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两种不同胸腰椎支具在各种躯体运动中对脊柱稳定性的影响。

Effect of 2 different thoracolumbar orthoses on the stability of the spine during various body movements.

机构信息

SpineServ GmbH & Co. KG, Soeflinger Strasse, Ulm, Germany.

出版信息

Spine (Phila Pa 1976). 2013 Aug 1;38(17):E1082-9. doi: 10.1097/BRS.0b013e3182983518.

Abstract

STUDY DESIGN

Biomechanical volunteer study.

OBJECTIVE

To quantify the stabilizing effect of 2 different semirigid thoracolumbar orthoses during various body movements.

SUMMARY OF BACKGROUND DATA

Various spinal diseases need to be treated by immobilization. The literature shows, that the immobilizing effect of orthoses strongly depends on the orthosis design and on the loading direction. Few data are available for loading directions other than flexion and extension.

METHODS

Ten young and healthy volunteers (22-44 yr, 5 male, 5 female) performed 4 different tasks: full active flexion/extension, lateral bending, and axial rotation as well as a full active everyday movement (flexion plus lateral bending plus axial rotation). These tasks were carried out without orthosis, with the DorsoFX (BORT GmbH, Weinstadt-Benzach, Germany) and with the SofTec Dorso orthosis (Bauerfeind AG, Zeulenroda-Triebes, Germany). The flexibility of the spine was measured using a 3-dimensional motion capturing system (Zebris Medical GmbH, Isny, Germany). Additionally, the pressure exerted by the orthoses on the subject's body surface was measured using a pressure sensor (Tekscan Inc., South Boston, MA).

RESULTS

The range of motion significantly decreased in all loading planes by 42% to 69%. The movement with the largest decrease was axial rotation and the smallest decreases were observed in extension (DorsoFX), flexion and the everyday movement (SofTec Dorso), respectively. The differences between the 2 orthoses were small and not statistically significant. The pressure between orthosis and the body surface was similar for both orthoses but differed between the movements.

CONCLUSION

Both orthoses had a similar stabilizing effect on the thoracolumbar spine. The stabilizing effect differed between the 4 movements, which indicates that all loading planes should be tested to understand the effect of an orthosis completely. Complete immobilization of the thoracolumbar spine was not possible with either of the 2 orthoses, but the stability increase was statistically significant.

LEVEL OF EVIDENCE

N/A.

摘要

研究设计

生物力学志愿者研究。

目的

量化两种不同半刚性胸腰椎支具在各种身体运动中的稳定效果。

背景资料概要

各种脊柱疾病需要通过固定来治疗。文献表明,支具的固定效果强烈依赖于支具设计和加载方向。对于除屈伸外的其他加载方向,可用的数据很少。

方法

10 名年轻健康的志愿者(22-44 岁,5 男,5 女)进行了 4 项不同的任务:完全主动屈伸、侧屈和轴向旋转,以及完全主动的日常运动(屈伸加侧屈加轴向旋转)。这些任务在不佩戴支具、佩戴 DorsoFX(BORT GmbH,Weinstadt-Benzach,德国)和 SofTec Dorso 支具(Bauerfeind AG,Zeulenroda-Triebes,德国)的情况下进行。使用三维运动捕捉系统(Zebris Medical GmbH,Isny,德国)测量脊柱的柔韧性。此外,使用压力传感器(Tekscan Inc.,South Boston,MA)测量支具对受试者体表的压力。

结果

所有加载平面的活动范围均显著减小,减小幅度为 42%至 69%。活动范围减小最大的是轴向旋转,屈伸和日常运动(SofTec Dorso)减小幅度最小。两种支具之间的差异较小,且无统计学意义。两种支具与体表之间的压力相似,但在不同的运动中有所不同。

结论

两种支具对胸腰椎均有相似的稳定效果。4 种运动之间的稳定效果不同,这表明应测试所有加载平面以全面了解支具的效果。两种支具都不能完全固定胸腰椎,但稳定性的增加具有统计学意义。

证据水平

无。

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