provide a theoretic support to choose ankle brace for people with different sports levels. Methods The key words (ankle brace OR ankle braces OR ankle bracing OR ankle support) AND (landing OR land OR jump OR hopped OR hopping) AND (biomechanics OR kinematics OR kinetics OR electromyography OR neuromuscular) in Chinese and English were searched from different electronic databases (CNKI, Web of Science, EBSCO, PubMed and other databases), for a period of Jan. 2000 to Dec. 2020. Cochrane was used to evaluate the quality of eligible studies. For meta analysis, subgroup analysis was used to assess the impact of ankle braces on ankle biomechanics.Results Thirteen studies with a total of 222 participants were included for mata analysis in this study. The semi-rigid ankle brace reduced the peak of ankle inversion by 25.8% compared with the elastic ankle brace (SMD=-0.562, P<0.001). Moreover, the elastic ankle brace reduced ankle plant flexion during landing among athletes (SMD=-3.42, P=-0.021). As for collagiate students, both elastic ankle and semi-rigid ankle decreased the ankle inversion (elastic ankle brace: 35.4%, SMD=-1.000, P=-0.013; semi-rigid ankle brace: 31.11%, SMD=-0.881, P<0.001) and ankle plant flexion (elastic ankle brace:23.30%, SMD=-1.381, P<0.001;semi-rigid ankle brace: 36.33%, SMD=-1.605, P<0.001).Conclusions Both ankle braces can prevent ankle sprain for athletes (basketball, volleyball, running) who experience training more than 5 years. The elastic ankle brace can limit the inversion and plantar flexion, while the semi-rigid ankle brace can merely decrease the ankle inversion. Therefore, athletes are more suitable for the elastic ankle brace. As for collegiate students without training history, both ankle brace can decrease the ankle inversion and plantar flexion. The elastic ankle brace has greater restriction on inversion, while the semi-rigid ankle brace has more restriction on plantar flexion. Therefore, the elastic ankle brace should be utilized if collegiate students have calcaneofibular ligament injury, while the semi-rigid ankle brace is more suitable for collegiate students who have a history of anterior talofibular ligament injury.
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Objective：In athletes who are still in the growing period, lumbar spondylolysis is mainly treated with brace therapy to enable bone fusion. During the brace period, sports activities are often discontinued. The purpose of this study was to investigate how the combination of brace therapy and early physiotherapy affects the duration of return to play in athletes with lumbar spondylolysis.Methods：Thirty-seven athletes in the growing period with unilateral spondylolysis were included in the study. They were classified into two groups：17 patients who rested during the brace period（brace group）and 20 patients who combined the brace with early physical therapy (combination group). The examined items were duration of the brace period and duration from the end of the brace therapy to return to play (return period). Both these items were compared between the brace group and the combination group. In addition, the union rate of both groups was also calculated.Results：The return period was significantly shorter in the combination group than in the brace group. However, there were no statistically significant differences between the groups with respect to other data.Conclusion：Since there was no significant difference in the duration of the brace period and the union rate between both groups, we believe that early physical therapy intervention does not adversely affect bone union in athletes with spondylolysis who are in the growing period. Therefore, it is considered that the combined use of brace therapy and early physical therapy can maintain flexibility and muscular strength during the brace period and can enable a smooth transit to playing after the bone union is complete.
