Simple Brace Research Articles

Effect of thoracolumbosacral braces on running ground reaction force components in male individuals with kyphosis

Background & aimsBraces are one of the methods for kyphosis treatment, but they can relocate the center of gravity of the trunk, affecting the ground reaction force (GRF) during running. Therefore, this study aimed to investigate the effects of two types of thoracolumbosacral braces on running GRF components in individuals with kyphosis. Materials & methodsParticipants were 15 males diagnosed with kyphosis who volunteered in this quasi-experimental study. Each subject performed the barefoot running trials on the force plate with one simple brace, with a sensor brace, and without the brace condition. The ground reaction forces components were calculated in the stance phase. Statistical analysis was done with repeated measures test with a significant level of 0.05. ResultsPeak medial ground reaction force when running with a sensor brace was lower than running with a simple brace (p = 0.017). Free moments were similar during three running conditions (p > 0.05). ConclusionLower maximum medial ground reaction force while using a sensor brace may possibly demonstrate the beneficial effects of a sensor brace in individuals with kyphosis.

Conservative Treatment Using Platelet-Rich Plasma for Acute Anterior Cruciate Ligament Injuries in Highly Active Patients: A Retrospective Survey.

Background The recommended treatment for anterior cruciate ligament (ACL) injuries in active, sports-oriented patients is reconstructive surgery in order to regain stability and prevent secondary meniscal injuries. However, ACL reconstruction requires a long recovery period and poses issues such as decreased muscle strength due to tendon harvesting and postoperative osteoarthritis (OA) progression, thereby raising significant expectations for the advancement of conservative treatments. Recent studies have shown that platelet-rich plasma (PRP) therapy, which utilizes the tissue repair-promoting property of platelets, is effective for ACL injuries. Methods We administered PRP therapy within six weeks after ACL injury in patients who expressed the desire for an early return to sports through conservative care. After the treatment, patients wore a simple brace that limited deep flexion but placed no restrictions on weight bearing. Four months was the standard goal established for returning to pre-injury condition, and, depending on the target level, timing, and knee condition, we adjusted the additional PRP treatments and rehabilitation approach, gradually authorizing the patients' return to sport. We assessed the ligament repair status by magnetic resonance imaging (MRI) just before the full return to sports.A retrospective survey was conducted to evaluate the status of ligament repair and the condition of return-to-sport in patients with ACLinjuries who underwent conservative treatment using PRP. Results The average patient age was 32.7 years and the average treatment was 2.8 PRP sessions. MRI evaluations confirmed that ligament continuity was regained in all cases. All the patients returned to their pre-injury level (Tegner Activity Scale 7.0) in an average of 139.5 days, but there was one instance of re-rupture following the return to sports. Conclusion All patients with ACL injury who underwent PRP therapy regained ligament continuity and returned to sport successfully with only one case of re-rupture.

Effect of Two Types of Thoracolumbosacral Brace (With and Without Sensors) on Electromyography Activity of Selected Muscles in People With Thoracic Kyphosis During Typing

Background and Aims People suffer from neck pain, headache, kyphosis and back pain while working with the computer for a long time, which seems to increase day by day with the advancement of technology. The present study aims to investigate the effect of two types of thoracolumbosacral braces (with and without sensors) on electromyography activity of selected muscles in people with thoracic kyphosis during typing. Methods In this quasi-experimental study, 15 males with thoracic kyphosis volunteered to participate in the study. Subjects performed typing task for one minute at three conditions (with no brace, with a simple brace, and with a brace having sensors). An 8-channel wireless electromyography system was used to record the activity of selected muscles in the upper limb and shoulder area. Repeated measures analysis of variance was used to compare the electrical activity of muscles between different conditions. The significance level was set at 0.05. Results The median frequency of trapezius muscle was significantly lower while using the brace with sensors compared to that without using brace (P=0.005). In median frequency of other muscles, no significant differences were observed among three conditions (P>0.05). Conclusion The use of thoracolumbosacral brace with sensors can reduce the median frequency of trapezius muscle in people with kyphosis. This reduction in median frequency may be related to the passive support of the brace. Reduction of electrical activity in trapezius muscle while using thoracolumbosacral brace can increase the time to reach fatigue.

