Wong M S, Evans J H
Jockey Club Rehabilitation Engineering Centre, Hong Kong Polytechnic University, China.
Prosthet Orthot Int. 1998 Apr;22(1):54-67. doi: 10.3109/03093649809164457.
Although, the history of orthotic treatment for idiopathic scoliosis goes back more than fifty years, the mechanism of curve control by spinal orthosis is still controversial. Hypothetical explanations have been provided but few, if any, have been tested clinically. This study aims at the biomechanical evaluation of a spinal orthosis (Milwaukee brace) in order to improve understanding about the mechanism of curves control in orthotic movement. From the results of the study, the change of the interface pressure between the patient's body and thoracic pad, and the tension of the thoracic strap were highly correlated (r = 0.84) as patients performed different lying postures and daily activities. Lying on the thoracic pad is found to have the highest correctional force among different lying postures that may be favourable for preventing curve deterioration. The findings indicate that an increase in tension of the thoracic strap will increase the interface pressure on the thoracic pad and thus increase the resultant force exerted on the patient's body by the thoracic pad. Care must be taken as an excessive strap tension will increase discomfort and restrict body shifting exercises. The results also suggest that in scoliosis with thoracic lordosis, a short outrigger (small pulling angle of the thoracic strap) should be used as it will decrease the anteriorly directed force component so as to prevent exaggerating the thoracic lordosis.
尽管特发性脊柱侧弯的矫形治疗历史可以追溯到五十多年前，但脊柱矫形器控制侧弯的机制仍存在争议。已经提出了一些假设性解释，但很少有（如果有的话）经过临床验证。本研究旨在对一种脊柱矫形器（密尔沃基支具）进行生物力学评估，以增进对矫形运动中侧弯控制机制的理解。根据研究结果，当患者进行不同的躺姿和日常活动时，患者身体与胸垫之间的界面压力变化与胸带张力高度相关（r = 0.84）。发现在不同躺姿中，躺在胸垫上具有最高的矫正力，这可能有利于防止侧弯恶化。研究结果表明，胸带张力增加会增加胸垫上的界面压力，从而增加胸垫施加在患者身体上的合力。必须注意的是，胸带张力过大将增加不适感并限制身体移动练习。研究结果还表明，对于伴有胸椎前凸的脊柱侧弯，应使用较短的支条（胸带的牵拉角度较小），因为这将减小向前的力分量，从而防止胸椎前凸加剧。
