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1.
Spine (Phila Pa 1976) ; 47(8): E353-E361, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35500086

RESUMO

STUDY DESIGN: Systematic literature review. OBJECTIVE: The aim of this study was to systematically review the literature and provide an overview of reported predictive factors on initial in-brace correction in patients with idiopathic scoliosis (IS). SUMMARY OF BACKGROUND DATA: Brace therapy is the best proven non-surgical treatment for IS. There is strong evidence that lack of initial in-brace correction is associated with brace treatment failure. To improve initial in-brace corrections and subsequently long-term brace treatment success, knowledge about factors influencing initial in-brace correction is a prerequisite. METHODS: A systematic literature search was performed in Pubmed, Embase, Web-of-Science, Scopus, Cinahl, and Cochrane in November 2020. Studies which reported factors influencing initial in-brace correction in IS patients treated with brace therapy were considered eligible for inclusion. RESULTS: Of the 4562 potentially eligible articles identified, 28 studies fulfilled the inclusion criteria and were included in this systematic review. Nine studies (32%) were classified as high quality studies and the remaining 19 studies (68%) as low quality. Thirty-four different reported factors were collected from the included studies. Strong evidence was found for increased curve flexibility as favorable predictive factor for initial in-brace correction. Moderate evidence was found for thoracolumbar or lumbar curve pattern as favourable predictive factor, and double major curve pattern as unfavourable predictive factor for initial in-brace correction. Also moderate evidence was found that there is no significant difference on initial in-brace correction between computer-aided design and manufacturing systems (CAD/CAM) braces with or without finite element models (FEM) simulation, and braces fabricated using the conventional plaster-cast. CONCLUSION: The results of this systematic review indicate that increased curve flexibility is strongly associated with increased initial in-brace correction.Level of Evidence: 1.


Assuntos
Braquetes , Escoliose , Moldes Cirúrgicos , Simulação por Computador , Desenho Assistido por Computador , Humanos , Escoliose/diagnóstico , Escoliose/terapia
2.
Sensors (Basel) ; 22(7)2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35408046

RESUMO

The recommended treatment for idiopathic congenital clubfoot deformity involves a series of weekly castings, surgery, and a period of bracing using a foot abduction brace (FAB). Depending on the age of the child, the orthotic should be worn for periods that reduce in duration as the child develops. Compliance is vital to achieve optimal functional outcomes and reduce the likelihood of reoccurrence, deformity, or the need for future surgery. However, compliance is typically monitored by self-reporting, which is time-consuming to implement and lacks accuracy. This study presents a novel method for objectively monitoring FAB wear using a single 3-axis accelerometer. Eleven families mounted an accelerometer on their infant's FAB for up to seven days. Parents were also given a physical diary that was used to record the daily application and removal of the orthotic in line with their treatment. Both methods produced very similar measurements of wear that visually aligned with the movement measured by the accelerometer. Bland Altman plots showed a -0.55-h bias in the diary measurements and the limits of agreement ranging from -2.96 h to 1.96 h. Furthermore, the Cohens Kappa coefficient for the entire dataset was 0.88, showing a very high level of agreement. The method provides an advantage over existing objective monitoring solutions as it can be easily applied to existing FABs, preventing the need for bespoke monitoring devices. The novel method can facilitate increased research into FAB compliance and help enable FAB monitoring in clinical practice.


Assuntos
Pé Torto Equinovaro , Órtoses do Pé , Acelerometria , Braquetes , Criança , Pé Torto Equinovaro/cirurgia , Humanos , Lactente , Resultado do Tratamento
3.
IEEE J Transl Eng Health Med ; 10: 1800308, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35391755

