New concept of spinal orthosis for weakened back muscles

Spinal Orthoses for Vertebral Osteoporosis and Osteoporotic Vertebral Fracture: A Systematic Review

OBJECTIVE

To systematically review the evidence of effectiveness of spinal orthoses for adults with vertebral osteoporosis.

DATA SOURCES

We conducted a systematic literature search using the databases of PubMed, MEDLINE, EMBASE, AMED, CINAHL, PEDro, and the Cochrane Library from January 1995 to October 2014.

STUDY SELECTION

Two reviewers evaluated eligibility. Randomized controlled trials (RCTs), pilot RCTs, and prospective nonrandomized controlled studies of spinal orthoses for people with vertebral osteoporosis or osteopenia with and without osteoporotic vertebral fracture (OVF) that examined outcomes related to fracture consolidation, pain, strength, posture, balance, physical function, quality of life, and complications were eligible.

DATA EXTRACTION

Two reviewers independently extracted data and evaluated methodological quality using a domain-based risk-of-bias approach.

DATA SYNTHESIS

Twelve studies were included: 8 RCTs or pilot RCTs and 4 nonrandomized studies involving 626 participants. Three studies (n=153) evaluated orthoses after acute OVF; none were of high quality. Complications were highest with rigid orthoses. Evidence that orthoses could affect vertebral deformity was lacking. Nine studies (n=473) of varying quality considered orthoses in subacute and longer rehabilitation. Three suggested a semirigid backpack thoracolumbar orthosis (TLO) could benefit strength, pain, posture, and quality of life. One found a weighted kypho-orthosis (WKO) improved balance.

CONCLUSIONS

The limited evidence about orthoses after acute OVF is inconclusive; better evidence of efficacy is needed, particularly when considering complications. The promising evidence regarding the backpack TLO and WKO needs to be explored further in studies of sufficient size and quality that include men.

The effects of two spinal orthoses on balance in elderly people with thoracic kyphosis

BACKGROUND

Hyperkyphosis increases the risk of falls for elderly people by reducing postural balance. Spinomed orthosis and the posture-training support are two available options for improving postural balance but have never been compared.

OBJECTIVES

To compare the effect of the Spinomed orthosis and the posture-training support on balance in elderly people with thoracic hyperkyphosis.

STUDY DESIGN

This study is a clinical trial on an accessible sample of elderly people with thoracic kyphosis.

METHOD

Eighteen participants (16 women and 2 men), aged 60-80 years, with thoracic kyphosis greater than 50°, completed the study procedure. Subjects were randomly allocated to two groups, namely, Spinomed orthosis and the posture-training support groups. Sensory organization test and limits of stability were assessed using the EquiTest system and the Balance Master system, respectively. Balance score, directional control, and reaction time were measured to evaluate balance with and without orthosis in a random order.

RESULTS

In the posture-training support group, significant changes were observed in the studied balance parameters: balance score (p < 0.001), directional control (p = 0.027), and reaction time (p = 0.047). There was a significant change in balance score (p < 0.001) and directional control (p = 0.032) in the Spinomed group. However, there were no significant differences in the effect of the two orthoses, the Spinomed orthosis and posture-training support, on balance factors.

CONCLUSION

Both Spinomed orthosis and posture-training support may improve balance in the elderly with thoracic hyperkyphosis in a similar manner.