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Objective:To observe the effect of braces combined with insoles on scoliosis and walking performance in patients with adolescent idiopathic scoliosis (AIS). Methods:From September, 2019 to September, 2020, 42 subjects with AIS were selected and randomly divided into brace group (n = 21) and brace combined with insole group (n = 21). Both groups received two-month routine rehabilitation, including braces for 22 to 23 hours a day and gymnastics for 30 minutes a day. The brace combined with insole group additionally wore insoles, at least eight hours a day for two months. Meanwhile, 32 even-aged adolescents were recruited as healthy controls. Firstly, gait and plantar pressure of 42 patients and 32 healthy adolescents were compared to find out abnormal indicators. Secondly, the scoliosis and above abnormal indicators were compared between the brace group and the brace combined with insole group Results:The center of pressure excursion index (CPEI) was higher in AIS group than in the healthy group (F = 3.120, P < 0.05), and there was no significant difference in walking speed, gait cycle and phase between two groups (P>0.05). An obvious imbalanced pressure was observed between the medial and lateral heel of the single foot and the bilateral foot in AIS patients (P < 0.05). After treatment, the Cobb's angle decreased in AIS patients (t > 7.552, P < 0.001), however, no difference was found between the brace group and the brace combined with insole group (t = 0.459, P > 0.05); the CPEI decreased (t = 2.209, P < 0.05), and the pressure in medial and lateral heel as well as the left and right foot tended to be balanced (t > 2.306, P < 0.05) in the brace combined with insole group, and were better than that of the brace group (|t| > 2.319, P < 0.05). Conclusion:Plantar pressure distribution shows obvious local and global asymmetric changes in AIS patients. The efficacy of insoles on the scoliosis is limited, but the insole can effectively improve the abnormal biomechanics and balance the force.
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Resumen: La necesidad de distanciamiento social impuesta por la actual pandemia por coronavirus obligó a las diferentes sociedades científicas a realizar sus actividades en formato completamente virtual. La Sociedad Europea de Cardiología no ha sido la excepción. Desde el 29 de agosto al 1 de septiembre de 2020 se celebró este evento sin precedentes que, además de contar con 125.000 profesionales de 213 países, permitió el acceso gratuito a todos los cibernautas. De esta manera, la actualidad en cardiología pudo llegar a todos los rincones del mundo, pese a las circunstancias tan complejas. Como ya es tradición de la revista, realizamos un resumen de los principales ensayos presentados durante el congreso: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)
Summary The need for social distancing imposed by the current coronavirus pandemic, forced the different scientific societies to carry out their activities in a completely virtual format. And the European Society of Cardiology has not been the exception. From August 29 to September 1 of 2020, this unprecedented event was held which, in addition to having 125,000 health professionals from 213 countries, allowed free access to all netizens. In this way, current affairs in cardiology could reach all corners of the world, despite such complex circumstances. As is the tradition of the magazine, we present a summary of the main essays presented during the congress: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)
Resumo A necessidade de distanciamento social imposto pela atual pandemia do coronavírus, obrigou as diferentes sociedades científicas a desenvolverem suas atividades de forma totalmente virtual. E a Sociedade Europeia de Cardiologia não foi exceção. De 29 de agosto a 1º de setembro 2020, foi realizado esse evento inédito que, além de contar com 125.000 profissionais de saúde de 213 países, possibilitou o acesso gratuito a todos os internautas. Dessa forma, a atualidade da cardiologia pode atingir todos os cantos do mundo, apesar de circunstâncias tão complexas. Como é tradição da revista, apresentamos um resumo dos principais ensaios apresentados durante o congresso: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)
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Objective@#To investigate the effect of the lower extremitas abduction brace pads which is designed by our team in helping patient turnover after orthopedic femoral neck fracture, intertrochanteric fracture, femoral head replacement.@*Methods@#Using prospective cohort study to facilitate sampling From October 2016 to August 2017, in an upper third-class hospital of Jiangsu province, we selected 100 patients in Orthopedics dept. No.1 at random as the experimental group and 80 patients in dept. No.2 as the control group. Lower extremitas abduction brace pads were used in experimental group and pillows, backrests and clothes were used in control group. Comfort level, incidence of skin pressure injury, joint dislocation rate and the compliance of the two groups were compared.@*Results@#The number of patients in experimental group who rated the comfort up to 3 (feel a little pain and uncomfortable) was much higher than that in control group (OD value was 5.801, P<0.01), while which rated 1 (feel painful, unbearable and extremely uncomfortable) was lower than that of control group (OD value was 0.168 ,P<0.01) . The ratio of stress injury and dislocation were lower in experimental group (OD value was 0.126, P=0.046). There was no significant difference between two groups in the ratio of dislocation after femoral head replacement (OD value was 0.000, P=0.444) and leg deep vein thrombosis (OD value was 0.000, P=1.000).@*Conclusion@#Lower extremitas abduction brace pads can effectively improve the comfort of the patients and reduce the ratio of stress injury.
