Effectiveness Of Orthotic Treatment Research Articles

Effect of Orthotic Treatment on Curve Correction and Cardio Respiratory Functions in Congenital Scoliosis with Single-Level Hemi Vertebrae

Background: The natural world of congenital scoliosis with hemi vertebrae is changeable, especially when it is combined with a unilateral unsegmental bar. Orthotic treatment’s primary aim is to stop further curve progression. The aim of this study is to find the effect in treating congenital scoliosis with single-level hemi vertebrae using orthotic interventions on curve correction and its cardio respiratory functions. Case description and method: A 14 years old with single-level hemi-vertebrae related congenital scoliosis tookunder non-operative treatment at his body with an average supplement period of 2 years. Spinal orthosis (moulded-TLSO, high Profile Boston Brace) was fitted on the patient according to SRS guidelines. Breathe cardio-respiratory data analysis and the metabolic data analysis are done through the COSMED-Srl-Italy,K4B2 respectively. Finding: The cardio-respiratory table and graph established a significantly better result in congenital scoliosis with spinal orthosis. Orthotic treatment gives good result over only physiotherapy treatment in term of curve progression and correction. Outcomes and conclusion: The case study shows that high profile Boston brace can stop curve progression in the case of congenital scoliosis without any adverse effect on cardio-respiratory parameters in hemi vertebrae patient.

The Effect of Orthotic Treatment on Midfoot Osteoarthritis Assessed Using Specifically Designed Patient Evaluation Questionnaires

Midfoot osteoarthritis (OA) is a degenerative condition of the foot that can be treated non-operatively by the use of orthotics. This prospective study was conducted to determine the effects of custom-made semi-rigid foot orthoses (FOs) and rigid carbon fibre (CF) footplates for the treatment of midfoot OA evaluated using specifically designed questionnaires. Fifty-seven subjects diagnosed with midfoot OA were recruited through a private clinic for inclusion in the study. Subjects were required to complete pre-treatment questionnaires prior to receiving orthotic treatment. All subjects received a pair of custom-made full-length semi-rigid FOs and 36 subjects also received CF footplates that were incorporated into the soles of the shoes worn on the symptomatic feet. Subjects completed post-treatment questionnaires at six weeks, three months and six months after receiving the orthotic treatment. The results demonstrated that there were no significant differences between the results of the subjects who received CF footplates and those who did not. The results of the questionnaires demonstrated that subjects experienced significant improvements in pain, activity levels, walking ability and footwear comfort at all intervals following the orthotic treatment (p < 0.01). Subjects' satisfaction with the appearance of their footwear did not decrease with the orthotic treatment despite needing shoes to fit the FOs and CF footplates. The questionnaires also demonstrated that subjects were generally satisfied with the orthotic treatment for the management of their midfoot OA.

Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head?

Management of neonates with nonsynostotic occipital plagiocephaly has been controversial, and there has been a lack of uniformity concerning its treatment. Patients with nonsynostotic occipital plagiocephaly have been treated surgically or with cranial remodeling orthotic devices and have shown improvement in asymmetry. The cost of orthotic treatment has risen, and its validity has been contested by many third-party insurance payers. The effectiveness of orthotic treatment has not been adequately compared to the natural history of nonsynostotic occipital plagiocephaly. A nonsurgical, nonorthotic treatment study was initiated in June 1995 at Phoenix Children's Hospital. All new patients referred with a diagnosis of nonsynostotic occipital plagiocephaly were categorized into two groups: those with mild-to-moderate asymmetry and those with moderate-to-severe asymmetry. Categories were determined by cephalic measurements. The patients with moderate-to-severe asymmetry were offered orthotic treatment with a cranial remodeling band. Those patients with mild-to-moderate asymmetry were treated with physiotherapy, repositioning of the head, and repeated notation of cephalic measurements without orthotic devices or surgery. Seventy-two neonates, seen consecutively, with mild-to-moderate, nonsynostotic occipital plagiocephaly were evaluated by noting cephalic measurements. The parents of six of these patients elected treatment with a cranial remodeling band and results in these patients were excluded from our data. The remaining 66, treated without orthotic devices, showed improvement in average cranial vault asymmetry (CVA) from 9.2 to 4.7 mm over an average treatment period of 4.5 months that commenced when the average age of the patient was 6.4 months. A comparison of the present data with data published in 1994 for neonates treated with a headband indicates that neonates with mild-to-moderate asymmetry who are treated aggressively with physiotherapy and repositioning have similar improvement in CVA.

Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head?

Plagiocephaly has recently received increased attention in pediatric neurosurgical circles and its treatment has been controversial. Lack of uniformity persists in the treatment of neonates with occipital plagiocephaly. Plagiocephaly resulting from synostosis is rare. Many patients with nonsynostotic plagiocephaly have been treated surgically. Cranial remodeling orthotic devices (such as headbands and helmets) have also been reported to correct nonsynostotic plagiocephaly. The cost of orthotic treatment has risen and its validity has been contested by many third-party insurance payers. The effectiveness of orthotic treatment has not been adequately compared to the natural history of nonsynostotic plagiocephaly. The first phase of a natural history study was initiated in June 1995 at Phoenix Children's Hospital. All new patients referred with a diagnosis of plagiocephaly were categorized into two groups: those with mild-to-moderate asymmetry and those with moderate-to-severe asymmetry. Categories were determined by cephalic measurements. The patients with moderate-to-severe asymmetry were offered orthotic treatment with a cranial remodeling band. Those patients with mild-to-moderate asymmetry were observed with repeated measurements. Data in patients left untreated and followed for natural history were compared to our data published in 1994 for those treated with external cranial orthosis. Our published data in 47 patients treated with a headband during the period from 1988 to 1993 indicated that cranial vault asymmetry improved from a mean of 8.9 mm to 4 mm over an average treatment period of 4.3 months beginning when the average age of the patient was 5.9 months. Seventy-two neonates treated with neck stretching exercises and repositioning of the head without surgery or orthotic devices showed improvement in cranial vault asymmetry from 10.6 mm to 5.5 mm over an average treatment period of 4.5 months beginning when the average age of the patient was 4.5 months. This study indicates that neonates with mild-to-moderate asymmetry who are less than 6 months of age and who are treated with physiotherapy and repositioning have similar improvement in cranial vault asymmetry as those treated with orthotic devices. The second phase of our study deals with neonates who have moderate-to-severe plagiocephaly.