Luo Changliang, Wu Huidong, Liu Wei, Luo Yuyan, Jie Yi, Ma Christina Zong-Hao, Wong Mansang
Department of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical University, Kunming 650032, China.
Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China.
Bioengineering (Basel). 2024 Dec 8;11(12):1242. doi: 10.3390/bioengineering11121242.
Orthotic treatment is a well-acknowledged conservative treatment for moderate adolescent idiopathic scoliosis (AIS). The efficacy of this treatment is significantly determined by the forces applied to the bodies of patients. However, there is uncertainty regarding the optimal force levels that should be applied to the patient's torso by spinal orthosis. This study aims to identify reference values for the controlling forces in AIS management.
A comprehensive literature search was performed in five databases (PubMed, Scopus, Cochrane Library, CINAHL, and Web of Science). Only studies written in English and covering the force/pressure measurements of spinal orthosis for the treatment of AIS were included, without publication date restrictions. The methodological index for non-randomized studies (MINORS) was employed for the methodological quality assessment, and force measurements were standardized to pressure in kilopascals (kPa) for comparison.
From the initial 10,452 records, 10 studies were admitted for the final analysis. All the included studies reported the interface pressure between the thoracic (T) pad and patient's trunk, and seven studies evaluated the pressure from the thoracolumbar/lumbar (TL/L) pad. These studies used different pressure sensors or transducers with the range from 5.6 to 82.5 kPa for the T pads, and 4.8 to 85.1 kPa for the TL/L pads. Four studies reported strap tensions of 26.8 to 60.4 N. Higher strap tension was correlated with increased interface pressure (r = 0.84).
The mean strap tension was 42.5 N, the median interface pressure of the T pads was 8.75 kPa, and the median pressure of TL/L regions was 7.11 kPa without the outliers. The findings provide a baseline value for designing adjustable straps and strategically distributing pressure in orthoses.
支具治疗是中度青少年特发性脊柱侧凸（AIS）公认的保守治疗方法。这种治疗的效果很大程度上取决于施加在患者身体上的力。然而，对于脊柱矫形器应施加在患者躯干上的最佳力水平存在不确定性。本研究旨在确定AIS治疗中控制力的参考值。
在五个数据库（PubMed、Scopus、Cochrane图书馆、CINAHL和科学网）中进行了全面的文献检索。仅纳入英文撰写且涵盖用于治疗AIS的脊柱矫形器的力/压力测量的研究，无出版日期限制。采用非随机研究方法学指数（MINORS）进行方法学质量评估，并将力测量标准化为千帕（kPa）压力进行比较。
从最初的10452条记录中，10项研究被纳入最终分析。所有纳入研究均报告了胸段（T）垫与患者躯干之间的界面压力，7项研究评估了胸腰段/腰段（TL/L）垫的压力。这些研究使用了不同的压力传感器或换能器，T垫的压力范围为5.6至82.5 kPa，TL/L垫的压力范围为4.8至85.1 kPa。四项研究报告的束带张力为26.8至60.4 N。较高的束带张力与界面压力增加相关（r = 0.84）。
平均束带张力为42.5 N，T垫的中位界面压力为8.75 kPa，TL/L区域的中位压力为7.11 kPa（排除异常值）。这些发现为设计可调节束带和在矫形器中合理分布压力提供了基线值。
