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Maryam Hekmatfard,Mohammad Ali Sanjari,Nader Maroufi,Hassan Saeedi,Esmail Ebrahimi,Hamid Behtash 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.5
Study Design: Clinical pilot study. Purpose: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. Overview of Literature: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. Methods: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects’ disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. Results: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p =0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p <0.001, p =0.02, respectively). Conclusions: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.
Measurement of Milwaukee Brace Pad Pressure in Adolescent Round Back Deformity Treatment
Taher Babaee,Mojtaba Kamyab,Amir Ahmadi,Mohammad Ali Sanjari,Mohammad Saleh Ganjavian 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4
Study Design: In this prospective study, we measured the pad pressures of the Milwaukee brace in adolescent hyperkyphosis treatment. Purpose: We evaluated the skin-brace interface forces exerted by the main pads of the Milwaukee brace. Overview of Literature: A fundamental factor associated with brace effectiveness in spinal deformity is pad force adjustment. However, few studies have evaluated the in-brace force magnitude and its effect on curve correction. Methods: Interface forces at four pads of the Milwaukee brace were measured in 73 patients withround back deformity (mean age,14.04±1.97 years [range, 10–18]; mean initial Cobb angle,67.70°±9.23° [range, 50°–86°]). We used a modified aneroid sphygmomanometer to measure the shoulder and kyphosis pad pressures. Each patient underwent measurement in the standing and sitting positions during inhalation/exhalation. Results: The mean pad pressures were significantly higher in the standing than in thesitting position, and significantly higher pressures were observed during inhalation compared toexhalation (p =0.001).There were no statistically significant differences between right and left shoulder pad pressures (p >0.05); however, the pressure differences between the right and left kyphosis pads were statistically significant (p <0.05). In a comparison of corrective forces with bracing for less or more than 6 months, corrective force was larger with bracing for less than 6 months (p =0.02). In the standing position, there were no statistically significant correlations between pad pressures and kyphosis curve correction. Conclusions: In the sitting position, there was a trend toward lower forces at the skin-brace interface; therefore, brace adjustment in the standing position may be useful and more effective. There was no significant correlation between the magnitude of the pad pressures and the degree of in-brace curve correction.