Effect Of Brace Research Articles

Stiffening effects-controlling sizing procedure of ADAS dampers in seismic retrofit of frame structures

Added Damping and Stiffness (ADAS) steel dissipators are among the most classical devices installed in dissipative bracing systems for the advanced seismic retrofit of frame buildings. An energy-based sizing procedure is formulated in this study for this class of dampers, where the total number of constituting plates is directly related, without iterative steps, to the supplementary damping energy required to jointly reduce stress states in structural members and storey drifts. The stiffening effects of the dissipative braces are expressly controlled, so as to compensate for the increase in storey shears induced by their incorporation in the frame skeleton. The sizing procedure is demonstratively applied to the retrofit design of a 6-storey reinforced concrete building, to explicate and discuss the use of its analytical relations and relevant limitations in practice. The evaluation of the seismic performance of the structure in retrofitted conditions allows comparing the response of the dissipative bracing system with the hypotheses formulated at the sizing stage.

Effect of Brace Treatment on Craniovertebral to Lumbopelvic Sagittal Parameters in Adolescents with Idiopathic Scoliosis: A Systematic Review.

The current study was carried out systematically by conducting a review of the literature. The purpose of this study was to conduct a systematic review of the literature to determine the effects of brace wearing on sagittal parameters in adolescents with idiopathic scoliosis (AIS). In this study, PubMed/MEDLINE (National Library of Medicine), Scopus, Ovid, CINAHL, PEDro, Google Scholar, and the Cochrane Library were accessed and searched using the patient, intervention, comparison, outcome, and study design model. We included studies that looked at the effects of brace treatment on sagittal spinopelvic parameters in AIS patients over the age of 18. The studies were chosen for their cross-sectional, retrospective, or prospective observational designs, and they were published in English. Review articles, case reports, case study designs, and conference abstracts were excluded from consideration. The methodological quality of the remaining articles was assessed using the Newcastle Ottawa Scale. A total of 12 studies were chosen, and 995 participants were evaluated, with 3 (25%) and 9 (75%) having high and moderate quality, respectively. The studies were classified based on the length of follow-up. Long-term, short-term, and immediate effects of brace wearing on sagittal spinopelvic parameters were reported in four, five, and three studies, respectively. The results of nine studies showed a significant decrease in Cobb angle after wearing the brace, which contradicted the findings of the other two. The cervical and sagittal pelvic parameters, thoracic kyphosis (TK), lumbar lordosis (LL), spinopelvic parameters, and sagittal balance were all evaluated in the intended studies, yielding varying results. According to the available literature, wearing a brace flattens the TK and LL. According to this systematic review, brace treatment may affect sagittal spinopelvic parameters in adolescents with AIS, particularly in TK and LL. The cervical and pelvic parameters yielded inconclusive results. This study backs up the idea that brace design and structure can influence sagittal parameter changes. The limitations of this study include different methods of parameter measurement, variations in the brace types and wear time, varying follow-up duration, and differences in participant characteristics.

Vertebral refracture after percutaneous vertebroplasty for osteoporotic vertebral compression fractures with and without brace wearing: A retrospective study of 300 patients.

The aim of the study was to examine the clinical incidence rate of vertebral body fractures after percutaneous vertebroplasty (PVP) with and without brace wearing and provide a new guiding ideology for preventing vertebral fractures after clinical surgeries. The retrospective analysis included 100 outpatients who underwent PVP between January 2017 and December 2018 without bracing after PVP surgeries (non-brace-wearing group). In total, 100 patients were paired into the rigid brace group and 100 patients were paired into the soft braces group according to propensity score matching. Seven independent variables were used in the soft and rigid brace group: age, sex, body mass index (BMI), visual analog scale (VAS), Oswestry Disability Index (ODI), and Cobb angle. The VAS, ODI, and Japanese Orthopaedic Association (JOA) scores were recorded preoperatively on the second day, after 1 month, after 3 months, and during the last follow-up postoperatively. We recorded the incidence of vertebral refracture in each of the three groups of patients and evaluated the effect of braces on postoperative fractures based on the ODI, VAS, and JOA scores. All patients were followed up for 8-24 months (mean 22.4 months). Compared with the preoperative values, the age, sex, BMI, bone density, ODI, VAS, and Cobb angle between refracture and non-refracture were not statistically significant. The VAS, ODI, and JOA scores significantly increased in the brace-wearing group compared with those of the non-brace-wearing group (p < 0.05). The incidence of vertebral refracture in the brace-wearing group was lower than that in the non-brace-wearing group, between which there was a significant difference (p < 0.05). Three months postoperatively, the JOA score of the soft brace group was significantly higher than that of the rigid brace group (p < 0.05). During the last follow-up, it was found that there was no difference in the VAS score, the incidence of refracture, or ODI between the soft brace group and the rigid brace group (p > 0.05). The improvement in the JOA score of the soft brace group was better than that of the rigid brace group, between which there was a significant difference (p < 0.05). Braces can improve the prognosis of quality of life and postoperative subjective perception, whose presence can relieve postoperative residual pains. In contrast, patients can have a better medical experience wearing a soft brace.