RESUMO

OBJECTIVE: A repeatable and reliable follow-up of knee injuries would be desirable to prevent delayed diagnosis and to monitor the efficacy of the applied treatment over time. Ultrasound (US) techniques are an attractive option to this purpose, since they are safe, low-cost and non-invasive. However, its use in the clinical practice is limited by the high dependency on the operator's experience. Hence, the objective of this study is to provide a standardization of the US image acquisition process for knee osteoarthritis (OA) allowing an extended clinical use of US technologies in this domain. METHODS: Clinical specifications were provided by expert musculoskeletal radiologists thus identifying the subject poses and the US probe positions needed to evaluate the cartilage structure, signs of synovitis and joint effusion. Such considerations were used to derive the technical requirements needed for the development of a wearable brace equipped with specific openings to guide the correct placement of the probe. The feasibility of the developed wearable brace was tested on three healthy volunteers, which were asked to acquire informative US images, similar to the reference images performed by the musculoskeletal radiologist. RESULTS: Thanks to the knee brace, the untrained subjects were able to self-acquire informative B-mode images comparable to the corresponding images acquired by an expert clinician. DISCUSSION/CONCLUSION: The use of a knee brace intended for knee OA US diagnosis demonstrated the possibility to standardize the acquisition protocol and make its application achievable also for untrained subjects, representing a key step toward tele-ultrasonography.


Assuntos
Osteoartrite do Joelho , Sinovite , Braquetes , Humanos , Articulação do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/diagnóstico por imagem , Ultrassonografia
4.
Comput Intell Neurosci ; 2022: 6775674, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392047

RESUMO

In recent years, artificial intelligence technology has been widely used in various medical fields to effectively assist physicians in patient treatment operations. In this paper, we design and implement a deep biblical network model-based orthotic design for adolescent idiopathic scoliosis to quickly and effectively assist physicians in designing orthotics for adolescent idiopathic scoliosis. A fuzzy set is used to express the knowledge of adolescent idiopathic scoliosis orthosis design, and a fuzzy reasoning based on the confidence level is implemented. Finally, the efficiency of the design of adolescent idiopathic scoliosis orthoses was improved by 50% through two cases of adolescent idiopathic scoliosis patients, and the deviation rate between the inference value and the actual operation value of the domain experts was less than 10%.


Assuntos
Escoliose , Adolescente , Inteligência Artificial , Braquetes , Humanos , Aparelhos Ortopédicos , Escoliose/reabilitação , Resultado do Tratamento
5.
BMC Musculoskelet Disord ; 23(1): 406, 2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35490213

RESUMO

PURPOSE: Brace treatment for adolescent idiopathic scoliosis is recognized as effective if the brace is worn as prescribed (20 to 23 hrs/day). Because of its negative biopsychosocial impact on adolescent patients' quality of life, brace adherence is a common problem (average bracewear of 12 hrs/day). The purpose of this paper is to develop an interprofessional support intervention model to enhance brace adherence in adolescents with scoliosis. METHODS: We enrolled 9 health professionals working with braced patients to participate in individual interviews. Interview guides were built following the Information-Motivation-Strategy Model (DiMatteo et al., Health Psychol Rev 6:74-91, 2012) and the Interprofessional Care Competency Framework (Education UoTCfI, Toronto Acad Health Sci Network, 2017). Thematic analysis was performed to identify the most relevant concepts for designing the intervention model. A panel of 5 clinical experts was recruited to review and validate the intervention model. RESULTS: Participants suggested educational, motivational, functional, psychological and interprofessional teamwork strategies to improve the support provided to patients and parents and potentially increase brace adherence. Using the emerging themes and their relationships, we designed an Interprofessional Adherence Support (IPAS) intervention model that identifies the actors, activities, structure and intended impacts of the intervention. According to the expert panel, the IPAS model is highly relevant to respond to the brace adherence problem and has potential for implementation in practice. CONCLUSION: We designed an interprofessional support intervention model based on professional perspectives in response to the brace adherence problem in adolescents with scoliosis. Plans for implementation of the IPAS model at our scoliosis clinic are under development and considered essential for improving brace treatment outcomes.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Humanos , Pesquisa Qualitativa , Qualidade de Vida , Escoliose/psicologia , Escoliose/terapia
6.
Bone Joint J ; 104-B(4): 495-503, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35360943

