一种基于躯干不对称的新型脊柱侧弯支具衬垫方法，用于脊柱侧弯治疗。
A new scoliosis brace padding method based on trunk asymmetry for scoliosis treatment.
机构信息
Department of Orthotics and Prosthetics, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
出版信息
Prosthet Orthot Int. 2023 Aug 1;47(4):416-423. doi: 10.1097/PXR.0000000000000210. Epub 2023 Jan 31.
BACKGROUND
Pressure pads are used with scoliosis braces to adjust the magnitude and location of corrective forces that mechanically support the torso to correct the spine deformity. In the conventional brace (C.B.) design approaches, the location and shape of pads are determined based on the visual assessment of the clinician. The accuracy of this approach could be improved because it is limited to the clinician's expertise. The present study aimed to develop a new brace (N.B.) padding method based on trunk asymmetry for adolescents with idiopathic scoliosis and compare the efficacy of the developed method with C.B. in improving the Cobb angle and body posture symmetricity.
METHODS
The trunk surface geometry was scanned using a 3-dimensional scanner. The best plane of symmetry was determined, and the original trunk was reflected in the plane of symmetry, creating the reflected trunk. The difference between the reflected and original trunks was computed and color-coded using deviation contour maps. The boundary of deformed regions, with a minimum of 6-mm deviation contour maps, was identified as the trim lines for brace pads. Eight participants were recruited and divided into conventional and new padding groups. The variation of Cobb angle and torso asymmetry parameters, including the trunk rotation and back surface rotation, as well as the brace satisfaction and trunk appearance perception of the 2 groups, were compared after 3 months of treatment.
RESULTS
Cobb angle improved equally in the N.B. and C.B. groups. However, back surface rotation improved in the N.B. group (+49.6%) and worsened in the C.B. group (-6.8%). The mean trunk rotation was improved by 30% in the N.B. and further exacerbated by -2.2% in the C.B. group. The brace satisfaction and trunk appearance perception scores were higher in the N.B. than in the C.B. group, however not statistically significant.
CONCLUSIONS
The present study showed that the proposed brace padding system improved the trunk appearance without negatively affecting the Cobb angle correction.
背景
矫形支具中使用压力垫来调节矫正力的大小和位置，以机械支撑躯干来矫正脊柱畸形。在传统支具（C.B.）设计方法中，垫子的位置和形状是根据临床医生的视觉评估来确定的。这种方法的准确性可以提高，因为它仅限于临床医生的专业知识。本研究旨在为特发性脊柱侧凸青少年开发一种基于躯干不对称的新型支具（N.B.）衬垫方法，并比较开发方法与 C.B. 在改善 Cobb 角和身体姿势对称性方面的疗效。
方法
使用三维扫描仪扫描躯干表面几何形状。确定最佳对称平面，并在对称平面上反射原始躯干，创建反射躯干。计算反射和原始躯干之间的差异，并使用偏差等高线图进行颜色编码。将变形区域的边界确定为具有至少 6 毫米偏差等高线图的支具垫的修剪线。招募了 8 名参与者，并将其分为传统衬垫组和新型衬垫组。治疗 3 个月后，比较两组 Cobb 角和躯干不对称参数的变化，包括躯干旋转和背面旋转，以及两组的支具满意度和躯干外观感知。
结果
新型和传统支具组的 Cobb 角都得到了同等程度的改善。然而，新型支具组的背面旋转得到了改善（+49.6%），而传统支具组的背面旋转则恶化了（-6.8%）。新型支具组的躯干旋转平均改善了 30%，而传统支具组的躯干旋转恶化了-2.2%。新型支具组的支具满意度和躯干外观感知评分高于传统支具组，但无统计学意义。
结论
本研究表明，所提出的支具衬垫系统改善了躯干外观，而不会对 Cobb 角矫正产生负面影响。
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