Experimental investigation on lateral behavior of novel hybrid cold-formed steel walls with composite sheathing

This paper proposes a new hybrid cold-formed steel (CFS) wall system with thick corner columns to improve the lateral performance of CFS structures. 16 CFS walls with various composite sheathing, diagonal bracing, and corner configurations, including ten hybrid and six conventional walls, are experimentally tested to investigate their lateral behavior and performance under monotonic and reversed-cyclic lateral loading. The experimental results demonstrate that the effect of the diagonal bracing varies depending on the presence of sheathing and the type of CFS wall. The shear capacity of both types of CFS walls without sheathing is highly improved by diagonal bracing. On the other hand, the diagonal bracing effect on the double-sided sheathed conventional wall is negligible. The brace-to-track connection causes diagonal bracing to exhibit different capacities and behavior under compression and tension. It should also be noted that the effect of loading mode on lateral performance varies depending on the configuration of the hybrid walls. The loading mode effect on the shear capacity of hybrid walls with sheathing is negligible, whereas its impact on the shear capacity of hybrid walls without sheathing is observed to be up to 14%. The wood-fiber cement board as sheathing material increases the shear capacity and stiffness of CFS walls while decreasing their ductility. Overall, compared with the conventional walls, proposed hybrid walls with a certain level of ductility demonstrate higher shear capacity and stiffness and comparatively less energy absorption capacity.

Does the use of postoperative brace help preventing mechanical complications following adult deformity surgery?

There is scarce information regarding the effectiveness of postoperative braces in decreasing mechanical complications and reinterventions following adult deformity surgery. Retrospective matched cohort study from a prospective adult deformity multicenter database. We selected operated patients, fused to the pelvis, > 6 instrumented levels, and minimum 2year follow-up. Three hundred and eighty patients were separated into two groups (Brace-3months TLSO-vs No Brace) and then matched controlling for age, gender and frailty. We studied demographic, intraoperative, and postoperative spinopelvic parameters. Both groups were compared regarding complications and reinterventions in the first 2 postoperative years, using univariate and multivariate logistic regression analysis. We finally analyzed 359 matched patients, mean age of 65.3 ± 8.9years, frailty-index (0.43 ± 0.15), and mostly females (84%). 224 patients wore a postoperative brace (B) and 135 didn't (NoB). They showed no difference in intraoperative variables and postoperative spinopelvic alignment. They differed (P < 0.05) in: Pelvic incidence (B:58° ± 13 vs NoB:54.5° ± 13); BMI (B:25.8 ± 4 vs NoB:27.4 ± 5); upper instrumented vertebra (B:81.7% T8-L1 vs NoB:72.6% T8-L1), and the use of multiple rods (B:47.3% vs NoB:18.5%).Univariate analysis showed a higher rate of mechanical complications and reinterventions when not using a brace. As well as higher NRS-back and leg pain at 6weeks. However, multivariate analysis selected the use of multiple rods as the only independent factor protecting against mechanical complications (OR: 0.38; CI 95% 0.22-0.64) and reinterventions (OR: 0.41; CI 95% 0.216-0.783). After controlling for potential confounders, our study could not identify the protective effect of postoperative braces preventing mechanical complications and reinterventions in the first two postoperative years.