RESUMO

AIMS: The aim of this study was to assess the ability of morphological spinal parameters to predict the outcome of bracing in patients with adolescent idiopathic scoliosis (AIS) and to establish a novel supine correction index (SCI) for guiding bracing treatment. METHODS: Patients with AIS to be treated by bracing were prospectively recruited between December 2016 and 2018, and were followed until brace removal. In all, 207 patients with a mean age at recruitment of 12.8 years (SD 1.2) were enrolled. Cobb angles, supine flexibility, and the rate of in-brace correction were measured and used to predict curve progression at the end of follow-up. The SCI was defined as the ratio between correction rate and flexibility. Receiver operating characteristic (ROC) curve analysis was carried out to assess the optimal thresholds for flexibility, correction rate, and SCI in predicting a higher risk of progression, defined by a change in Cobb angle of ≥ 5° or the need for surgery. RESULTS: The baseline Cobb angles were similar (p = 0.374) in patients whose curves progressed (32.7° (SD 10.7)) and in those whose curves remained stable (31.4° (SD 6.1)). High supine flexibility (odds ratio (OR) 0.947 (95% CI 0.910 to 0.984); p = 0.006) and correction rate (OR 0.926 (95% CI 0.890 to 0.964); p < 0.001) predicted a lower incidence of progression after adjusting for Cobb angle, Risser sign, curve type, menarche status, distal radius and ulna grading, and brace compliance. ROC curve analysis identified a cut-off of 18.1% for flexibility (sensitivity 0.682, specificity 0.704) and a cut-off of 28.8% for correction rate (sensitivity 0.773, specificity 0.691) in predicting a lower risk of curve progression. A SCI of greater than 1.21 predicted a lower risk of progression (OR 0.4 (95% CI 0.251 to 0.955); sensitivity 0.583, specificity 0.591; p = 0.036). CONCLUSION: A higher supine flexibility (18.1%) and correction rate (28.8%), and a SCI of greater than 1.21 predicted a lower risk of progression. These novel parameters can be used as a guide to optimize the outcome of bracing. Cite this article: Bone Joint J 2022;104-B(4):495-503.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Feminino , Humanos , Estudos Retrospectivos , Escoliose/diagnóstico , Escoliose/terapia , Coluna Vertebral
7.
Eur Spine J ; 31(4): 980-989, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35190896

RESUMO

PURPOSE: Studies have shown that bracing is an effective treatment for patients with idiopathic scoliosis. According to the current classification, almost all braces fall in the thoracolumbosacral orthosis (TLSO) category. Consequently, the generalization of scientific results is either impossible or misleading. This study aims to produce a classification of the brace types. METHODS: Four scientific societies (SOSORT, SRS, ISPO, and POSNA) invited all their members to be part of the study. Six level 1 experts developed the initial classifications. At a consensus meeting with 26 other experts and societies' officials, thematic analysis and general discussion allowed to define the classification (minimum 80% agreement). The classification was applied to the braces published in the literature and officially approved by the 4 scientific societies and by ESPRM. RESULTS: The classification is based on the following classificatory items: anatomy (CTLSO, TLSO, LSO), rigidity (very rigid, rigid, elastic), primary corrective plane (frontal, sagittal, transverse, frontal & sagittal, frontal & transverse, sagittal & transverse, three-dimensional), construction-valves (monocot, bivalve, multisegmented), construction-closure (dorsal, lateral, ventral), and primary action (bending, detorsion, elongation, movement, push-up, three points). The experts developed a definition for each item and were able to classify the 15 published braces into nine groups. CONCLUSION: The classification is based on the best current expertise (the lowest level of evidence). Experts recognize that this is the first edition and will change with future understanding and research. The broad application of this classification could have value for brace research, education, clinical practice, and growth in this field.


