Brace Group Research Articles

Health-related quality of life in adolescents with idiopathic scoliosis: a cross-sectional study including healthy controls.

To describe health-related quality of life in adolescents with idiopathic scoliosis and controls. This cross-sectional study analysed data from 307 individuals with idiopathic scoliosis and 80 controls without scoliosis (mean age 15.5 ± 2.1 and 14.0 ± 2.2years, respectively). Health-related quality of life (HRQoL) was assessed using EuroQol 5-dimensions (EQ-5D) questionnaire, and the scoliosis specific Scoliosis Research Society-22r questionnaire (SRS-22r). HRQoL data in individuals with scoliosis were compared to controls, between treatment groups (untreated, ongoing brace, previously braced and surgically treated) and stratified according to curve size. Adolescents with idiopathic scoliosis had reduced HRQoL compared with controls, observed through lower SRS-22r subscore (respective means 4.16 and 4.68, p < 0.001) and lower EQ-5D index (respective means 0.92 and 0.95, p = 0.032). No differences in SRS-22r subscore or EQ-5D index were detected when comparing different scoliosis treatment groups. Within the SRS-22r function domain the surgically treated group scored 4.40, significantly lower compared to the untreated (4.65) and ongoing brace groups (4.68, p = 0.005). The surgically treated and untreated group were more affected by pain, compared to the ongoing brace group (p = 0.01) with the surgically treated group scoring lowest. Non-surgically treated scoliosis individuals with larger curves (> 30 degrees) had a lower SRS-22r subscore (4.08) compared to those with smaller curves (4.31, p = 0.001). Adolescents with idiopathic scoliosis had a reduced HRQoL compared to healthy controls. Minor differences were detected when comparing between idiopathic scoliosis treatment groups. Non-surgically treated scoliosis patients with larger curves had a lower HRQoL shown by lower SRS-22r values.

Quantification of Salivary Nitric Oxide in Patients with Fixed Orthodontic Treatment

Nitric oxide (NO) is considered a regulator of bone response to mechanical stress that mediates adaptive bone formation, the pathological effects of lipopolysaccharides (LPS), tumour necrosis factor (TNF), interleukin 1 (IL-1) and other cytokines; regulates leukocytes and epithelial cell adhesion; inhibits T cell proliferation; and enhances natural killer (NK) cell activity, as well as other immune-related processes. The aim of the current study was to test the potential use of salivary NO as a biomarker of bone response that is specific and sensitive to local changes, following the application of different types of dental appliances. Material and methods: Salivary NO was determined in 30 patients divided into three groups with 10 participants each: control (C), fixed metal braces group (M), and aligners group (A). Salivary NO was determined four times in each group (before the procedure, at 2 weeks, 30 days, and 60 days after the procedure) using ELISA and rapid semi-quantitative assay with Nitric Oxide Saliva Test Strips (Berkeley, CA, USA). The mean results were compared with the ANOVA test, and the Pearson correlation index was calculated. The results show a significant increase in salivary NO levels by both methods only in the metal braces group, which is suggestive of oxidative damage, increased invasiveness, and bone response to metal braces. In conclusion, our study showed that metal brackets lead to a significant temporary increase in oral oxidative stress as an adaptive reaction to the presence of foreign bodies in the oral cavity. The subsequent concentration decrease at 60 days suggests a normalization of the body’s response to foreign bodies.

Prescription of knee braces after anterior cruciate ligament reconstruction: Fact or fiction?