A gait stability evaluation method based on wearable acceleration sensors.

In this study, an accurate tool is provided for the evaluation of the effect of joint motion effect on gait stability. This quantitative gait evaluation method relies exclusively on the analysis of data acquired using acceleration sensors. First, the acceleration signal of lower limb motion is collected dynamically in real-time through the acceleration sensor. Second, an algorithm based on improved dynamic time warping (DTW) is proposed and used to calculate the gait stability index of the lower limbs. Finally, the effects of different joint braces on gait stability are analyzed. The experimental results show that the joint brace at the ankle and the knee reduces the range of motions of both ankle and knee joints, and a certain impact is exerted on the gait stability. In comparison to the ankle joint brace, the knee joint brace inflicts increased disturbance on the gait stability. Compared to the joint motion of the braced side, which showed a large deviation, the joint motion of the unbraced side was more similar to that of the normal walking process. In this paper, the quantitative evaluation algorithm based on DTW makes the results more intuitive and has potential application value in the evaluation of lower limb dysfunction, clinical training and rehabilitation.

Effects of textured insoles and elastic braces on dynamic stability in patients with functional ankle instability

BackgroundFunctional ankle instability (FAI) is a common condition that affects individuals who have experienced previous ankle sprains. Textured insoles and elastic ankle braces have been previously used as interventions to improve stability in FAI patients. However, the optimal combination of these interventions has not been fully explored. The objective of this study was to investigate the effects of different types of textured insoles and elastic ankle braces on the dynamic stability of individuals diagnosed with FAI.MethodsThe study involved 18 FAI patients who performed single-leg landing tasks with and without wearing an eight-band elastic ankle brace while wearing textured insoles with protrusion heights of 0 mm, 1 mm, and 2 mm. The dynamic posture stability index (DPSI) and its components in the anterior-posterior (APSI), mediolateral (MLSI) and vertical (VSI) directions were calculated from the ground reaction force collected from the Kistler force plate during the first three seconds of the landing tasks.ResultsA significant interaction was found between textured insole type and ankle brace for DPSI (P = 0.026), APSI (P = 0.001), and VSI (P = 0.021). However, no significant interaction was observed for MLSI (P = 0.555). With elastic ankle braces, textured insoles with 1-mm protrusions significantly enhanced anterior-posterior, mediolateral, vertical, and overall stability compared to textured insoles with no and 2 mm protrusions (P < 0.05). Without elastic ankle braces, textured insoles with 1-mm protrusions significantly improved the anterior-posterior (P = 0.012) and overall stability (P = 0.014) of FAI patients compared to smooth insoles.ConclusionsThe combination of textured insoles with 1-mm protrusion heights and an elastic ankle brace could enhance the dynamic stability of individuals with FAI, potentially mitigating the risk of ankle sprains.

Modeling Knee-Brace Fastener Slippage in Post-Frame Buildings with Diaphragm-Action Design

Highlights Effects of knee braces, with and without fastener slippage, on a post-frame structure with diaphragm-action design. Modeling techniques of knee braces with fastener slippage. Effects of fastener slippage on a primary frame with knee braces. Knee brace may have an undesired (negative) effect on posts and roof trusses. Abstract. Knee braces should not be an add on after the post-frame building is designed because they do affect the behavior of the structure. It is recommended that the building designer first check the need for knee bracing when diaphragm action is included in the design. Knee braces may benefit buildings with certain geometrical configurations and loading conditions where diaphragm action alone is not enough. Modeling knee bracing within a post-frame building is complex. The complexity extends to the roof-truss design because the truss design must include the knee brace reaction forces. The building designer is responsible for reviewing truss drawings to verify that knee brace loads are applied correctly, and that correct governing load combinations are applied. In this study, a structural analog that includes knee braces, with and without slippage, was developed to model the effects of knee braces on designs of post-frame buildings with diaphragm action. In the five buildings analyzed in this study, use of knee braces produced inconsistent results. Knee braces may increase or decrease horizontal eave deflection, load demand on the diaphragm and endwalls, load demand on the foundation, and stress unity in the posts. In all buildings with knee braces, posts were subjected to additional bending stresses under gravity loads. This behavior was more pronounced in buildings with long truss spans. Knee braces should not be specified in the design documents unless their effects on the building are considered by structural analysis. Keywords: Diaphragm action, Knee braces, Modeling connection slippage, Post-frame buildings.

