Lecture 5: Spine Orthoses Flashcards

Question

what are rigid trunk orthoses

Answer 1

most often made of molded plastic purpose = protect spine and facilitate healing utilize 3 point counterforce system

Answer 2

restrict spinal motion limit thoracic flexiona or supporting an excessive thoracic kyphosis prevent progression of scoliotic curves * depending on design can alter breathing patterns; reduced total volume and increased RR

Answer 3

sagittal = rigid AP panel frontal = rigid panel in mid axillary line transverse - LSO = less effective at controlling RT since trunk RT mainly happens at T/S - TLSO = more effective at controlling transverse plane trunk movement

Answer 4

chair back - sagittal plane control knight LSO - sagittal and frontal plane control clamshell body jacket - sagittal, frontal, and transverse plane control

Answer 5

controls all planes of movement don/doff in supine since pt may not be allowed to be upright without wearing brace

Answer 6

restricts motion from T6 to L1 limit flexion, allows extension evidence suggests no additive benefit of orthoses

Answer 7

restricts motion from T6 to L1 limit flexion, allows ext

Answer 8

evidence suggests similar outcomes to postural training in adults

Answer 9

use of custom rigid lumbar brace for 3 months may reduce pain intensity

Answer 10

minimal impact on sagittal and transverse plane movement restricts some frontal plane movement mixed evidence on impact on back and abdominal mm strengthening

Answer 11

back braces may relieve pain per self report also important to edu on proper form

Answer 12

used in pts with LBP due to hypo mobility assist with stabilizing SIJ

Answer 13

PT, manipulation, acupuncture, multi modal interventions, or addition of rigid pelvic belt to exercise seemed to relieve pelvic or back pain more than usual care alone

Answer 14

common in adolescents and females LBP prevalence = 40% onset at younger age and larger curve = worse prognosis

Answer 15

idiopathic congenital neuromuscular

Answer 16

due to mm imbalance and/or weakness common in pts with CP, muscular dystrophy, SCI, or with leg length discrepancy

Answer 17

based on direction of CONVEXITY and location in spine

Answer 18

same side as convexity

Answer 19

long spinal fusion common if curve is greater than 45 deg

Answer 20

prevent worsening of curve until growth stops for those with adolescent idiopathic: - worn during times of growth - recommended for curves between 25-45 deg that have progressed at least 5 deg since initial detection

Answer 21

daytime = work minimum of 18 hours; preferable 23 hours/day nighttime = worn 8-10 hours per day 5-7 nights/week

Answer 22

first step to avoid or postpone sx brace for curves 20 deg +/- 5 that are progressing rigid bracing recommended for infants and curves between 45-60 deg to avoid sx full time wear or no less than 18 hours/day brace worn until end of bony growth monitor compliance and brace for periodic radiographs to monitor effectiveness of brace

Answer 23

CTLSO good for superior curves supically used for curves with apex T6 or above

Answer 24

custom TLSO good for lower thoracic and lumbar curves brace wear was considered successful (curve didn't progress to 50 deg) in 72% pts (68% with Boston brace) outcomes improved with brace wear time

Answer 25

custom total contact TLSO curve progressed (>5 deg) for compliance around 62% curve did not progress with compliance >85%

Answer 26

custom TLSO over corrects curve most effective for curves with apex below T7 recommended for curves 20-40 deg

Answer 27

custom TLSO over corrects curve more often used for S curves than Charleston bending brace

Answer 28

dynamic brace good for early prevention should be worn >20 hours/day may not be as effective as rigid braces