This study aims to compare the clinical results of patients rehabilitated with or without a rehabilitative knee brace (RKB) after anterior cruciate ligament (ACL) reconstruction. This retrospective, comparative study was conducted at between January 2013 and December 2017. A total of 119 patients (112 males, 7 females; mean age: 32.0±8.6 years; range, 18 to 45 years) with acute ACL ruptures treated with arthroscopic ACL reconstruction and rehabilitated with (n=56) or without RKB (n=63) participated in the study. The minimum follow-up time was 24 months. The ACL quality of life (QoL) questionnaire, Lysholm Knee Scoring Scale, and Tegner Activity Level Scale were used for the evaluation of the QoL, knee function, and activity level, respectively. The time to return to sports was recorded. The side-to-side difference in the anterior translation of the tibia was measured using a KT-1000 arthrometer. The mean follow-up time was 38.4±9.1 (range, 24 to 56) months. Baseline demographics and clinical characteristics were similar between groups. Regarding QoL, knee function, and activity level, no significant difference was observed between patients who used RKB and those who did not use it at the postoperative 12th month (p=0.95, p=0.56, p=0.98, respectively) and the latest follow-up (p=0.21, p=0.73, p=0.99, respectively). The mean time to return to sports (nearly 11 months for both groups) and side-to-side difference in the anterior tibial translation at the latest follow-up was also similar between groups (p=0.15 and p=0.15, respectively). There was no graft rupture during the follow-up in both groups. The complication rates were 7.9% and 7.1% for no brace and brace groups, respectively, without a statistically significant difference (p=0.87). According to the results of this study, there was no significant difference between the rehabilitative brace and no brace groups in clinical outcomes after ACL reconstruction.

Functional Bracing of Femur Fractures in Young Children Avoids Anesthesia and Spica Casting with Equivalent Outcomes: A Randomized Prospective Study

Purpose: AAOS Clinical Practice Guidelines recommend spica casting for pediatric femur fractures ages 6 months to 5 years. Kramer et al. reported the use of custom made functional braces as an alternative; however, custom making braces presented many logistical challenges. We hypothesized braces could be pre-fabricated ahead of time in multiple standardized sizes then customized to fit the patient. The purpose of this study was to compare outcomes of patients treated with prefabricated functional braces to spica casting. Methods: A randomized prospective study was performed at two pediatric centers of patients 6 months to 5 years with diaphyseal femur fractures. Patients with polytrauma, medical comorbidities impacting fracture healing, or &lt; 6-week follow-up were excluded. Spica casts were placed in the operating room under general anesthesia; functional braces were placed at bedside. Malunion was defined as 6 months - 2 years: &gt; 30 o varus/valgus; &gt;30 o procurvatum; or &gt;15mm shortening; 2 years - 5 years: &gt; 15 o varus/valgus; &gt;20 o procurvatum; or &gt;20mm shortening. Results: 56 patients (29 spica; 27 brace) met inclusion criteria. Mean age was 2.3 years in both groups . Injury films had similar shortening (p = 0.33), varus angulation (p = 0.09) and procurvatum (p = 0.54). At 6-weeks post-treatment, all fractures had achieved union. There were no differences in femoral shortening (spica = 17.1mm ± 2.6, brace = 14.9mm ± 2.0, p = 0.50) or varus angulation (spica = 2.0o ± 1.8, brace = 3.6o ± 1.6, p = 0.52). The spica group had higher mean procurvatum at 22.6o ± 3.1 compared to 12.4o ± 2.2 for the brace group (p = 0.01). There were no malunions in either group. Two brace patients had fungal skin infections. 20 patients have 1-year follow-up (11 spica; 9 brace). There were no differences in femoral shortening (spica = 2.6mm ± 0.9, brace = 3.7mm ± 2.3, p = 0.61), varus angulation (spica = 0.6o ± 2.0, brace = 1.2o ± 2.0, p = 0.83), or procurvatum (spica = 16o ± 3.43, brace = 8o ± 2.3, p = 0.06). All patients were ambulatory, except one with new ankle fracture. Conclusion: In this prospective randomized trial, patients treated with functional bracing had equivalent outcomes to those treated with spica casting. Significance: Standardized functional braces provide a viable treatment alternative to spica casting, avoiding cost and anesthesia associated with operating room cast placement.

