Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis

Abstract Background Spinal orthoses are commonly prescribed for adolescent idiopathic scoliosis (AIS), yet their three-dimensional correction was not fully understood. The amount of deformity control largely depends on the corrective forces applied, which remain empirically based due to a lack of co...

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Main Authors: Hui-Dong Wu, Chang-Liang Luo, Chen He, Lu Li, Winnie Chiu-Wing Chu, Wei Liu, Man-Sang Wong
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-024-08014-8
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author Hui-Dong Wu
Chang-Liang Luo
Chen He
Lu Li
Winnie Chiu-Wing Chu
Wei Liu
Man-Sang Wong
author_facet Hui-Dong Wu
Chang-Liang Luo
Chen He
Lu Li
Winnie Chiu-Wing Chu
Wei Liu
Man-Sang Wong
author_sort Hui-Dong Wu
collection DOAJ
description Abstract Background Spinal orthoses are commonly prescribed for adolescent idiopathic scoliosis (AIS), yet their three-dimensional correction was not fully understood. The amount of deformity control largely depends on the corrective forces applied, which remain empirically based due to a lack of consensus on optimal force application. This study investigated the effects of different corrective force directions exerted by spinal orthoses on patients with AIS. Methods A retrospective analysis was conducted on 78 subjects. The trunk was segmented into four quadrants using coronal and sagittal planes from a top-down perspective. Each left or right posterolateral quadrant (with 90°) was further subdivided into zones 1–4, from the sagittal to coronal planes. Based on the zone where the resultant corrective force direction fell, the subjects were categorized into Group 1 (zone 1), Group 2 (zone 2), Group 3 (zone 3), or Group 4 (zone 4). The direction of the corrective force was estimated using modified models of the subjects’ bodies, designed through a computer-aided design and manufacturing system integral to the orthosis fabrication process. The effects of corrective forces in different zones on scoliotic spine were assessed. Results Among the subjects, 3 were in Group 1, 17 in Group 2, 52 in Group 3, and 6 in Group 4. Due to the limited number of subjects, data from Groups 1 and 4 were not analysed. Groups 2 and 3 showed significant reductions in Cobb angle in the coronal plane and plane of maximum curvature (PMC) following orthosis fitting (p < 0.05). Group 2 displayed a significant decrease > 5º in thoracic kyphosis (p < 0.05). Both Groups 2 and 3 exhibited significant reductions in lumbar lordosis. PMC orientation remained unchanged over time (p > 0.05) but was notably higher in Group 2 after orthosis fitting (p < 0.05). Conclusions Corrective forces applied by spinal orthoses in zones 2 and 3 effectively controlled lateral curve progression. Notably, only forces in zone 3 neither significantly reduced thoracic kyphosis nor exacerbated the deviation of scoliotic spine from the sagittal plane. Further research is needed to validate and expand upon these results.
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spelling doaj-art-bcc98bd104e84a199a19f84edff41a1a2024-11-17T12:06:02ZengBMCBMC Musculoskeletal Disorders1471-24742024-11-012511810.1186/s12891-024-08014-8Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosisHui-Dong Wu0Chang-Liang Luo1Chen He2Lu Li3Winnie Chiu-Wing Chu4Wei Liu5Man-Sang Wong6Department of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical UniversityDepartment of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical UniversityInstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and TechnologyDepartment of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical UniversityDepartment of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong KongDepartment of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical UniversityDepartment of Biomedical Engineering, The Hong Kong Polytechnic UniversityAbstract Background Spinal orthoses are commonly prescribed for adolescent idiopathic scoliosis (AIS), yet their three-dimensional correction was not fully understood. The amount of deformity control largely depends on the corrective forces applied, which remain empirically based due to a lack of consensus on optimal force application. This study investigated the effects of different corrective force directions exerted by spinal orthoses on patients with AIS. Methods A retrospective analysis was conducted on 78 subjects. The trunk was segmented into four quadrants using coronal and sagittal planes from a top-down perspective. Each left or right posterolateral quadrant (with 90°) was further subdivided into zones 1–4, from the sagittal to coronal planes. Based on the zone where the resultant corrective force direction fell, the subjects were categorized into Group 1 (zone 1), Group 2 (zone 2), Group 3 (zone 3), or Group 4 (zone 4). The direction of the corrective force was estimated using modified models of the subjects’ bodies, designed through a computer-aided design and manufacturing system integral to the orthosis fabrication process. The effects of corrective forces in different zones on scoliotic spine were assessed. Results Among the subjects, 3 were in Group 1, 17 in Group 2, 52 in Group 3, and 6 in Group 4. Due to the limited number of subjects, data from Groups 1 and 4 were not analysed. Groups 2 and 3 showed significant reductions in Cobb angle in the coronal plane and plane of maximum curvature (PMC) following orthosis fitting (p < 0.05). Group 2 displayed a significant decrease > 5º in thoracic kyphosis (p < 0.05). Both Groups 2 and 3 exhibited significant reductions in lumbar lordosis. PMC orientation remained unchanged over time (p > 0.05) but was notably higher in Group 2 after orthosis fitting (p < 0.05). Conclusions Corrective forces applied by spinal orthoses in zones 2 and 3 effectively controlled lateral curve progression. Notably, only forces in zone 3 neither significantly reduced thoracic kyphosis nor exacerbated the deviation of scoliotic spine from the sagittal plane. Further research is needed to validate and expand upon these results.https://doi.org/10.1186/s12891-024-08014-8ScoliosisOrthosisCorrective ForceClinical Outcome
spellingShingle Hui-Dong Wu
Chang-Liang Luo
Chen He
Lu Li
Winnie Chiu-Wing Chu
Wei Liu
Man-Sang Wong
Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
BMC Musculoskeletal Disorders
Scoliosis
Orthosis
Corrective Force
Clinical Outcome
title Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
title_full Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
title_fullStr Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
title_full_unstemmed Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
title_short Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
title_sort effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis
topic Scoliosis
Orthosis
Corrective Force
Clinical Outcome
url https://doi.org/10.1186/s12891-024-08014-8
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