Halina Protasiewicz-Fałdowska

Effectiveness of Chêneau brace treatment for idiopathic scoliosis: prospective study in 79 patients followed to skeletal maturity.

BackgroundProgressive idiopathic scoliosis can negatively influence the development and functioning of 2-3% of adolescents, with health consequences and economic costs, placing the disease in the centre of interest of the developmental medicine. The aim of this study was to evaluate the effectiveness of Chêneau brace in the management of idiopathic scoliosis.MethodsA prospective observational study according to SOSORT and SRS recommendations comprised 79 patients (58 girls and 21 boys) with progressive idiopathic scoliosis, treated with Chêneau brace and physiotherapy, with initial Cobb angle between 20 and 45 degrees, no previous brace treatment, Risser 4 or more at the final evaluation and minimum one year follow-up after weaning the brace. Achieving 50° of Cobb angle was considered surgical recommendation.ResultsAt follow-up 20 patients (25.3%) improved, 18 patients (22.8%) were stable, 31 patients (39.2%) progressed below 50 degrees and 10 patients (12.7%) progressed beyond 50 degrees (2 of these 10 patients progressed beyond 60 degrees). Progression concerned the younger and less skeletally mature patients.ConclusionConservative treatment with Chêneau orthosis and physiotherapy was effective in halting scoliosis progression in 48.1% of patients. The results of this study suggest that bracing is effective in reducing the incidence of surgery in comparison with natural history.

Evaluation of the effectiveness of Chêneau brace treatment for idiopathic scoliosis – own observations

Abstract Introduction Progressive nature of scoliosis significantly affects the development and functioning of a young organism. The extensive interest of medical experts in spinal deformities stems from their high incidence in the population of youth (2–3%), health consequences resulting from the disease progression as well as high economic and social costs. Aim Evaluation of the effectiveness of the Cheneau brace in the treatment of idiopathic scoliosis. Materials and methods The research material comprised 302 patients treated in the Chair and Teaching Hospital of Rehabilitation and the Provincial Childrens Hospital in Ameryka near Olsztyn, for idiopathic scoliosis, ranging in ages from 8 to 17. The observation period was from 2 to 5 years. Qualification for orthopedic brace was conducted according to the recommendations of an international group of experts. We analyzed radiograms in the antero-posterior projection taken during the treatment and assessed the Cobb angles. The treatment was finished after skeletal maturity was achieved. Results At the stage of research material analysis some patients were excluded for the following reasons: lack of skeletal maturity – 66 (21.8%), interrupted treatment – 110 (36.4%), co-existing diseases impacting on the clinical course of scoliosis – 47 (15.5%). The study group, i.e. 79 patients, who completed their treatment, were divided into sub-groups depending on the effect of their treatment. 20 patients improved (24.7%), 18 (22.2%) were stable, 9 (11.1%) worsened, and 32 (41.9%) were qualified for surgical procedure. Discussion Meta-analyses of international literature have shown that bracing is an effective therapeutic method for idiopathic scoliosis. However, our studies have shown that a large number of patients decide to finish their therapy too early or do not undertake brace treatment at all. Conclusions A large number of patients in the lowest mean age group (12.4 years) who were eventually qualified for surgical procedure is disconcerting. The best outcome of the Cheneau brace treatment was achieved in the group of the highest mean age of 14.3.

Objective parallel-forms reliability assessment of 3 dimension real time body posture screening tests.

BackgroundScreening tests play a significant role in rapid and reliable assessment of normal individual development in the entire population of children and adolescents. Body posture screening tests carried out at schools reveal that 50-60% of children and adolescents demonstrate body posture abnormalities, with 10% of this group at risk for progressive spinal deformities. This necessitates the search for effective and economically feasible forms of screening diagnosis. The aim of this study was to assess the reliability of clinical evaluation of body posture compared to objective assessment with the Zebris CMS-10 system (Zebris Medical GmbH).MethodsThe study enrolled 13-15-year-old pupils attending a junior secondary school (mean age 14.2 years). The study group consisted of 138 participants, including 71 girls and 67 boys, who underwent a clinical evaluation of the body posture and an examination with the Zebris CMS 10 system.ResultsStatistically significant discrepancies between the clinical and objective evaluation were noted with regard to lumbar lordosis in boys (n = 67) and thoracic kyphosis in girls (n = 71). No statistically significant differences in both groups were noted for pelvic rotation and trunk position in the frontal plane.Conclusions1. The finding of significant discrepancies between the results of assessment in the sagittal plane obtained in the clinical examination and Zebris CMS-10-based assessment suggests that clinical evaluation should be used to provide a general estimation of accentuation or reduction of spinal curvatures in the sagittal plane.2. The clinical evaluation of posture is reliable with regard to assessment in the frontal plane.3. The Zebris CMS-10 system makes the clinical examination significantly more objective with regard to assessment of the physiological curvatures and may be used to make screening tests more objective with regard to detecting postural defects.

Influence of myofascial taping application on postural stability in adolescents with pain in the anterior joint of the knee

1 Department of Rehabilitation, School of Medicine, University of Warmia and Mazury in Olsztyn, Poland 2 Department of Trauma and Orthopaedic, Regional Specialised Children’s Hospital in Olsztyn, Poland 3 Clinic of Rehabilitation, Regional Specialised Children’s Hospital in Olsztyn, Poland 4 Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Poland 5 Podhale State Higher School in Nowy Targ, Poland