Functional Resistance Training After Anterior Cruciate Ligament Reconstruction Improves Knee Angle and Moment Symmetry During Gait: A Randomized Controlled Clinical Trial

The purpose of this study was to determine 1) whether progressive functional resistance training (FRT) during walking would improve knee biomechanical symmetry after anterior cruciate ligament (ACL) reconstruction and 2) whether the mode of delivery of FRT would have a differential effect on symmetry. Thirty individuals who underwent primary ACL reconstruction at a single institution volunteered for this study. Participants were randomized into one of three groups: 1) BRACE, 2) BAND, or 3) CONTROL. The BRACE group received FRT with a novel robotic knee brace along with real-time kinematic feedback. The BAND group received FRT with a custom resistance band device along with real-time kinematic feedback. The CONTROL group received only real-time kinematic feedback. Participants in all groups received training (2-3/week for 8 weeks) while walking on a treadmill. Knee angle and moment symmetry were calculated immediately prior to beginning the intervention and within 1 week of completing the intervention. Statistical Parametric Mapping was used to assess differences in biomechanical symmetry between groups across time. There was a significant interaction in knee moment symmetry from 21 and 24% of the stance phase (P= .046), in which the BAND group had greater improvements following training compared with both BRACE (P= .043) and CONTROL groups (P= .002). There was also a significant time effect in knee angle symmetry from 68 to 79% of the stance phase (P= .028) and from 97 to 100% of the swing phase (P=.050) in which only the BRACE group showed significant improvements after the intervention (stance: P= .020 and swing: P < .001). The results of this randomized controlled clinical trial indicate that 8 weeks of progressive FRT during treadmill walking in individuals with ACL reconstruction improves knee angle and moment symmetry during gait. The findings suggest that FRT could serve as a potential therapeutic adjuvant to traditional rehabilitation after ACL reconstruction and can help restore knee joint biomechanical symmetry. Level II, randomized controlled trial.

Scapholunate Ligament Reconstruction without Immobilization Is Safe and Leads to Better Functional Results.

Background Reconstruction of the scapholunate ligament (SL) is associated with a reduction in range of motion. In this study, we compared SL reconstruction and early mobilization with SL reconstruction and Kirschner wires (K-wire) fixation for 6 weeks. Methods We performed a nonrandomized trial involving patients with an arthroscopically confirmed SL ligament injury. In total, 11 patients were assigned to SL reconstruction with internal brace augmentation and early mobilization and 10 were assigned to standard SL reconstruction and K-wire fixation for 6 weeks before mobilization started. We assessed the range of motion, grip strength, functional status, intensity of pain, global perceived effect, and duration until return to work. Results In both groups, there was one traumatic breakout of the reconstructed ligament and two patients in the control group were lost to follow-up. The 10 patients in the internal brace group had a mean increase in wrist flexion of 1.8 degrees at 1 year compared with a decrease in wrist flexion of 13.4 degrees in the seven patients of the control group. Wrist extension increased by 4.5 degrees in the internal brace group and decreased by 4.5 degrees in the control group. In addition, the internal brace group scored 6.1 (much improved) for the global perceived effect and the control group 4.7 (slightly improved), and treatment without immobilization resulted in an earlier return to work (35.1 vs. 73.6 days). Conclusions In SL reconstruction, internal brace augmentation and early mobilization result in improved wrist flexion and extension, higher satisfaction, and earlier return to work.

Objective Outcomes of All-inside Anterior Cruciate Ligament Reconstruction with and Without Internal Suture Augmentation Technique: Randomized Controlled Trial

To report and compare patient outcomes (PROs) (IKDC score, Lysholm Score) and knee laxity using Lachmeter -The digital Rolimeter ® - among patients who underwent hamstrings autograft anterior cruciate ligament reconstruction (ACLR) with and without internal tape augmentation. Randomized trial of 41 patients in which 21 patients underwent all-inside ACLR with internal suture augmentation (Group I, Brace group) and 20 patients underwent all-inside ACLR without internal suture augmentation (Group II, non-brace group). Primary outcomes Lachmeter examinations and PROs were analyzed at 3,6,9 months postoperative. Secondary outcomes were graft failure, synovitis, and infection. Mean follow-up duration was 18 months ± 3.4. Date was expressed as Mean±SD for quantitative parametric data or number and percentage for categorized data. Delta change (dC) principle was used to test the actual mathematical change in the outcomes between 0-9 months and 3-9 months intervals postoperative. Lysholm score at 9-months was significant and better in brace group mean: 94 (92.4-96.5), p&lt;0.005. Postoperative Lachmeter at 3,9 months was significant with less laxity in brace group mean: 1.98 (1.89- 2.07), 2.14 (2.06-2.22) p&lt;0.005. dC Lachmeter in both intervals was significant with less laxity in brace group mean: .09 (.06-.11) p&lt;0.001. dC IKDC score was significant in 3-9 months interval mean: .31 (.28-.35) p&lt;0.001. dC Lysholm score was significant in 0-9 months interval mean: .86 (.72-.99) p&lt;0.001. Both scores were better in brace-group. One graft failure was reported in Group II and one case of synovitis in Group I. All-inside ACLR with brace showed better laxity measures and lower failure rate at 9-months postoperative. However, the subjective functional outcomes did not show clear evidence of superiority in the suture tape augmentation group.