Morphological Characteristics and Prevention of Tooth Enamel Demineralization during Orthodontic Treatment with Non-Removable Appliances.

Despite the large number of studies on the effect of braces on teeth, there is no information on the dynamics of the state of the ultrastructure of the hard tissues of teeth during orthodontic treatment. The purpose of this study is to examine the state of the hard tissues of the teeth and carry out preventive measures to reduce the risk of complications in the process of orthodontic treatment using a non-removable device. Methods: For the in vitro study, 68 teeth were randomly divided into group A-no prophylactic treatment, and group B-treated with the fluorine varnish Tiefenfluorid. After 35 days, all the teeth were prepared for microscopic examination. The clinical study included 59 patients aged 12-17 years with orthodontic brackets. The split-mouth technique was used. The areas around the bracket of one-half of the oral cavity were treated with Tiefenfluorid every 6 months during the entire treatment period. The teeth of the second half of the oral cavity served as the control group. The data were processed in the SPSS19 package. Results: In vitro and clinical study results showed a statistically significant difference between the prophylactic and control groups of teeth in favor of the prophylactic group, where the statistical significance was p ≤ 0.01.

Performance of Compression-free turnbuckle braces using partially fibered CFRP under cyclic load

Turnbuckle braces have been widely used as the seismic-resistant member of steel structures. Being a very slender member, the compressive resistance capacity is not considered in the structural design, but these braces buckle easily due to compressive forces, and the buckling deformation damages the finishing material and causes local plastic strain concentration and plastic fatigue failure. Based on this, the authors of this study developed a compression-free brace that can be easily installed on existing steel turnbuckle braces. We focused on the use of lightweight, high-strength carbon fiber reinforced polymer (CFRP) as a brace material and joined the CFRP rod to the existing steel turnbuckle braces through a pipe style turnbuckle body. The proposed compression-free brace uses partially fibered CFRP (PFCFRP) rods to absorb compressive deformation so that only tensile forces are applied to the brace, and out-of-plane deformation due to buckling is significantly reduced. In addition, the combined use of steel turnbuckle braces can be expected to absorb seismic energy by the plastic deformation of steel. PFCFRP rods are only fiberized in the middle position and the unfiberized position (CFRP rods positions) at both ends are used for the joints. They are molded by pultrusion because of their excellent cost-effectiveness, superior mechanical performance, and stability. The partially fibered sections are created without resin injection. PFCFRP rods are connected to the braces using a pipe-style turnbuckle body. The method used to fix the PFCFRP rod and the pipe-style turnbuckle body involves widening the end of the PFCFRP rod to drive a wedge and insert it into the turnbuckle body. Then, it is filled with steel balls and epoxy resin to prevent it from pulling out. Furthermore, we use the pipe-style turnbuckle body to connect the steel structure like a sleeve joint to provide easy and useful assembly. Two different tests were carried out to confirm the effectiveness of the compression-free braces. Firstly, testing of materials used in compression-free braces was conducted. The results of the tests were used to compare the strength of steel turnbuckle braces to clarify the scope of the application of compression-free braces. Next, cyclic loading tests were carried out on a full-scale steel structural frame to simulate the actual seismic bracing situation. The results show that the proposed compression-free braces have similar historical behavior to existing steel turnbuckle braces. Because the PFCFRP rod absorbs the compressive axial deformation, the out-of-plane deformation can be significantly reduced. These results demonstrate that the proposed compression-free braces using PFCFRP can provide a safe and applicable seismic bracing system.