Assuntos
Braquetes , Escoliose , Consenso , Humanos , Aparelhos Ortopédicos , Escoliose/terapia , Resultado do Tratamento
8.
Expert Rev Med Devices ; 19(2): 113-122, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35130797

RESUMO

INTRODUCTION: Ankle sprains are common injuries within the civilian and military populations, with lingering symptoms that include pain, swelling, giving-way, and a high likelihood for recurrence. Numerous bracing systems are available to stabilize the ankle joint following sprains, with new design iterations frequently entering the market. Currently available braces generally include sleeve, lace-up, and stirrup designs. Sleeves provide mild compression and warmth but limited stability for the ankle, while lace-ups and stirrups appear to be more effective at preventing and treating lateral ankle sprains. AREAS COVERED: This review summarizes the use of various brace options in practice. Their major clinical benefits, and limitations are highlighted, followed by an overview of emerging concepts in brace design. Current advancements in biomechanical simulation, multifunctional material fabrication, and wearable, field-deployed devices for human injury surveillance are discussed, providing possibilities for conceiving new design concepts for next-generation smart ankle braces. EXPERT OPINION: Performance of the commercially available braces are limited by their current design concepts. Suggestions on future brace design include: (1) incorporating high-performance materials suitable for extreme environments, (2) leveraging modeling and simulation techniques to predict mechanical support requirements, and (3) implementing adaptive, customizable componentry material to meet the needs of each unique patient.


Assuntos
Traumatismos do Tornozelo , Militares , Entorses e Distensões , Traumatismos do Tornozelo/prevenção & controle , Articulação do Tornozelo , Braquetes , Humanos
9.
Med Biol Eng Comput ; 60(4): 907-920, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35157195

RESUMO

Adolescent idiopathic scoliosis (AIS) is a musculoskeletal disorder characterized as three-dimensional (3D) deformity, and bracing is a common conservative treatment for AIS. Finite element analysis (FEA) is a technique for numerically solving the differential equations arising in engineering and mathematical modeling and has been widely used in biomechanical studies. Recently, FEA has been under intensive focus to improve the clinical outcomes of brace treatment. This review focuses on using FEA to assist brace treatment for AIS and technique choices that may be encountered during the construction of the finite element model (FEM). The construction of geometric models, the mechanical property, element type, the boundary condition, and the observation items of FEA have been summarized while establishing FEM. In each technical aspect, different fields and limitations of FEA are discussed. The observation items based on FEA are collected in addition to the biomechanical value in clinical research. We also summarized the technical aspects of brace treatment by FEA and observation items and provided guidance and directions to improve the brace treatment.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Análise de Elementos Finitos , Humanos , Escoliose/terapia
10.
Pediatrics ; 149(2)2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35104362

RESUMO

Idiopathic congenital clubfoot is the most common serious musculoskeletal birth defect in the United States and the world. The natural history of the deformity is to persist into adult life with a significant decrease in function and quality of life. The Ponseti method (serial casting, Achilles tenotomy, and bracing of the clubfoot) has become the most effective and accepted treatment of children born with clubfoot worldwide. The treatment is successful, particularly when the Ponseti-trained practitioner (often a pediatric orthopedic surgeon), the primary care clinician, and the family work together to facilitate success. An important factor in the ultimate success of the Ponseti method is parental understanding of the bracing phase. There is a very high rate of recurrent deformity when bracing is not done properly or is stopped prematurely. The importance of positive education and support for the parents to complete the entire treatment protocol cannot be overstated. The goal of treatment is a deformity-free, functional, comfortable foot. Ponseti clubfoot programs have been launched in most countries throughout the world, including many countries with limited resources. Ultimately, the goal is that every infant born with a clubfoot will have access to care with the Ponseti method. This clinical report is intended for medical practitioners who are involved in the care of pediatric patients with clubfoot. Understanding the standard of care will help these practitioners to care for patients and their families.


