Rahimi S, Vahab Kashani R, Saeed Ershadi F, Karimlo M. Comparing In-brace Correction, Compliance, and Quality of Life Between Milwaukee and Lyon Braces in Adolescents With Thoracic Hyperkyphosis. PTJ 2019; 9 (4) :211-218
URL:
http://ptj.uswr.ac.ir/article-1-428-en.html
1- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Epidemiology and Biostatistics, Faculty of Tehran Medical Science, Islamic Azad University, Tehran, Iran.
Abstract: (3409 Views)
Background: A thoracic curve degree of greater than 45° leads to thoracic hyperkyphosis, and its common treatment method is orthotic treatment. The acceptance rate of spinal orthosis depends on in-brace correction, patient`s compliance and quality of life.
Objective: In this study, we aimed to compare in-brace correction, compliance and quality of life in patients with thoracic hyperkyphosis wearing Milwaukee and Lyon braces.
Methods: In this case study, we retrospectively analyzed data for 23 adolescents with thoracic hyperkyphosis worn Milwaukee brace (n=15) and Lyon brace (n=8). In-brace correction was assessed by comparing Cobb angle before and two months after wearing brace. Compliance was determined by the percentage of actual hours worn in accordance with the prescribed regimen. The Quality of Life Profile for Spinal Deformities questionnaire was used to assess the quality of life and mental/psychological functions. Data normality assumption was assessed by Kolmogorov-Smirnov test. Other tests used for data analysis included paired t-test and independent t-test.
Results: Patients had thoracic kyphosis angle of 55-75 degrees aged 10-17 years. They were divided into two groups of Milwaukee(n=15; mean age= 14 years; mean first Cobb angle= 67.9 degrees) and Lyon (n=8; mean age= 13.75 years ; mean first Cobb angle= 61.7 degrees). No significant difference was found between in-brace correction of two groups (p= 0.073), while the compliance of Lyon group was better. Furthermore, findings reported a significant difference in quality of life between groups (p= 0.018), where Lyon group had improved quality of life.
Conclusion: Lyon brace had less detrimental effect on the quality of life of patients in comparison with the Milwaukee brace, while the compliance after using Lyon brace was better; however, identical in-brace correction was achieved by both braces. Therefore, by considering and integration of significant factors in treatment plan, these braces can be used for in-brace correction.
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● Supplying data on the crucial items impacting the outcome of brace treatment (in-brace correction, QOL and compliance);
● Comparison of two group braces (Milwaukee, Lyon), the results illuminated that the appearance of brace is able to boost the range of compliance and QOL;
● The overall in-brace correction would be improved which it was seen in Lyon brace in comparison with Milwaukee brace.
Plain Language Summary
This manuscript is determined the influential factors on brace treatment and comparison them between two spinal brace (Milwaukee brace, Lyon brace) in thoracic hyperkyphosis. The effective factors on orthotic treatment were categorized in three variables: in-brace correction, compliance, and quality of life and this paper also discusses patients` mental and physical situation when they wear spinal brace. Our result introduced apt treatment protocol which is established appropriate features for the structure of brace, with concentration on psychological field, and it also provide highly chance to improve brace treatment. The knowledge of comparison between effective factors in two brace groups can provide an appropriate selection of spinal braces in thoracic hyperkyphosis among teenagers and the less of clear research, we believe that the findings presented in our paper will be appeal to medicines, orthotist, physical therapist and even psychologists. Given the mentioned comparison has been crucial to diagnose the success of treatment thus our findings will allow researchers to identify the principles of brace wearing in hyperkyphosis as team work and consider physical and mental patient`s situation clearly to improve outcome treatment.
Type of Study:
Research |
Subject:
Special Received: 2019/03/27 | Accepted: 2019/08/25 | Published: 2019/10/1