Experimental and numerical analyses on stress concentration factors of concrete-filled welded integral K-joints in steel truss bridges

A novel fully welded concrete-filled integral K-joint incorporating longitudinal perfobond ribs welded to the inner faces of the chord is proposed to improve the fatigue behavior. To evaluate the stress concentration factor (SCF) of such joints, a 1:5 scale truss specimen was fabricated and tested to measure the SCF distribution in the fatigue prone joint. A finite element model was also developed to evaluate the SCFmax of concrete-filled welded integral K-joints and was validated against the test results. A parametric study was carried out and a comprehensive database was obtained considering the effects of brace width-to-chord thickness ratio (2γ), brace-to-chord thickness ratio (τ), the angle between braces and chord (θ) on the SCFmax. Also, the following three basic loading conditions were examined: brace axial force, chord axial force and chord in-plane bending. Based on the results of 192 numerical models, new equations to predict the SCFmax of concrete-filled welded integral K-joint were derived for design purposes. Finally, the fatigue behavior of three different designs is compared in terms of SCFmax and hot spot stress range Sh-N curves. These systems are rectangular hollow section (RHS) K-joints, concrete-filled rectangular hollow section (CFRHS) K-joints and concrete-filled welded integral K-joint. It was shown that the concrete-filled integral welded K-joint has the best fatigue behavior, followed by the CFRHS K-joint, while the RHS K-joint has the poorest fatigue behavior.

Does Bracing Control the Progression of Adolescent Idiopathic Scoliosis in Curves Higher Than 40°? A Systematic Review and Meta-analysis.

Routinely, adolescent idiopathic scoliosis (AIS) curves that progress beyond 40° in skeletally immature adolescents require surgery. However, some adolescents with AIS and their parents utterly refuse surgery and insist on wearing a brace. Debate continues regarding the appropriateness of bracing for AIS curves exceeding 40° in patients who have rejected surgical intervention. This systematic review and meta-analysis was conducted to review the literature on the effectiveness of bracing and its predictive factors in largermagnitude AIS curves ≥40°. This study replicated the search strategy used by the PICOS system for formulating study questions, which include consideration of the patient/population (P), intervention (I), comparison (C), outcome (O), and study design (S). The search was conducted up to January 2022 in the following bibliographic online databases only in the English language: PubMed, Google Scholar, Scopus, and Web of Science. Two assessors reviewed the articles for qualification. Eligible studies were assessed for risk of bias at the study level using the Newcastle-Ottawa Scale. The effect size across the studies was determined using standardized mean differences (Cohen's d) and 95% confidence intervals for the meta-analysis. Among the eight included moderate quality studies, evidence of potential publication bias (p <0.05) for the trials included was found in the Cobb angle outcome. Results obtained through meta-analysis indicated that the effectiveness of bracing in controlling Cobb angle progression in curves ≥40° is significantly positive. Additionally, initial curve severity, Risser stage, in-brace curve correction, curve type, and apical vertebral rotation were considered risk factors associated with brace effectiveness. This systematic review revealed that bracing could alter the normal course of AIS curves ≥40° in patients refusing posterior spinal fusion (PSF). However, the suggested course for patients refusing PSF remains unclear because of the significant heterogeneity in the risk factors associated with bracing failure.

Progressive collapse mechanisms of multi-story steel-framed modular structures under module removal scenarios

Due to different assembly requirements and novel integration strategies, the modular structures may have undesirable loading mechanisms and distinct structural behaviors. However, there are limited data on the progressive collapse performances of modular structures, which impedes their industrial applications. This study numerically investigates the structural robustness of multi-story steel-framed modular structures against progressive collapse by using pushdown analysis. A six-story structure with five modules per floor is designed and established. The applied load, failure process and load redistribution mechanisms are studied under module removal scenarios. Parametric analyses are also conducted to investigate influences of cross-sectional dimensions of frame members, number of stories and bays, arrangements of bracings, and module removal scenarios on the robustness of the modular structures. The results show that the prototype modular structure designed with Hong Kong design code can withstand collapse under module removal scenarios. The load redistribution mechanisms among columns are significantly influenced by the overturning action and bracing effects. The ceiling beam in the lower module and the floor beam in the upper module form a double beam system. The column section, beam section, arrangement of bracings and number of stories significantly influence the robustness of the modular structure. Finally, a design method based on buckling load equation for columns is proposed to estimate the progressive collapse resisting capacity of modular structures with good accuracy and efficiency.