Assuntos
Braquetes , Pé Torto Equinovaro/diagnóstico por imagem , Pé Torto Equinovaro/terapia , Tenotomia/métodos , Ultrassonografia Pré-Natal/métodos , Braquetes/tendências , Humanos , Tenotomia/tendências , Resultado do Tratamento , Ultrassonografia Pré-Natal/tendências
11.
Sci Rep ; 12(1): 1846, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35115632

RESUMO

Adolescent idiopathic scoliosis (AIS) is the most prevalent pediatric spinal deformity. We previously demonstrated elongated cilia and an altered molecular mechanosensory response in AIS osteoblasts. The purpose of this exploratory study was to characterize the mechanosensory defect occurring in AIS osteoblasts. We found that cilia length dynamics in response to flow significantly differ in AIS osteoblasts compared to control cells. In addition, strain-induced rearrangement of actin filaments was compromised resulting in a failure of AIS osteoblasts to position or elongate in function of the bidirectional-applied flow. Contrary to control osteoblasts, fluid flow had an inhibitory effect on AIS cell migration. Moreover, flow induced an increase in secreted VEGF-A and PGE2 in control but not AIS cells. Collectively our data demonstrated that in addition to the observed primary cilium defects, there are cytoskeletal abnormalities correlated to impaired mechanotransduction in AIS. Thus, we propose that the AIS etiology could be a result of generalized defects in cellular mechanotransduction given that an adolescent growing spine is under constant stimulation for growth and bone remodeling in response to applied mechanical forces. Recognition of an altered mechanotransduction as part of the AIS pathomechanism must be considered in the conception and development of more effective bracing treatments.


Assuntos
Citoesqueleto de Actina/metabolismo , Cílios/metabolismo , Mecanotransdução Celular , Osteoblastos/metabolismo , Escoliose/metabolismo , Coluna Vertebral/metabolismo , Citoesqueleto de Actina/patologia , Adolescente , Braquetes , Estudos de Casos e Controles , Movimento Celular , Células Cultivadas , Criança , Cílios/patologia , Dinoprostona/metabolismo , Feminino , Humanos , Osteoblastos/patologia , Escoliose/patologia , Escoliose/terapia , Coluna Vertebral/patologia , Estresse Mecânico , Fator A de Crescimento do Endotélio Vascular/metabolismo
12.
Ned Tijdschr Geneeskd ; 1662022 01 11.
Artigo em Holandês | MEDLINE | ID: mdl-35138734

RESUMO

In a recent article in the BMJ an attempt is made to evaluate the difference in effect of after-treatment with a cast or a brace in case of an ankle fracture. Although the research question is important, the heterogeneity of the researched group is too high to get a practical outcome for our daily practice. The article is discussed and comments are given on possible alterations for future analysis of the presented study group.


Assuntos
Fraturas do Tornozelo , Assistência ao Convalescente , Fraturas do Tornozelo/terapia , Articulação do Tornozelo , Braquetes , Moldes Cirúrgicos , Humanos
14.
J Knee Surg ; 35(3): 255-265, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35088398

RESUMO

Anterior cruciate ligament (ACL) injuries and surgeries are both increasing in incidence. A notable rate of reinjury and failure does occur after ACL surgery. As a result, interventions that may reduce ACL injury or reinjury are needed and are active areas of innovation. Knee bracing as a strategy to either prevent primary ACL injury, reduce reinjury, or failure after ACL surgery is common. The evidence for bracing around ACL injuries is not straightforward. Clinicians therefore need to understand the relevant literature on bracing around ACL injuries to make personalized decisions for individuals who may be at risk for ACL injury. The purpose of this review is to provide an overview on bracing for ACL injuries and summarize the current available clinical evidence for its use in ACL injuries.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Braquetes , Humanos , Incidência
15.
Spine Deform ; 10(3): 537-542, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35028915