Stress level and quality of life of adolescents with idiopathic scoliosis during brace treatment.

Objectives This study aimed to evaluate the effect of brace treatment on the stress level and quality of life (QoL) of adolescents with idiopathic scoliosis. Patients and methods A total of 194 adolescent individuals were evaluated in two groups: the adolescent idiopathic scoliosis (AIS) group with 97 patients (20 males, 77 females; mean age: 13.9±1.8 years; range 10 to 18 years) and the control group with 97 age-and sex-matched participants (20 males, 77 females; mean age: 14.3±1.7 years; range 10 to 18 years) with no spinal deformity. The AIS group wore the Milwaukee brace or a thoracolumbosacral orthosis based on the location of the apical vertebra. All participants of the AIS group filled the Persian versions of the revised Scoliosis Research Society 22-item questionnaire (SRS-22r), the eight-item Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity, and BSSQ-Brace. The control group only answered the first 20 items (subtotal items) of the SRS-22r. The brace-related QoL and stress level were assessed based on sex, brace, and deformity types. Results The subtotal score of the SRS-22r in the AIS group was significantly lower than the control group (p<0.001). There was a significant difference between deformity-related stress and brace-related stress (p<0.001). Regarding the type of treatment, there were no significant differences in QoL and stress level between the Milwaukee brace and thoracolumbosacral orthosis groups (p>0.05). Moreover, there was a weak correlation between the BSSQ-Brace and the self-image, mental-health scores, and the total scores of the SRS-22r (r=0.39 to 0.42, p<0.001); the low level of perceived stress was associated with a high level of perceived QoL. Conclusion The stress due to brace treatment can decrease function/activity and self-image of adolescents with idiopathic scoliosis.

Effect of joint immobilization using extension splint immediately after total knee arthroplasty on post-operative knee function and pain: a randomized clinical trial.

Investigate the effect of semirigid extension bracing after total knee arthroplasty (TKA) on articular pain and function. The present randomized clinical trial included 72 patients undergoing unilateral primary TKA. Patients in the case group received eight days of post-operative semirigid extension-locked knee bracing, whereas controls did not. The outcomes assessed preoperatively and on the first, ninth, 30th day, and oneyear post-operatively included the knee society score (KSS), functional KSS (FKSS), VAS pain score, amount of postoperative opiate painkiller usage (tablet oxycodone 5mg), and knee ROM. The case group had a significantly lower flexion ROM on postoperative day nine compared to the control group (95.3° vs. 100.8°, p=0.03), while it became significantly higher 1 month (114.1° vs. 104.7°, p=0.03) and one year post-operative (128.0° vs. 120.5°, p=0.002). Also, FKSS was significantly higher in the case group than in the controls in the onemonth post-operative assessment (37.0 vs. 32.6, p=0.009) but not in the oneyear post-operative assessment. The case group patients had a significantly lower pain than the controls on days one (5.8 vs. 7.2, p=0.02) and nine post-operative (4.1 vs. 5.2, p=0.048), but not at later assessments. The amount of onemonth post-operative opium (oxycodone) consumption was significantly lower in the brace group (12.4 vs. 14.1 tablets, p=0.03). The KSS were not significantly different between the groups after the surgery. Extension-locked splinting immediately after TKA is a noninvasive, non-pharmacological, and inexpensive intervention with possible promising effects on knee ROM, short-term functional improvement, and acute post-operative pain management.