Comparing the Immediate Effect of Pneumatic and Conventional Knee Braces on Gait, Satisfaction and Pain in Patients With Knee Medial Osteoarthritis

Background/Aims Knee braces can change loading direction on knees in people with osteoarthritis, thereby reducing symptoms and progression of the disease. The aims of this study were to explore the immediate effect of two types of braces, a pneumatic knee brace with air pressure embedded in a sandal cuff (sandal cuff pressure) and a conventional knee brace on gait, pain and satisfaction during walking in patients with knee medial osteoarthritis. Methods A total of 28 patients with knee medial osteoarthritis were assigned to two groups, 14 patients used a conventional brace and 14 used a prototype brace with a pneumatic system, which was designed and fabricated by the authors, and followed the mechanism of variable pressures in the stance and swing phases of a gait cycle in a patient’s knee. The gait parameters (walking self-selected speed, cadence, stride length, knee range of motion, and maximum knee adduction moment) were measured with a Kistler force plate and Vicon motion analysis under two conditions: with and without brace for the conventional brace group, and under three conditions of no brace, brace with sandal cuff pressure, and brace without sandal cuff pressure for the pneumatic brace group. Patients’ pain and satisfaction were also measured using a visual analogue scale and Likert scale respectively. Results Both groups showed a significant reduction in maximum knee adduction moment and pain wearing braces in comparison to no brace during walking (P&lt;0.05). The knee range of motion was significantly decreased in the pneumatic brace group with and without sandal cuff pressure compared with no brace (P&lt;0.001). No significant difference was found for any of the variables when using the pneumatic brace with and without sandal cuff pressure (P&gt;0.05). In the between-group comparison, only patients’ satisfaction was significantly reduced when using the pneumatic brace in both walking with (P=0.041) and without (P=0.02) sandal cuff pressure compared to those using the conventional brace. Conclusions Both conventional and pneumatic braces led to reduced knee adduction moment and pain in patients with knee osteoarthritis. However, using a pneumatic brace reduced the knee range of motion and satisfaction of patients, which could be because the brace was a prototype.

Musculoskeletal Gait Simulation to Investigate Biomechanical Effect of Knee Brace.

Musculoskeletal modeling and simulation have been an emerging trend in human gait analysis. It allows the user to isolate certain biomechanical conditions and elucidate the dynamics of joints and muscles. This study used an open-source musculoskeletal modeling and simulation tool, opensim to investigate the biomechanical effect of knee brace. It collected gait data from thirty-eight participants and examined the gait spatio-temporal parameters, joint angles, and joint moments. Static optimization was performed to estimate the lower extremity muscle force. Statistical analysis was conducted to identify the difference between normal and braced gaits. The results demonstrated the feasibility of this method to investigate the interaction and coordination of lower extremity joints and muscles. The knee brace constrained the range of the motion of the knee during walking. It also changed the walking speed, step length, and stance-to-swing ratio. Several significant differences were found in the joint moments and muscle forces of the rectus femoris, gastrocnemius, soleus and tibialis anterior. Musculoskeletal modeling and simulation tool offers a less invasive and practical alternative to analyze human motion. It also provides a means to investigate the effect of medical devices such as knee brace, which can be potentially beneficial for the future design and development of such devices and for the derivation of future rehabilitation treatment to improve patient's gait.

