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首页> 外文期刊>Clinical Interventions in Aging >Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture
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Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture

机译：半刚性胸腰椎矫形器对骨质疏松性椎体压缩性骨折患者步态和矢状位的影响

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Background: An important goal in the treatment of osteoporotic vertebral compression fractures (OVCFs) is the prevention of new vertebral fractures and the subsequent progression to global sagittal malalignment. Current conservative treatment is multimodal and comprises analgesics, medication for osteoporosis, and physical therapy. However, little is known about the value of orthoses in the treatment of OVCFs. Aims: The primary purpose of this study was to examine the direct effect of a semirigid thoracolumbar orthosis on gait in patients suffering from an OVCF. The secondary purpose was to evaluate changes in gait, radiographic sagittal alignment, pain, and quality of life over time. Methods: Fifteen postmenopausal patients with an OVCF were treated with a semirigid thoracolumbar orthosis. At baseline, after 6 weeks, and after 6 months, gait analysis was performed with a dual belt–instrumented treadmill with a 180° projection screen providing a virtual environment (computer-assisted rehabilitation environment) combined with clinical and radiographic assessments. Results: At baseline, bracing caused a significantly more upright posture during walking and patients walked faster, with larger strides, longer stride times, and lower cadence compared to walking without orthosis. After 6 weeks, radiographic and dynamic sagittal alignment had improved compared to baseline. The observed effect was gone after 6 months, when the orthosis was not worn anymore. Conclusion: A semirigid thoracolumbar orthosis seems to have a positive effect on gait and stability in patients suffering from an OVCF, as was shown by a more upright posture, which may result in decreased compressive loading of the vertebrae. For studying the true effectiveness of dynamic bracing in the treatment of OVCFs, a prospective, randomized controlled trial will be needed.
机译：背景：治疗骨质疏松性椎体压缩性骨折（OVCF）的一个重要目标是预防新的椎体骨折以及随后发展为整体矢状位错位。当前的保守治疗是多模式的，包括止痛药，骨质疏松症的药物和物理疗法。但是，关于矫形器在OVCF治疗中的价值知之甚少。目的：本研究的主要目的是研究半刚性胸腰椎矫形器对OVCF患者步态的直接影响。次要目的是评估步态，放射线矢状对准，疼痛和生活质量随时间的变化。方法：采用半刚性胸腰椎矫形器治疗15例绝经后的OVCF患者。在基线，6周和6个月后，使用带180°投影屏的双皮带式跑步机进行步态分析，提供虚拟环境（计算机辅助康复环境）以及临床和放射线评估。结果：在基线时，与没有矫正器的行走相比，支撑在行走过程中引起明显的直立姿势，并且患者走得更快，步幅更大，步幅时间更长，步频更低。 6周后，放射线和动态矢状位对准与基线相比有所改善。 6个月后，当不再使用矫形器时，观察到的效果消失了。结论：半硬性胸腰椎矫形器似乎对OVCF患者的步态和稳定性有积极影响，如更直立的姿势所示，这可能导致椎骨的压缩负荷降低。为了研究动态支撑在治疗OVCF中的真正有效性，将需要一项前瞻性，随机对照试验。

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