spinal orthoses

Question 1

orthotic goals

Answer 1

correction, accommodation, stabilize, reduce pain

Question 2

correction goal

Answer 2

• for flexible deformity
• restore follower load
• reduce moment

Question 3

how do we measure correction? success?

Answer 3

measure by doing a Cobb angle

Question 4

accommodation goal

Answer 4

• for fixed deformity
• want to prevent deformity from progressing

Question 5

stabilization goal

Answer 5

• limit gross vertebral sway
• decrease moment
• increase load carrying capacity
• ex: fractures

Question 6

reduce pain goal condition examples

Answer 6

spondylylosis and spondylothesis

Question 7

free desired control

Answer 7

motion is free
- ex: elastic binder

Question 8

stop desired control

Answer 8

posterior component that stops ext

Question 9

hold desired control

Answer 9

limiting motion throughout entire plane
- ex: burst fracture

Question 10

hold-variable desired control

Answer 10

mainly used for transverse plane; allows best chance at managing rotary deformities

Question 11

list of biomechanical principles of spinal orthoses

Answer 11

• end-point control
• total contact
• three point pressure system
• kinesthetic reminder
• increased intracavitary pressure

Question 12

what is end-point control

Answer 12

motion control of a free body

Question 13

what theory is associated with end-point control

Answer 13

Euler’s theory

Question 14

critical load definition

Answer 14

upper limit of a load that the spine can withstand before it bends

Question 15

end-point control application

Answer 15

scoliosis to increase stability

Question 16

end-point control explanation for curve progression during height/weight changes

Answer 16

10% increase in height or weight changes leads to an automatic 20% decrease in the critical load or spinal stability

Question 17

total contact purpose

Answer 17

applying forces to get correction
- pressure = force/area

Question 18

what is the three-point pressure system

Answer 18

2 forces going in the same direction and the 3rd force going in an equal and opposite direction

Question 19

what is the purpose of a three-point pressure system

Answer 19

• trying to limit motion
• encourage person to withdraw from the stimulus
• introducing a higher shear to moment ratio

Question 20

three-point pressure system application

Answer 20

used with someone who has a compression fracture

Question 21

alternative to three-point pressure system

Answer 21

• introduces a more bending moment and taking away the shear
• more comfortable for patient
• designed into an extended position

Question 22

alternative to three-point pressure application

Answer 22

good for kyphosis

Question 23

kinesthetic reminder purpose

Answer 23

• reminder to move in a manner slower than normal
• creates a stimulus to withdraw

Question 24

increased intra-cavitary pressure purpose

Answer 24

• trying to achieve a reduction in discal pressure

Question 25

which pathologies do you want to put into an extended position

Answer 25

burst fracture, seatbelt fracture, disc herniation, or compression fracture

Question 26

which pathologies do you want to put into a flexed position

Answer 26

spondylolysis, spondylylothesis, central stenosis, or lateral stenosis

Question 27

corset biomechanical properties

Answer 27

total contact, kinesthetic reminder, increased intracavitary pressure, modified three point pressure system

Question 28

corset pathologies

Answer 28

muscle strain, post-surgical, low back pain, maternity

Question 29

which spinal orthosis is the least effective at limiting gross trunk motion

Answer 29

corsets

Question 30

total contact biomechanical principles

Answer 30

three point pressure system, end-point control, kinesthetic reminder, increased intracavitary pressure

Question 31

how do you don/doff a total contact spinal system

Answer 31

in supine to reduce axial load on the spine

Question 32

idiopathic adolescent scoliosis gender and curve progression

Answer 32

females, the bigger the curve the more likely it will progress

Question 33

TLSO location

Answer 33

T7 and below

Question 34

CTLSO location

Answer 34

T7 and above

Question 35

idiopathic adolescent scoliosis mechanisms to manage curves

Answer 35

curve correction, end-point control, and transverse load

Question 36

how long should you wear an orthosis per day

Answer 36

more than 6 hours but less than 18 hours

Question 37

greatest influence on patient compliance regarding wearing of the orthosis

Answer 37

- difficulty paying attention in school - emotional about having to wear orthosis - problems with eating - difficulty in sitting - breathing - look worse in clothes

Question 38

neuromuscular scoliosis population

Answer 38

spina bifida, non-ambulatory

Question 39

what is cast syndrome

Answer 39

loss of extension or lordosis