Functional Resistance Training Improves Thigh Muscle Strength after ACL Reconstruction: A Randomized Clinical Trial.

Quadriceps weakness is common after anterior cruciate ligament (ACL) reconstruction, resulting in prolonged disability and increased risk for reinjury and osteoarthritis. Functional resistance training (FRT) combines resistance training with task-specific training and may prove beneficial in restoring quadriceps strength. The primary purpose of this study was to determine if a walking-specific FRT program (e.g., resisted walking) improves knee strength in individuals after ACL reconstruction. Thirty participants were randomized into one of three groups: 1) FRT with a customized knee BRACE applied to the ACL leg, 2) FRT with elastic BAND tethered to the ankle of the ACL leg, or 3) a TARGET MATCH condition where no resistance was externally applied. Participants in all groups received training while walking on a treadmill 2-3 times per week for 8 wk. Isometric knee extension and flexion strength were measured before the start of the intervention, after the intervention (POST), and 8 wk after intervention completion (POST-2). The BRACE group had greater knee extensor strength compared with the TARGET MATCH group at POST and POST-2 ( P < 0.05). The BRACE group had greater knee flexor strength than the TARGET MATCH group at POST and POST-2 ( P < 0.05) and the BAND group at POST ( P < 0.05). FRT applied via a customized knee brace results in improvements in knee extensor and flexor strength after ACL reconstruction. FRT is a beneficial adjuvant to ACL rehabilitation and leads to better strength compared with standard of care.

Effectiveness and cost-effectiveness of dynamic bracing versus standard care alone in patients suffering from osteoporotic vertebral compression fractures: protocol for a multicentre, two-armed, parallel-group randomised controlled trial with 12 months of follow-up

IntroductionPatients with osteoporosis may suffer from a fracture after minimal trauma. Osteoporotic vertebral compression fractures (OVCFs) are among the most common fractures, often leading to substantial pain. There is a...

A New Treatment Algorithm That Incorporates Minimally Invasive Surgery for Pyogenic Spondylodiscitis in the Thoracic and Lumbar Spines: The Results of Its Clinical Application to a Series of 34 Patients.

Background and Objectives: Spinal minimally invasive surgery (MIS) experts at the university hospital worked as a team to develop a new treatment algorithm for pyogenic spondylodiscitis in lumbar and thoracic spines. They modified a flow chart introduced for this condition in a pre-MIS era to incorporate MIS techniques based on their extensive experiences accumulated over the years, both in MIS for degenerative lumbar diseases and in the treatment of spine infections. The MIS procedures incorporated in this algorithm consisted of percutaneous pedicle screw (PPS)–rod fixation and transpsoas lateral lumbar interbody fusion (LLIF). The current study analyzed a series of 34 patients treated with prospective selection of the methods according to this new algorithm. Materials and Methods: The algorithm first divided the patients into those who had escaped complicated disease conditions, such as neurologic impairment, extensive bone destruction, and the need to be mobilized without delay (Group 1) (19), and those with complicated pyogenic spondylodiscitis (Group 2) (15). Group 1 had image-guided needle biopsy followed by conservative treatment alone with antibiotics and a spinal brace (12) (Group 1-A) or a subsequent addition of non-fused PPS–rod fixation (7) (Group 1-B). Group 2 underwent an immediate single-stage MIS with non-fused PPS–rod fixation followed by posterior exposure for decompression and debridement through a small midline incision (12) (Group 2-A) or an additional LLIF procedure after an interval of 3 weeks (3) (Group 2-B). Results: All patients, except four, who either died from causes unrelated to the spondylodiscitis (2) or became lost to follow up (2), were cured of infection with normalized CRP at an average follow up of 606 days (105–1522 days). A solid interbody fusion occurred at the affected vertebrae in 15 patients (50%). Of the patients in Group 2, all but two regained a nearly normal function. Despite concerns about non-fused PPS–rod instrumentation, only seven patients (21%) required implant removal or replacement. Conclusions: Non-fused PPS–rod placements into infection-free vertebrae alone or in combination with posterior debridement through a small incision worked effectively in providing local stabilization without contamination of the metal implant from the infected tissue. MIS LLIF allowed for direct access to the infected focus for bone grafting in cases of extensive vertebral body destruction.