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Objective：In athletes who are still in the growing period, lumbar spondylolysis is mainly treated with brace therapy to enable bone fusion. During the brace period, sports activities are often discontinued. The purpose of this study was to investigate how the combination of brace therapy and early physiotherapy affects the duration of return to play in athletes with lumbar spondylolysis.Methods：Thirty-seven athletes in the growing period with unilateral spondylolysis were included in the study. They were classified into two groups：17 patients who rested during the brace period (brace group) and 20 patients who combined the brace with early physical therapy (combination group). The examined items were duration of the brace period and duration from the end of the brace therapy to return to play (return period). Both these items were compared between the brace group and the combination group. In addition, the union rate of both groups was also calculated.Results：The return period was significantly shorter in the combination group than in the brace group. However, there were no statistically significant differences between the groups with respect to other data.Conclusion：Since there was no significant difference in the duration of the brace period and the union rate between both groups, we believe that early physical therapy intervention does not adversely affect bone union in athletes with spondylolysis who are in the growing period. Therefore, it is considered that the combined use of brace therapy and early physical therapy can maintain flexibility and muscular strength during the brace period and can enable a smooth transit to playing after the bone union is complete.
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Objective:To observe the effect of a wrist brace on activities of spastic hemiplegic hand after stroke, based on Botulinum toxin type A (BTX-A) injection and electrical stimulation. Methods:From January, 2016 to December, 2018, 52 stroke patients with spastic hemiplegia on upper extremities accepted BTX-A injection, and electrical stimulation two days later, while group A (n = 26) wore a wrist brace during stimulation and group B (n = 26) did not. They were assessed with modified Ashworth Scale (MAS), Box and Block test (BBt) and Action Research Arm Test (ARAT) before treatment (T0), and two (T1), four (T2) and twelve 12 (T3) weeks after treatment. Results:The scores of MAS, BBt and ARAT improved after treatment in both groups (Ftime > 118.32,P < 0.001), and improved more in group A than in group B in the scores of BBt and ARAT at each time point (Fgroup > 31.26,P < 0.001;Finteract = 10.65,P < 0.001). Conclusion:Based on the BTX-A injection and electrical stimulation, wearing a wrist brace would further improve the activities of hand for stroke patients.
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BACKGROUND: 3D printing external fixation fixture can make individualized external fixation scheme for fracture patients and is easy to wear. Zicao oil (a Chinese traditional medicine oil) for trauma treatment has the effect of reducing swelling and removing blood stasis to assist the rehabilitation treatment of fracture. The combination of the two could benefit the rehabilitation of patients with fracture conservative treatment. OBJECTIVE: To investigate the clinical application value of the 3D printed orthopedic cast combined with Zicao oil in the treatment of distal radial fracture, hoping to provide a basis for the further study of a combined Chinese and western medicine treatment scheme for the recovery of wrist function after distal radius fractures. METHODS: Sixty-four patients with distal radial fracture were selected and randomly divided into two groups. Patients in the trial group received 3D-printed cast combined with Zicao oil treatment after manual reduction. Patients in the control group received traditional splint cast combined with Zicao oil after manual reduction. The Jakim scoring for distal radial fracture treatment, as well as pain degree, swelling degree, wrist range of motion, grasping ability and deformity degree were evaluated and compared 2 weeks after removal of external fixation in both groups. RESULTS AND CONCLUSION: (1) The excellent and good rate was 94% in the trial group and 78% in the control group. There was significant difference between the two groups (P < 0.01). (2) At 2, 4, 8 and 14 days after treatment, the scores of wrist range of motion and visual analogue scale were significantly better than those before treatment (P < 0.01). At different time points after treatment, the scores of wrist range of motion and visual analogue scale in the trial group were significantly better than those in the control group (P < 0.05). (3) The swelling degree of the trial group was better than that of the control group 2, 4, 8 and 14 days after treatment (P < 0.05). (4) The results show that 3D printed cast combined with Zicao oil is effective in the treatment of distal radius fracture, can effectively improve the function of wrist joint, reduce the pain of patients and improve the quality of rehabilitation.