Thin Edges in Braces

The bicontraction of a vertex $v$ of degree two in a graph, with precisely two neighbours $v_1$ and $v_2$, consists of shrinking the set $\{v_1,v,v_2\}$ to a single vertex. The retract of a matching covered graph $G$, denoted by $\widehat{G}$, is the graph obtained from $G$ by repeatedly bicontracting vertices of degree two. Up to isomorphism, the retract of a matching covered graph $G$ is unique. If $G$ is a brace on six or more vertices, an edge $e$ of $G$ is thin if $\widehat{G-e}$ is a brace. A thin edge $e$ in a simple brace $G$ is strictly thin if $\widehat{G-e}$ is a simple brace. Theorems concerning the existence of strictly thin edges have been used (implicitly by McCuaig (Pólya's Permanent Problem, Electron. J. of Combin., 11, 2004) and explicitly by the authors (On the Number of Perfect Matchings in a Bipartite Graph, SIAM J. Discrete Math., 27, 940-958, 2013)) as inductive tools for establishing properties of braces.Let $G$ and $J$ be two distinct braces, where $G$ is of order six or more and $J$ is a simple matching minor of $G$. It follows from a theorem of McCuaig (Brace Generation, J. Graph Theory, 38, 124-169, 2001) that $G$ has a thin edge $e$ such that $J$ is a matching minor of $G-e$. In Section 2, we give an alternative, and simpler proof, of this assertion. Our method of proof lends itself to proving stronger results concerning thin edges.Let ${\cal G}^+$ denote the family of braces consisting of all prisms, all Möbius ladders, all biwheels, and all extended biwheels. Strengthening another result of McCuaig on brace generation, we show that every simple brace of order six or more which is not a member of ${\cal G}^+$ has at least two strictly thin edges. We also give examples to show that this result is best possible.

A Commentary on: "A New Removable Uterine Compression by a Brace Suture in the Management of Severe Postpartum Hemorrhage".

A Commentary on: "A New Removable Uterine Compression by a Brace Suture in the Management of Severe Postpartum Hemorrhage".

Buckling Restrained Braced Frame with All-Bolted Gusset Connections

A braced-frame, lateral-load-resisting system was developed in which inelastic deformations due to seismic loading were intended to be isolated to easily replaceable buckling restrained braces (BRB). Bolted brace-to-gusset and gusset-to—beam and column connections were utilized to facilitate simple brace and gusset plate installation and replacement. Full-scale testing using two BRBs was executed to assess performance. Analytical frame models were developed using the nonlinear load-deformation characteristics of the braces. The experimental and analytical results were compared to validate reasonable nonlinear parameters for industry use. All-bolted brace connections designed per AISC requirements provided adequate capacity to develop the BRBs. With proper detailing, inelastic deformations can be isolated substantially to the BRBs such that a repairable system is achieved. Load-deformation data for individual braces as provided by the supplier can be used to create reasonable analytical models for frames designed with all-bolted connections.

Assessment, diagnosis, and treatment of developmental dysplasia of the hip

LEARNING OBJECTIVES • Identify risk factors for developmental dysplasia of the hip (DDH) • Recognize common causes of hip dysplasia among infants • Describe physical examination findings indicative of DDH in infancy and in childhood • Relate expert guidelines on diagnosis and evaluation of DDH Diagnosis and treatment of DDH during the first 6 weeks of life involves a simple brace and is highly effective, avoiding dire consequences and possibly saving a child's hip.

Early Results with Use of the Midfoot Fusion Bolt in Charcot Arthropathy

Charcot neuroarthropathy is a complicated condition affecting up to 1 in 680 diabetic patients that can rapidly cause severe destruction of the bony architecture in the foot, with resultant gross instability and frank deformity. Conservative care is not always successful at maintaining an intact soft tissue envelope of the foot; therefore, surgical reconstruction is often attempted in an effort to salvage the limb. The goal is to create a stable, plantigrade foot that can be placed in a shoe or simple brace. However, this effort is dramatically more challenging because of the pathologic bone biology, the inelasticity of the connective tissues, and the difficulty in maintaining non-weightbearing status during the postoperative period. Various forms of internal and external fixation have been described in published studies for use in this setting, all of which have been accompanied by complications such as nonunion, dehiscence, and implant failure. Although the concept of beaming the longitudinal columns of the foot is not new, it has previously been described with the use of cannulated screws. Cannulated screws are inherently weaker than solid-core screws and thus subject to failure at lesser loads. The midfoot fusion bolt offers a technical advantage compared with other forms of fixation in these challenging cases. We present our limited experience with 4 patients who had this device used as a part of the surgical approach and the short-term results. All patients went on to successful union of all fusion sites and were able to return to ambulation in diabetic shoe gear and appropriate bracing.