Effect of Internal Bracing on Broström Operation Clinical Outcomes

Category: Ankle; Other Introduction/Purpose: When patients fail conservative management for chronic lateral ankle instability, a Broström procedure is often recommended. The purpose of this study was to investigate the postoperative trends between Broström recipients who were and were not augmented with suture tape, while secondarily assessing the relationship between demographics and medical history with postoperative outcomes for those patients. Methods: We conducted a retrospective review of 125 patients treated with a modified Broström by a single fellowship-trained foot and ankle surgeon at an academic medical center between 2016 and 2020. Overall, 39 patients received suture tape augmentation, 95 underwent a primary Broström and 30 a revision, and 24 were operated on with a nanoscope. Various demographics, medical history, patient-reported outcome measures (PROMs) (e.g., Foot and Ankle Outcome Score [FAOS], Foot and Ankle Ability Measure [FAAM]), and postoperative outcomes were collected. Average follow-up was 1.0 years (0.25-4.58). Results: There were no differences in any postoperative PROMs (i.e., FAOS, FAAM) between suture tape augmentation cohorts. Similarly, no difference existed in follow-up duration or complication rate. The only significant difference between cohorts pertained to the proportion of patients who underwent a reoperation specifically for incision and debridement (suture tape=71.4%, no suture tape=0.0%; p=.013). Furthermore, when analyzing the primary and revision Broström operation cohorts, there were no differences in any postoperative PROM, follow-up duration, or complication. Finally, when analyzing cohorts whose procedures did and did not use a nanoscope, there was no difference in any PROMs, complications, or reoperation rate, but follow-up duration was significantly longer for those whose procedures did not use a nanoscope (nanoscope=0.71 years, no nanoscope=1.13 years; p=.003). (Table 1) Conclusion: Neither suture tape augmentation or revision status was found to affect postoperative outcomes or PROMs for the Broström operation. However, unlike the control group, no patients who did not received suture tape augmentation underwent reoperation for deep infection, and these patients had a lower complication rate. The only variable that showed a difference in postoperative outcomes was whether a patient was concomitantly operated on with a nanoscope, in which their follow-up duration was reduced. Based on their overall predictiveness, preoperative PROMs may provide insight into clinical success following a Broström operation.

The Effect of an External Ankle Brace on Return to Play Following Ankle Sprains in Elite Collegiate Athletes

Category: Sports; Ankle Introduction/Purpose: Ankle sprains are some of the most common injuries experienced by collegiate athletes. The goal of treatment is to restore function to the ankle allowing the athlete to return to full activity while minimizing lost playing time. There is a paucity of literature on return to play (RTP) for Grade I-IV sprains. There is also no literature regarding the role of external ankle bracing in elite collegiate athletes. The purpose of this study was to determine the return to play in Division I collegiate athletes after being treated in an external ankle brace following Grade I-IV ankle sprain. Methods: All athletes at an NCAA Division I Institution who sustained ankle sprains (Grade I-IV) between August 2020 and November 2021 and were treated with an external ankle brace were included. Athletes were allowed to gradually RTP using the external ankle brace. Athletes were Graded I-IV by the team's ATC and physician (Malliaropoulos et. al 2009). Grade I sprains were characterized by full weight-bearing capacity (WBC), minimal swelling, isolated tenderness to one ankle ligament, and no instability. Grade II sprains were characterized by partial-to-full WBC, moderate swelling, tenderness to two ankle ligaments, and mild-moderate instability. Grade III sprains were defined by no-to-partial WBC, severe swelling, tenderness to two or more ankle ligaments, and moderate-severe instability. Grade IV sprains were defined as syndesmotic sprains. Athlete RTP was defined as full participation in sports-specific activities with full WBC and clearance for competition. RTP between sprain grades was compared using the Mann-Whitney U test. Results: Thirteen elite collegiate athletes participating in cleated sports were treated: football (n=10), lacrosse, baseball, and track and field (all n=1). Grade I sprains (n=4) averaged RTP of 5.8 +- 1.4 days. Grade II sprains (n=8) averaged RTP of 14.4 +- 2.2 days. No Grade III sprains were observed. The athlete sustaining a Grade IV sprain (n=1) had a RTP of 17 days. A significant difference was found for time for RTP between Grade I and Grade II ankle sprains (p=0.02). Athletes with Grade I and II sprains wore the external brace during sport for 10.8 +- 3.9 days and 10.4 +- 4.7 days, respectively. There were no Grade III sprains observed. The athlete sustaining a Grade IV sprain wore the external brace for 24 days for RTP. There were no secondary complications using the external ankle brace during this study. Conclusion: Our results suggest an external ankle brace is a viable alternative to taping and internal bracing for rapid RTP for elite collegiate athletes. There was a significant difference in RTP of 8.6 days for athletes sustaining Grade I and II sprains that were treated with the external ankle brace. There is a lack of literature documenting the time for RTP for ankle sprains. Further investigation is needed to compare external ankle bracing with other ankle sprain treatment modalities regarding RTP.