RESUMO

PURPOSE: Bracing treatment for adolescent idiopathic scoliosis (AIS) is typically initiated in skeletally immature patients with primary curves greater than 25°. The goal of this study was to develop a model predicting a patient's likelihood of progressing to bracing treatment. METHODS: All patients with AIS presenting to a large pediatric spine center with a primary curve below 25° and skeletally immature (Sanders stage 1-6) were included. A patient was considered to have progressed into the bracing range if their primary curve reached a 25° threshold prior to skeletal maturity. Binary logistic regression analysis was performed to predict the likelihood of curve progression into bracing range. RESULTS: A total of 180 patients (71% female) were included in this study with an average presenting age of 13.2 ± 1.4 years. At presentation, 31 (17%) were pre-peak height velocity, 62 (34%) were at their peak height velocity, and 87 (48%) were in the late adolescent growth stage. The high-risk patient group was defined as Sanders 1-2 and curve size > 10 and < 25° or Sanders 3-6 and curve size > 20 but < 25°. Those in the high-risk group demonstrated an over 5 times higher risk of progression to bracing range when accounting for age, sex, and curve location (OR: 5.168, 95% CI: 2.212-12.071, p < 0.001). CONCLUSION: Patient's curve magnitude and skeletal maturity can be used to predict their likelihood of curve progression to greater than 25° and thus require bracing treatment. Orthopaedic providers can consider earlier treatment interventions or stricter follow-up adherence for patients at high risk for progression. LEVEL OF EVIDENCE: 3-retrospective cohort study.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Escoliose/terapia , Coluna Vertebral
16.
Spine Deform ; 10(3): 543-551, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35034344

RESUMO

PURPOSE: To investigate the relationship between coronal deformity angular ratio (C-DAR) and in-brace correction (IBC) and their role in predicting the long-term bracing outcome in adolescents with idiopathic scoliosis (AIS). METHODS: In this retrospective multicenter study, the patient's sex, age, primary curve Cobb angle (at initiation of brace treatment, best in-brace, before spinal fusion, and final follow-up), curve pattern, duration of brace treatment, brace type, and C-DAR at initiation of bracing were recorded. The C-DAR values were classified as < 5, 5 ≤ to ≤ 6, and > 6. The IBC values were classified as ≥ 50%, 40% ≤ to ≤ 49%, and < 40%. We classified the patients into two groups of success and failure according to the Cobb angle at the final follow-up. RESULTS: A total of 164 patients (25 boys and 119 girls) were included. Bracing was successful in 60.4% of them. There was a significant association between C-DAR and bracing outcome (p < 0.0001). 63.9% of the patients with C-DAR < 5 had an IBC ≥ 50%. However, when C-DAR was 5 ≤ to ≤ 6 and > 6, 29.2% and 16.9% of the patients had an IBC of ≥ 50%, respectively. For patients with IBC ≥ 50%, the success rate of bracing was 89.2%. Results of logistic regression analysis revealed that the strongest predictor for brace treatment outcome was the C-DAR, with an odds ratio of 2.11. CONCLUSION: C-DAR may be used as a predictive factor for the long-term outcome of brace treatment in AIS. LEVEL OF EVIDENCE: IV.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Feminino , Humanos , Masculino , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Escoliose/terapia , Resultado do Tratamento
17.
Medicine (Baltimore) ; 101(1): e28429, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-35029888

RESUMO

INTRODUCTION: New-onset scoliosis in adults is different from that in congenital and idiopathic scoliosis. We applied personalized custom 3D printed orthopedic braces combined with traditional manipulative physiotherapy to treat adult patients with new-onset scoliosis and observed the effectiveness of the treatment. PATIENT CONCERNS: Nine patients aged 20-52 years presented with unequal height of hips and asymmetrical waist. One shoulder was obviously protruding or enlarged compared to the other; when lying on the bed, the legs were not equal in length, and when bending down, the back was not equal on the left and right. DIAGNOSIS: New-onset scoliosis. INTERVENTIONS: Application of individual customized 3D printing brace combined with traditional treatment. Evaluation of clinical efficacy after treatment, including functional exercise test (FMS) before and after treatment, ability of daily living (ADL), visual analog pain score (VAS), and scoliosis angle (Cobb angle). OUTCOMES: The total effective treatment rate was 100.00% (9/9). The VAS score, Cobb angle of the spine, FMS test, and ADL test were significantly improved compared with those before treatment. CONCLUSION: The customized 3D printed orthopedic brace combined with traditional techniques to treat scoliosis and innovatively combined human bionic technology with traditional medicine to achieve the continuity and precise correction of scoliosis treatment is a clinically effective technique.