The influence of brace type on the success rate of the Ponseti treatment protocol for idiopathic clubfoot

The success of the Ponseti method for treating idiopathic clubfoot deformity is dependent on the casting techniques and the adherence of the patient to the foot abduction brace protocol. Newly developed brace designs claim to be more comfortable, to be easier to use and to prevent dislodgement of the foot from the brace, making them more efficient and improving patient compliance. They are, however, more costly, and, therefore, accessible to fewer patients. We compared the compliance and treatment outcome using two brace designs, the traditional simple brace of pre-walking shoes attached to a Dennis Browne (DB) bar and the new sophisticated Mitchell brace. We compared the functional outcome and compliance with the post-corrective bracing protocol of 38 children with idiopathic clubfoot treated in our institution using two brace designs. Twenty-one chose the DB brace and 17 chose the Mitchell brace. There was no difference in the compliance rate or in the final clinical and radiological outcomes of the two groups after a minimum of 2years of follow-up. A positive correlation was found between the Pirani score at the beginning of treatment and the final functional score for both groups. Both groups were satisfied with the selected brace. Both groups were equally compliant with the brace protocol. We conclude that new and more expensive brace designs do not necessarily provide better clinical results. Fully corrected foot and a strong family-treating team partnership are crucial to adherence with the brace protocol.

Computer assisted knee arthrodesis in a primary case of septic arthritis: A case report

We report a case of a 78 year old patient with primary septic arthritis who was treated with knee arthrodesis using computer navigation. Use of computer navigation avoided violating the medullary canal and its associated risks. Also, it offered the advantage of making precise bone cuts in all the three planes, thus minimizing the risk of malalignment. At 3 months, our patient showed good appositional contact of the bone ends, stable fusion, with no sign of infection and was mobilized with a simple brace. At 6 months review, the patient was walking painlessly without support. We achieved a mechanical axis alignment of 0° and 11° flexion as planned.

A comparison of knee braces during walking for the treatment of osteoarthritis of the medial compartment of the knee

In this cross-over study, we evaluated two types of knee brace commonly used in the conservative treatment of osteoarthritis of the medial compartment. Twelve patients confirmed radiologically as having unilateral osteoarthritis of the medial compartment (Larsen grade 2 to grade 4) were studied. Treatment with a simple hinged brace was compared with that using a valgus corrective brace. Knee kinematics, ground reaction forces, pain and function were assessed during walking and the Hospital for Special Surgery scores were also determined. Significant improvements in pain, function, and loading and propulsive forces were seen with the valgus brace. Treatment with a simple brace showed only significant improvements in loading forces. Our findings suggest that although both braces improved confidence and function during gait, the valgus brace showed greater benefit.

Developmental Orthopaedics. III: Toddlers

The most common orthopaedic problems seen in toddlers are: (1) in-toeing due to femoral torsion, internal tibial torsion, talar torsion (persistent medial deviation of the neck of the talus), or metatarsus adductus; (2) genu valgus (bow-leg) and genu varus (knock-knee); and (3) pes valgus (flat-feet). In most cases these conditions will resolve spontaneously, as has been substantiated by a number of published studies. However, a small percentage of the disorders will persist if untreated. To prevent the deformity from becoming established and irreversible, treatment must begun while the patient is still young. Therefore the orthopaedist needs objective criteria to select those children in whom the deformity is likely to persist and who thus require prompt management. If femoral torsion persists, it becomes fixed by the time the child reaches eight years of age. Surgery is the only definitive treatment which can be offered, although gait training by augmented feedback methods may result in correcting by increasing the range of external rotation of the hip. Internal tibial torsion or talar torsion usually resolve spontaneously before the children reach seven years of age. However, in 8 per cent of cases in-toeing persists; it is cosmetically objectionable in the adult. I advise simple brace treatment in infants up to the age of 18 months if the medical deviation of the foot from the mid-sagittal plane is greater than 10 degrees. Because metatarsus adductus corrects spontaneously in many cases, some authors suggest that this condition should not be treated. However, I think it is prudent to use serial plaster-casts for infants under eight months of age in whom the deformity is moderate or severe. If treatment is withheld while the patient is observed, and if spontaneous correction does not occur, the deformity will become fixed and correctable only with surgery. Genu valgus and varus correct without treatment in the majority of patients. However, some cases of genu varus appear to develop into the progressive form of the disorder, Blount's disease. When the varus femoral-tibial angle exceeds the norm for age, early treatment with the Danish night-splint appears to prevent the development of this serious disease. 'Flat foot' (pes valgus) must be defined carefully by physical and radiographic examination. Treatment and radiographic examination. Treatment might be considered only for those feet classified as pes valgus with plantar flexed talus of 50 degrees or more. For children with this disorder between the ages of two and six years, a corrective moulded plastic shoe-insert may help to improve the abnormal anatomy while natural ligamentous tightening occurs.