Brace versus cast following surgical treatment of distal radial fracture: a prospective randomised study comparing quality of recovery

Background:Immobilisation following surgical treatment of distal radial fractures (DRF) is traditionally performed with a dorsal cast splint. There is an interest in changing the rigid cast to a removable brace. This can reduce the risk for cast-corrections, complications and improve recovery of function. The aim of the study was to compare quality of recovery (QoR) between brace and traditional cast for immobilisation during the first postoperative week. Methods:60 patients with American Society of Anesthesiologists (ASA) physical status 1-3, scheduled for surgical treatment of DRF under a supraclavicular block (SCB) in a day-surgery setting were randomised into two groups of immobilisation post-surgery; brace (n=30) versus traditional cast (n=30). Study objectives were: differences in self-assessed QoR using the QoR-15 questionnaire, postoperative oral oxycodone consumption, perioperative time events and unplanned healthcare contacts one week postoperatively. Results:54 patients, 46 females/eight males were included in the analysis; 27 with brace and 27 with traditional cast. QoR-15 median scores improved significantly from baseline/preoperative to day 7 (brace p=0.001, cast p=0.001) with no differences between the two groups. The only difference found was that patients in the brace group had significantly worse pain score 24-hours post-surgery (p=0.022). No significant differences were seen in total median oxycodone consumption the first three postoperative days. No differences were found in perioperative events or unplanned healthcare contacts. Conclusions:Brace appears to be a feasible option to traditional cast for immobilisation following surgical treatment of DRF. The early QoR was similar in both groups apart from more pain in the brace group the first 24 postoperative hours.

Factors associated with the relapse in Ponseti treated congenital clubfoot

ObjectivesWe retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method.MethodsWe retrospectively reviewed all children with congenital clubfoot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples’ Hospital Ethics Committee.ResultsIn this study, there were 148 cases (164 ft) in total that underwent the Ponseti method, with the follow–up period at least 5 years. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50 ± 2.15 months. The average initial Pirani score was 4.98 ± 1.33, and the average number of casts was 5.71 ± 2.28 times. The mean age of mothers at birth was 25.81 ± 2.38 years old. The walking age of children was at a mean of 14.83 ± 1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 ft (76.4%). The average follow–up period was 7.27 ± 1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group .ConclusionThe initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.

Brace versus cast following surgical treatment of distal radial fracture: a prospective randomised study comparing quality of recovery

Background: Immobilisation following surgical treatment of distal radial fractures (DRF) is traditionally performed with a dorsal cast splint. There is an interest in changing the rigid cast to a removable brace. This can reduce the risk for cast-corrections, complications and improve recovery of function. The aim of the study was to compare quality of recovery (QoR) between brace and traditional cast for immobilisation during the first postoperative week. Methods: 60 patients with American Society of Anesthesiologists (ASA) physical status 1–3, scheduled for surgical treatment of DRF under a supraclavicular block (SCB) in a day-surgery setting were randomised into two groups of immobilisation post-surgery; brace (n=30) versus traditional cast (n=30). Study objectives were: differences in self-assessed QoR using the QoR-15 questionnaire, postoperative oral oxycodone consumption, perioperative time events and unplanned healthcare contacts one week postoperatively. Results: 54 patients, 46 females/eight males were included in the analysis; 27 with brace and 27 with traditional cast. QoR-15 median scores improved significantly from baseline/preoperative to day 7 (brace p=0.001, cast p=0.001) with no differences between the two groups. The only difference found was that patients in the brace group had significantly worse pain score 24-hours post-surgery (p=0.022). No significant differences were seen in total median oxycodone consumption the first three postoperative days. No differences were found in perioperative events or unplanned healthcare contacts. Conclusions: Brace appears to be a feasible option to traditional cast for immobilisation following surgical treatment of DRF. The early QoR was similar in both groups apart from more pain in the brace group the first 24 postoperative hours.