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BACKGROUND: Knee braces have been shown to improve knee mechanics in the case of slow walking, but most studies lack the data regarding the effects of a brace on knee injury in the case of lack of movement. OBJECTIVE: Jumping, emergency stop, rotation which easily induce knee joint injury during the rapid exercise were simulated to investigate whether silicon mesh braces can provide stable support for the knee joint and provide data support for the protection against anterior cruciate ligament injury. METHODS: Twelve healthy subjects were selected to perform three movements: Squatting, one-leg jump and steering jump respectively with and without a brace. Reflection markers were placed on the feet, calves, thighs, and pelvis of the subjects. A Qualisys motion capture system was used to obtain kinematic data of the knee joints. Knee joint motion was compared between with and without a brace. This study was performed by Medical Ethics Committee of Guizhou College of Traditional Chinese Medicine on August 8, 2018 (approval No. 2018661). RESULTS AND CONCLUSION: There were significant differences in the angle and angular velocity of the knee joint among sagittal plane, coronal plane, and horizontal plane. The knee joint valgus and internal rotation angle were reduced when wearing a brace in particular in one-leg jump and steering jump. The angular velocity of horizontal surface rotation also decreased obviously when wearing a brace. These findings suggest that wearing a brace can affect the motion mechanics of the knee joint in the coronal and horizontal planes. This suggests that knee joint can effectively control the stability when wearing a brace in the process of dynamic movement, and wearing a brace can improve the control of knee peak valgus angular velocity and external rotation angular velocity, which can help effectively prevent anterior cruciate ligament injury of patients with anterior cruciate ligament defects.
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Identifying maize genotypes with favorable root architecture traits for drought tolerance is prerequisite for initiating a successful breeding program for developing high yielding and drought tolerant varieties of maize. The aims of the present study were: (i) to identify drought tolerant genotypes of maize at flowering and grain filling, (ii) to interpret the correlations between the drought tolerance and root architecture traits and (iii) to identify the putative mechanisms of drought tolerance via root system traits. An experiment was carried out in two years using a split plot design with three replications. The main plots were assigned to three water stress levels, namely: well watering (WW), water stress at flowering (WSF) and water stress at grain filling (WSG), and sub-plots to 22 maize cultivars and populations. Drought tolerance index (DTI) had strong and positive associations with crown root length (CRL), root circumference (RC) and root dry weight (DRW) under both WSF and WSG, a negative correlation with brace root whorls (BW), and positive correlations with crown root number (CN) under WSF and brace root branching (BB) and crown root branching (CB) under WSG. These root traits are therefore considered as putative mechanisms of drought tolerance. The cultivars Pioneer-3444, SC-128, Egaseed-77, SC-10 and TWC-324 showed the most drought tolerant and the highest yielding in a descending order; each had a number of such drought tolerance mechanisms. Further investigation should be conducted to determine the underlying root mechanisms contributing to the selection of water-efficient hybrids of maize.
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Over 500,000 women die each year due to complications of pregnancy and childbirth, a number that has remained relatively unchanged since 1990, when the first global estimates of the burden of maternal mortality were developed. Hemorrhage due to uterine atony, adherent placenta and PPH are still the causes of maternal death in developing countries. Although advances have been made in the development of conservative medical and surgical treatment of obstetric haemorrhage like brace sutures, internal iliac artery ligation, selective arterial embolization etc emergency obstetric hysterectomy remains a lifesaving procedure in the management of intractable haemorrhage unresponsive to conservative management.