Clinical Significance of Strap Tension Adjustment on Spinal Orthoses for Neuromuscular Scoliosis
Date Issued
2005-12-31
Date
2005-12-31
Author(s)
DOI
932213E002075
Abstract
Background: Individuals with neuromuscular scoliosis are thought to have respiratory muscle
weakness causing a restrictive pattern, abnormal compliance of the chest wall and lung, and
mismatched ventilation and perfusion. Therefore, a spinal orthosis, a rigid supporting body
jacket, leads to restriction of chest expansion and significant reduction in vital capacity immediately.
Strap tension has an influence on pulmonary function; on the other hand, strap tension also affects
the correction of spinal deformity. If the patient does not apply enough force on straps, the
effective correction of spinal deformity will be reduced. The tension adjustment of straps on
spinal orthoses is clinically significant for neuromuscular scoliosis. The overall effectiveness of the
spinal orthosis will therefore depend on how tightly its strap is adjusted and fastened. Objectives:
To quantify the strap tension and find an optimal value to achieve the best correction of spinal
deformity but least compromise of pulmonary function. Setting: Orthotic services, National
Rehabilitation Engineering Research Center, Taipei , Taiwan. Participant: A seven-year-old girl
with spinal muscular atrophy, presenting a scoliotic curve. The curve was a left lumbar C curve
and the apex was at L1. Intervention: A custom molded co-polymer anterior-opening
Thoracic-Lumbar-Sacral Orthosis (TLSO) with three adjustable straps. Optimal strap tension
solution: An objective function was chosen as the weighted sum of two indexes, i.e., an index of the
pulmonary function and an index of vertebral correction. Main Outcome Measures: Strap tensions,
slow vital capacity (SVC) for the pulmonary function index, Cobb angle and apex rotation for the
vertebral correction index. Results: Optimal strap tensions all lie in between 60% to 70% of the
tightest tension which the subject can tolerate. Conclusions: In the past, clinicians had no idea to
adjust objectively the tightness of the straps on TLSO for individuals with neuromuscular scoliosis.
This study provided a systematic approach to find an optimal strap tension where both pulmonary
function and vertebral correction were taken into consideration at the same time.
Publisher
臺北市：國立臺灣大學醫學工程學研究所
Type
report
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