Dynamic fixation using rigid tape in rehabilitation after surgery of terrible triad injury of the elbow: A randomized trial.

The aim of the study was to identify the efficacy of dynamic fixation using rigid tape (RT) in rehabilitation after surgery of terrible triad injury of the elbow (TTIE). Sixty patients who underwent surgery of TTIE were equally randomly divided into RT group and hinged external fixation brace (HEFB) group. Dynamic fixations were applied for 8 weeks. General rehabilitation programs were performed for 3months, 5 times a week. Follow-up (FU) was at six months. Main outcomes included pain (Visual Analogue Scale, VAS), muscle strength, range of motion (ROM), Elbow Function (Mayo Elbow Performance Index, MEPI), Quality of Life (QOL) (Short Form 36 Questionnaire, SF-36). There were significant time x group interactions for pain, ROM, MEPI, SF-36 (all p= 0.000), which demonstrated positive efficacy of both the two interventions. Difference at each time-point (except for baseline) of pain and ROM between the two groups was statistically significant (all p< 0.05). Some differences between the two groups were not statistically significant which at 14d on MEPI (p= 0.108) and at 21d (p= 0.259) and FU (p= 0.402) on QOL. Moreover, the increased muscle strength at each time-point had no statistically significant difference between the two groups (all p> 0.05). Both RT and HEFB could significantly improve the postoperative functional outcomes of the TTIE. However, early rehabilitation intervention could increase pain, which affected the corresponding function (MEPI) and QOL. Note that this kind of impact was short-term and reversible. The muscle strength and ROM were not affected by the increased severe pain, maintaining a trend of improvement. In addition, the subjects in the RT group improved faster and more efficiently and had better results with pain, ROM, MEPI, and QOL compared to the subjects in the HEFB group.

Differences in finished case quality between Invisalign and traditional fixed appliances.

To compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances. This randomized controlled trial included 66 patients, 32 aligners, and 34 fixed-appliance patients. The median ages of the aligner and braces patients were 26.7 (interquartile range [IQR]: 9.8) and 25.9 (IQR: 16.6) years, respectively. Pretreatment occlusion was assessed using the ABO Discrepancy Index. Posttreatment (T1) and 6-month retention (T2) occlusions were quantified using the ABO Objective Grading System (OGS) scores. The braces group finished treatment significantly (P < .001) earlier (0.4 years) than the aligner group. The median DI scores for the aligner and braces groups were 4.5 and 7.0, respectively, which was a statistically significant (P = .015), but clinically insignificant, difference. There were no statistically significant between-group differences for the total OGS scores or any of the individual component scores at debond (T1) or after 6 months of retention (T2). During the posttreatment period, alignment and overjet worsened significantly in the aligner group, while buccolingual inclinations and occlusal relations improved. Over the same period, alignment worsened in the braces group and buccolingual inclinations improved. There was no statistically significant between-group difference in posttreatment changes of the total OGS scores. While patients with simple malocclusions require 4.8 months longer treatment times with aligners than traditional braces, the treatment and 6-month posttreatment occlusal outcomes are similar.

A qualitative twitter analysis of the patient experience with invisible orthodontics; lingual braces versus invisalign

