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关于脊柱侧弯患者的移动性和步态:在仪器辅助计时起立行走测试中传统支具与3D打印支具的比较。

On mobility and gait in scoliosis patients: a comparison of conventional and 3D-printed braces during an instrumented timed-up and go test.

作者信息

Costantini Simone, Redaelli Davide Felice, Fraschini Paolo, Biffi Emilia, Storm Fabio Alexander

机构信息

Scientific Institute, I.R.C.C.S. "E.Medea", Bosisio Parini, Italy.

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.

出版信息

BMC Musculoskelet Disord. 2025 Jan 27;26(1):86. doi: 10.1186/s12891-025-08311-w.

Abstract

OBJECTIVE

Spinal orthoses are the most viable conservative treatment for scoliosis, and additive manufacturing techniques have shown huge perspective in producing patient-specific braces, reducing material waste, and production times. This pilot study aimed at determining whether 3D-printed braces could induce advantages or disadvantages compared to conventional braces in terms of mobility and gait, and at quantitatively evaluating the effects of braces on mobility and gait.

METHODS

Ten participants were included in the study, eight with adolescent idiopathic scoliosis and two with osteogenesis imperfecta. Participants were asked to perform Timed-Up and Go (TUG) tests wearing a triaxial accelerometer under three conditions: unbraced, wearing a conventional (i.e., thermoformed) brace, and wearing a 3D-printed brace. After segmenting each TUG test in sub-phases, metrics quantifying gait and mobility were computed, and Friedman tests among all conditions were performed.

RESULTS

No significant differences in scoliotic patients mobility and gait between conventional and 3D-printed brace conditions were found, potentially suggesting that 3D-printed braces are as effective as conventional ones. Conversely, Stand flexion amplitude and Sit extension amplitude were lower in both conventional and 3D-printed brace conditions compared to the unbraced, meaning that braces limited the trunk range of motion. As for gait parameters, no significant differences in Walk Cadence and Walk Velocity among the three conditions were found, indicating that braces did not affect gait, at least during TUG tests.

TRIAL REGISTRATION

The study was registered at Clinicaltrials.gov (Study ID NCT04282408, Date of Registration February 11th, 2020).

摘要

目的

脊柱矫形器是脊柱侧弯最可行的保守治疗方法,增材制造技术在生产定制化支具、减少材料浪费和缩短生产时间方面展现出巨大潜力。这项初步研究旨在确定与传统支具相比,3D打印支具在活动能力和步态方面是否具有优势或劣势,并定量评估支具对活动能力和步态的影响。

方法

本研究纳入了10名参与者,其中8名患有青少年特发性脊柱侧弯,2名患有成骨不全症。参与者被要求在三种情况下佩戴三轴加速度计进行定时起立行走(TUG)测试:不佩戴支具、佩戴传统(即热成型)支具和佩戴3D打印支具。在将每个TUG测试划分为子阶段后,计算量化步态和活动能力的指标,并在所有情况下进行弗里德曼检验。

结果

在脊柱侧弯患者中,未发现传统支具和3D打印支具在活动能力和步态方面存在显著差异,这可能表明3D打印支具与传统支具一样有效。相反,与不佩戴支具相比,在佩戴传统支具和3D打印支具的情况下,站立屈曲幅度和坐位伸展幅度均较低,这意味着支具限制了躯干的运动范围。至于步态参数,在三种情况下的步行节奏和步行速度均未发现显著差异,这表明支具至少在TUG测试期间不影响步态。

试验注册

该研究已在Clinicaltrials.gov上注册(研究ID:NCT04282408,注册日期:2020年2月11日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad20/11773887/ce7805ec4e14/12891_2025_8311_Fig1_HTML.jpg

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