Assuntos
Braquetes , Modalidades de Fisioterapia , Impressão Tridimensional , Escoliose/diagnóstico por imagem , Escoliose/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coluna Vertebral/diagnóstico por imagem , Resultado do Tratamento
18.
J Knee Surg ; 35(3): 232-241, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35088399

RESUMO

Patellofemoral disorders are common causes of knee pain that result in frequent visitations to musculoskeletal care clinics. Patellar tendinopathy, patellar instability and patellar maltracking, and pain are some of the most common pathologies resulting in patellofemoral dysfunction. For each of these diagnoses, there are unique orthoses and braces available, some of which are uniquely designed to address the pathology involved. While the spectrum of patellofemoral disorders is wide ranging and can often be challenging to treat, bracing frequently plays a large role in the overall treatment algorithm. In this article, we summarized the current literature and treatment recommendations related to the most common types of patellar braces. We performed a thorough review of randomized controlled trials and up to date literature to reach well-informed conclusions on current best practice regarding the uses of patellar braces for patellofemoral disorders.


Assuntos
Instabilidade Articular , Articulação Patelofemoral , Fenômenos Biomecânicos , Braquetes , Humanos , Articulação do Joelho , Patela , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
BMC Musculoskelet Disord ; 23(1): 88, 2022 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-35081931

RESUMO

OBJECTIVES: We retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method. METHODS: We retrospectively reviewed all children with congenital clubfoot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples' Hospital Ethics Committee. RESULTS: In this study, there were 148 cases (164 ft) in total that underwent the Ponseti method, with the follow-up period at least 5 years. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50 ± 2.15 months. The average initial Pirani score was 4.98 ± 1.33, and the average number of casts was 5.71 ± 2.28 times. The mean age of mothers at birth was 25.81 ± 2.38 years old. The walking age of children was at a mean of 14.83 ± 1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 ft (76.4%). The average follow-up period was 7.27 ± 1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group . CONCLUSION: The initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.


Assuntos
Pé Torto Equinovaro , Adulto , Braquetes , Moldes Cirúrgicos , Criança , Pé Torto Equinovaro/diagnóstico , Pé Torto Equinovaro/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Recidiva , Estudos Retrospectivos , Tenotomia , Resultado do Tratamento , Adulto Jovem
20.
J Med Case Rep ; 16(1): 20, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34986882

RESUMO

BACKGROUND: The recommended treatment for mild to moderate infantile idiopathic scoliosis curves involves serial casting. There are concerns, however, regarding the safety of repeated casting in very young children owing to the requirement for anesthetization during the casting process. Very little research has been conducted on the influence of bracing as an initial treatment for scoliosis in this age group. This report details the successful treatment of a large thoracic curve using a thoracolumbosacral orthosis in an infant diagnosed with infantile idiopathic scoliosis. CASE PRESENTATION: The Dutch-Australian patient presented at 11 weeks of age with a 44° thoracic scoliosis and a rib vertebral angle difference of 14°. The history and physical examination failed to reveal a cause of the curvature, and a diagnosis of infantile idiopathic scoliosis was made. The patient was prescribed a thoracolumbosacral orthosis (ScoliBrace) to be worn on a part-time basis for a period of 8 months. At the end of the bracing program, the patient's curve had been reduced to 7° and a rib-vertebral angle difference of 0°. A final follow-up of the patient at 2 years after the cessation of treatment revealed no evidence of scoliosis. The parents were compliant with the bracing protocol and reported that the treatment was tolerated by the infant. CONCLUSION: The use of an orthosis as a standalone treatment in this patient resulted in significant reduction in a large thoracic scoliosis. Based on the results witnessed in this patient, further investigation into bracing as an alternative to casting is warranted.


Assuntos
Escoliose , Austrália , Braquetes , Criança , Pré-Escolar , Humanos , Lactente , Aparelhos Ortopédicos , Estudos Retrospectivos , Escoliose/terapia , Resultado do Tratamento
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