Assessment of spinal movement reduction by thoraco-lumbar-sacral orthoses.

Bracing is a common modality in treating spinal fractures. Its objective is to reduce spinal movements and to stabilize the fracture. Until now, factual insight into the movement-reducing properties of Thoraco-Lumbar-Sacral Orthoses (TLSOs) has been missing. Two common TLSOs (e.g., Jewett and Voigt-Bähler) were tested for their movement-reducing properties in two small groups of healthy subjects. In the first study, maximal gross spinal movements, with and without a TLSO, were measured by means of a Portable Posture Registration Set (PPRS) in three different planes. In the second study, maximal segmental vertebral movements in the regions T10 to L4 were measured via X-rays. With few notable exceptions, wearing a TLSO, as measured by the PPRS and X-ray techniques, significantly reduced the segmental as well as gross spinal movements. However, the amount of movement reduction varied greatly from subject-to-subject and was sometimes small. Unfortunately, data are lacking on the amount of movement reduction that is clinically relevant.

A comparison of working postures of parcel sorters using three different working methods.

The postures of the trunk of eight parcel sorters were measured continuously under three different working conditions, during whole shifts. The working methods used were two different sorting tables and a hydraulic lifting platform on which the carts were to be placed. The question posed by the PTT-Post occupational health service was whether the latter method proved to be the better one with respect to the load on the musculoskeletal system. This study will help them to make a well-considered decision on which working method to choose for the new distribution centre in Rotterdam. The method used for measuring the working postures and movements of the trunk is the Portable Posture Registration Set (PPRS). This method was developed at the department of Biomedical Physics and Technology of the Erasmus University Rotterdam. While using the lifting platform, the subjects stood 8-11% more erect compared to the work at the sorting tables, thereby reducing the load on the lumbar spine. For this reason the lifting platform is preferred, although sagittal flexion of the back was somewhat more. It is stressed that the way in which sorters use the lifting platform is very important.