The facilitation of trunk muscles by abdominal bracing during walking in chronic low back pain patients

Walking is known to be beneficial for chronic low back pain (LBP) patients and fast walking recruits more trunk muscles. Abdominal bracing has also been shown to improve LBP and facilitate several trunk muscles. We aimed to investigate the effects of walking velocity and abdominal bracing on the activation of trunk muscles in chronic LBP patients during walking. Forty-six volunteers with chronic LBP underwent walking exercise on the treadmill without (“non-braced walking”) and with abdominal bracing (“braced walking”) at speeds of 4, 5, and 6 km/h, with the surface electrodes placed on their trunk muscles to measure muscle activity. The root mean square values of the surface electromyography amplitude data were obtained at the multifidus of lower (ML) and upper lumbar (MU), erector spinae of lower lumbar (EL) and thoracic (ET), rectus abdominis (RA), and external oblique (EO). All muscles activated significantly more at faster walking. The “braced walking” facilitated the ET and RA significantly more than the “non-braced walking”. The interaction between the walking speed and abdominal bracing was significant at ML, MU, and RA. The increase in muscle activation observed at lower speed diminished as speed increased. Since “braced walking” seems to additionally facilitate the trunk muscles especially at slower gait speeds, patients who cannot walk fast may still be able to train their muscles by “braced walking.”

Immediate effects of counterforce brace with and without vibration on pain, muscle strength and range of motion in participants with lateral epicondylitis. A pilot study

ABSTRACT Lateral epicondylitis is one of the most common elbow problems. Counterforce braces are commonly used to manage lateral epicondylitis. Recent studies showed that vibration can decrease pain and increase muscle strength by improving motor abilities. The aim of this study was to evaluate the effects of a counterforce brace with and without vibration on pain, muscular strength, wrist and elbow joints range of motion in the participants with lateral epicondylitis. In this repeated measure pre-post clinical trial study, 28 participants with lateral epicondylitis were included. Pain were measured with Visual Analogue Scale (VAS), wrist and elbow flexor/extensor muscles strength with digital dynamometer, wrist and elbow flexion/extension range of motion with goniometer in 3 condition baseline, counterforce brace and counterforce brace with vibration. Pain using counterforce bracing with vibration showed a significant reduction as compared with baseline and counterforce bracing (P < 0.001). Wrist flexor muscles strength (P = 0.005), elbow flexor/extensor muscles strength respectively (P = 0.04, P = 0.02), wrist flexion/extension range of motion (P < 0.001) following the use of counterforce bracing with vibration increased significantly compared with baseline. The results show that the counterforce bracing with and without vibration relieves pain and improves range of motion and muscles strength in lateral epicondylitis participants, but this improvement is more significant with the use of vibration.

Additive Manufacturing of Spinal Braces: Evaluation of Production Process and Postural Stability in Patients with Scoliosis.

Spinal orthoses produced using additive manufacturing show great potential for obtaining patient-specific solutions in clinical applications, reducing manual operations, time consumption, and material waste. This study was conducted to evaluate the production process of spinal orthoses produced by additive manufacturing, and to test the effects of 3D-printed braces on postural stability in patients with adolescent idiopathic scoliosis and osteogenesis imperfecta. Ten patients were recruited consecutively and were asked to wear a spinal orthosis produced by additive manufacturing for 2 weeks. The four phases of the production process for each brace were evaluated separately on a scale from 0 (not acceptable) to 3 (optimal). Postural stability in the unbraced and the two braced conditions (3D-printed and conventional) was assessed using validated metrics obtained from a wearable inertial sensor. The production process was evaluated as good in four cases, acceptable in five cases, and not acceptable in one case, due to problems in the printing phase. No statistically significant differences were observed in any of the postural balance metrics between the 3D-printed and conventional brace. On the other hand, postural balance metrics improved significantly with both types of braces with respect to the unbraced condition. Spinal orthoses produced with an innovative production process based on digital scans, CAD, and 3D printing are valid alternatives to conventionally produced orthoses, providing equivalent postural stability.