Objectives: The aim of this qualitative study was to examine orthodontic patients’ thoughts and experiences about the invisible orthodontic treatment options – lingual braces and Invisalign – through the analysis of Twitter posts’ content. Materials and Methods: A software program was written for the data collection. The program consecutively collected the tweets posted over an 8-month period from Twitter’s publicly accessible database. Tweets that were written in the English language and contained any of the four keywords “Invisalign,” “lingualorthodontics,” “lingualbraces,” and “invisiblebraces” were collected. The tweets that included irrelevant or incoherent posts, professional advertisements, unclear/not applicable content, and reposts were excluded from the study. Two authors, with different experiences, independently read, and analyzed the tweets. Each applicable tweet was classified into one of the three categories: Positive, negative, and neutral for two study groups (Invisalign and lingual braces). Pearson Chi-square test was used to analyze the negative and positive tweet rates of the groups. Results: 1176 of 2407 tweets were selected as applicable and analyzed by the authors. There was a statistically significant very good agreement between the two observers (Kappa = 0.933, P &lt; 0.001). The negative comment rate (39%) and neutral comment rate (31.1%) in the lingual group were statistically higher than the Invisalign group (27.2% and 21.7%, respectively; P &lt; 0.001). The positive comment rate in the Invisalign group was significantly higher (51.1%) compared to the lingual group (29.9%, P &lt; 0.001). Conclusion: Orthodontic patients use social media to share their experiences and feelings about their treatment process. The applicable Tweet number and the positive Tweet rate in the Invisalign group were higher than the lingual braces group.

Knee bracing vs Taping as an Adjunct to Rehabilitative Exercise in Patellofemoral Pain Syndrome Management among Basketball Players: A Prospective Study

Patellofemoral pain syndrome (PFPS) is a common source of knee problems found mostly in physically active young adults. Causative factors are multifactorial, including lower extremity weakness, especially quadriceps muscles. Conservative treatment of PFPS consists mainly of knee bracing and knee taping combined with physical therapy. This study was aimed to analyse the outcome comparison between knee bracing and knee taping in combination with rehabilitative exercise for PFPS management. A prospective study was performed involving twenty-five bas- ketball players suffering from PFPS, aged 19–30 years old with regular practice sessions. The subjects were each grouped randomly into a taping or a bracing group. Follow-up evaluations in term of Kujala patellofemoral score were done in the 1 st , 2 nd , and 4 th weeks after treatment. Unpaired t-test and chi-square were used to analyse the difference between both groups in pre- and post-intervention. Baseline characteristics of each group did not dif- fer significantly (p&gt;0.05). Both groups had significantly higher functional scores after the 1 st , 2 nd , and 4 th weeks of intervention (p&lt;0.05). Significantly higher functional scores were found in the bracing group on the 2 nd (p=0.013) and 4 th weeks (p=0.002). No significant differences were found in functional scores between both groups in the 1 st week (p=0.142). While both methods were efficacious, knee bracing is more effective compared to knee taping in improving functional outcomes as an adjunct to rehabilitative exercise in PFPS management.

Can a Hip Brace Improve Short-Term Hip-Related Quality of Life for People With Femoroacetabular Impingement and Acetabular Labral Tears: An Exploratory Randomized Trial.

To examine whether a hip brace can improve hip health quality-of-life (QoL) and is well-tolerated in people with femoroacetabular impingement syndrome (FAIS) or symptomatic labral tears after 6 weeks of wear. Parallel, two-arm, exploratory randomized trial. Hospital and private clinics of orthopaedic surgeons. Individuals >18 years with FAIS or labral tears. Usual conservative care versus usual conservative care plus a hip brace. Patient-reported outcomes were assessed with the International Hip Outcome Tool (iHOT-33), and Copenhagen Hip and Groin Outcome Scores (HAGOS). Brace acceptability was measured using the Quebec User Evaluation of Satisfaction with Assistive Technology survey. Independent t-tests assessed between-group differences. Thirty-eight participants were recruited, 19 each group, 60% women, mean age 39.3 ± 11.8 years, body mass index 25.3 ± 4.4 kg/m2, iHOT-33 36.6 ± 24.8. Three participants dropped out (one usual care, 2 braced). The mean between-group difference for iHOT-33 was 19.4 (95% confidence interval [CI] 1.68-37.06, P = 0.03) favoring the brace. There were improvements in most HAGOS subscale scores favoring the brace. Issues with brace tolerability for some participants were perceived comfort and effectiveness. Three brace-related adverse events were reported. Between-group differences favored the braced group for hip health QoL, pain, symptoms, and function. Although these were promising results, the CIs for the estimates were wide, the small sample size likely a contributing factor. Our results suggest that further investigation of the brace is warranted, we calculated sample sizes and made recommendations for the design of a future trial.