The physical effect of lumbar spinal supports

Grew, Nehemiah; Deane, Graham

doi:10.3109/03093648209166772

Cited by 35 publications

(7 citation statements)

References 9 publications

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“…Elastic supports were studied in four studies. 5,13,15,31 Combined effect sizes of these studies were 1.01 (95% CI: 0.10 -1.92) for flexion-extension, 0.84 (95% CI: 0.24 -1.43) for lateral bending, and 1.81 (95% CI: Ϫ0.22-3.84) for rotation.…”

Section: Changes In Body Posture or Movements Inmentioning

confidence: 95%

“…17,26,27,37 Reported results in all four showed an increase in IAP, but electromyogram in the erector spinae muscles consistently decreased in only one. 27 In seven studies, investigators measured IAP but did not simultaneously record an electromyogram of the back muscles (Table 3), 15,16,24,43,42,52,62 Investigators in two of these studies reported an increase in IAP in subjects using lumbar supports, 16,52 in two studies they reported inconsistent results, 15,43 and three they found no effect of a lumbar support on IAP. 24,42,62 Separate meta-analyses for studies on electromyogram of erector spinae muscles and on IAP were conducted.…”

Section: Reduction In Back Muscle Forcementioning

confidence: 99%

“…In practice, however, it remains to be seen whether a restriction in trunk motion by lumbar supports indeed has a beneficial effect on the risk of back injury, because, so far, contradictory results have been reported on lumbar supports in the prevention of back pain. [1][2][3]15,25,48,54,56,[57][58][59] Reduction in Back Muscle Force. Investigators reported inconsistent results on the effects of lumbar supports on outcomes possibly related to the back muscle force.…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

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Mechanisms of Action of Lumbar Supports

Poppel

Looze²,

Koes³

et al. 2000

Spine

114

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There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.

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Section: Changes In Body Posture or Movements Inmentioning

confidence: 95%

Section: Reduction In Back Muscle Forcementioning

confidence: 99%

Section: Mechanisms Of Actionmentioning

confidence: 99%

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Mechanisms of Action of Lumbar Supports

Poppel

Looze²,

Koes³

et al. 2000

Spine

114

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“…Past studies have examined the effects of spinal orthoses on intervertebral motion [5][6][7], gross spinal motion [8], and restriction of the spine in positions of maximal trunk flexion-extension-rotation [6][7][8][9][10]. Association of results from these evaluations to the spinal motions that occur during walking is difficult.…”

Section: Introductionmentioning

confidence: 99%

Effect of restricted spinal motion on gait

Konz

Fatone

Gard

2006

JRRD

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Spinal orthoses are common in the treatment of various conditions that affect the spine. They encompass both the spine and pelvis and thus have implications for pelvic and lower-limb motion during walking in addition to a direct effect on spinal motion. The role of the spine in walking is largely ill-defined, and the consequences of restricted spinal motion on walking have yet to be explored. This study investigated the effect of spinal restriction on gait in able-bodied persons. Gait analyses were performed on 10 able-bodied subjects as they walked at five different speeds that were distributed across their comfortable range of speeds. Data were collected during walking with and without spinal restriction by a fiberglass body jacket, which is similar to a thoracolumbosacral orthosis (TLSO). With spinal restriction, peak-to-peak (PP) pelvic obliquity and rotation were significantly reduced across all walking speeds (p < 0.001), while PP pelvic tilt was significantly reduced at only the fastest walking speeds (p = 0.017). PP hip abduction-adduction motion was significantly reduced with spinal restriction across all speeds (p < 0.001), while PP hip flexion-extension significantly increased at only the slow and very slow speeds (p < 0.001 and p = 0.023, respectively). A better understanding of the effects of restricted spinal motion on gait may help clinicians predict and avoid development of additional problems from TLSO use or surgical restriction of spinal motion. An awareness of these issues will enable clinicians to monitor patients for problems that may result from decreased spine and pelvic motion.

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“…In the thoracolumbar spine, orthoses reduce gross spinal motion to varying degrees depending on their de sign. 4,6,13,16,25,29,32 Overall, the body cast is most effective in limiting motion in all planes of the thoracolumbar and lumbar spine. 13,32 The Jewett hyperextension brace is ef fective in limiting instability in flexion but not in rotation or lateral bending.…”

mentioning

confidence: 99%

Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial

Bailey

Dvorak

Thomas

et al. 2009

SPI

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Object The authors compared the outcome of patients with thoracolumbar burst fractures treated with and without a thoracolumbosacral orthosis (TLSO). Methods As of June 2002, all consecutive patients satisfying the following inclusion criteria were considered eligible for this study: 1) the presence of an AO Classification Type A3 burst fractures between T-11 and L-3, 2) skeletal maturity and age < 60 years, 3) admission within 72 hours of injury, 4) initial kyphotic deformity < 35°, and 5) no neurological deficit. The study was designed as a multicenter prospective randomized clinical equivalence trial. The primary outcome measure was the score based on the Roland-Morris Disability Questionnaire assessed at 3 months postinjury. Secondary outcomes are assessed until 2 years of follow-up have been reached, and these domains included pain, functional outcome and generic health-related quality of life, sagittal alignment, length of hospital stay, and complications. Patients in whom no orthotic was used were encouraged to ambulate immediately following randomization, maintaining “neutral spinal alignment” for 8 weeks. The patients in the TLSO group began being weaned from the brace at 8 weeks over a 2-week period. Results Sixty-nine patients were followed to the primary outcome time point, and 47 were followed for up to 1 year. No significant difference was found between treatment groups for any outcome measure at any stage in the follow-up period. There were 4 failures requiring surgical intervention, 3 in the TLSO group and 1 in the non-TLSO group. Conclusions This interim analysis found equivalence between treatment with a TLSO and no orthosis for thoracolumbar AO Type A3 burst fractures. The influence of a brace on early pain control and function and on long-term 1- and 2-year outcomes remains to be determined. However, the authors contend that a thoracolumbar burst fracture, in exclusion of an associated posterior ligamentous complex injury, is inherently a very stable injury and may not require a brace.

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The physical effect of lumbar spinal supports

Cited by 35 publications

References 9 publications

Mechanisms of Action of Lumbar Supports

Mechanisms of Action of Lumbar Supports

Effect of restricted spinal motion on gait

Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial

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