Julie Deceuninck

Vital capacity evolution in patients treated with the CMCR brace: statistical analysis of 90 scoliotic patients treated with the CMCR brace

SummaryObjectiveTo study the evolution of pulmonary capacity during orthopaedic treatment of scoliosis with the CMCR brace.BackgroundInvestigating the impact of moderate scoliosis on respiratory capacity and its evolution during CMCR brace treatment with mobile pads.ContextSeveral studies demonstrate the impact of scoliosis on respiratory capacity but few of them focus on the impact of bracing treatment. We studied the evolution of the pulmonary capacity of a cohort of 90 scoliotic patients.MethodsThis retrospective study included 90 scoliotic patients treated since 1999 with a brace with mobile pads called CMCR (n = 90; mean age: 13 years; 10-16). These patients were diagnosed with an idiopathic scoliosis (mean angulation 20.6°). All patients underwent a radiographic and respiratory evaluation at the beginning, the middle and the end of treatment.ResultsMean age at treatment start was 13. Before treatment, our patients did not have a normal pulmonary capacity: Forced Vital Capacity (FVC) was only 75% of the theoretical value. All curvature types (thoracic, thoraco-lumbar and combined scoliosis) involved this reduced pulmonary capacity, with moderate-angulated scoliosis having a negative impact. At the beginning of brace treatment, the loss of real vital capacity with brace (0.3 litres) was 10% lower than without brace.At CMCR removal, the FVC had increased by 0.4 litre (21% +/- 4.2% compared to the initial value). The theoretical value had increased by 3%. This positive evolution was most important in girls at a low Risser stage (0,1,2), and before 11 years of age.ConclusionThese results supported our approach of orthesis conception for adolescent idiopathic scoliosis which uses braces with mobile pads to preserve thorax and spine mobility.

French validation of brace questionnaire

Material and methods The BrQ is made of 34 items on Likert Scale, divided in 8 domains. The questionnaire was developed in order that the child could fill in it alone and is adapted for 9 to 18 years old. The lowest scale is 20 and the best 100. The highest scales show a better QoL. The process of cultural adaptation of the questionnaire was in accordance with the International Quality of Life Assessment (IQOLA) Guidelines.

French validation of the Brace Questionnaire (BrQ)

BackgroundQuality of Life (QoL) scales have to be introduced in the treatment evaluation of our patients with adolescent idiopathic scoliosis.Vasiliadis et. al. created the Brace Questionnaire (BrQ), which is specific for brace-treated adolescents. This tool was developed and validated in Greek.The aim of our study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into French.MethodsThe BrQ is made of 34 items on Likert scale, divided in eight domains. The questionnaire was developed for self-completion by the children and is adapted for 9 to 18-year-old patients.The process of cultural adaptation of the questionnaire was in accordance with the International Quality of Life Assessment (IQOLA) guidelines.In the first place, descriptive statistics were used to calculate mean scores and standard deviations for a given question and a domain. The second level was comparative, concerning reliability and validity.ResultsThe internal consistency was satisfactory; Cronbach’s alpha coefficient was 0.85. There were no floor or ceiling effects.ConclusionsThe French version of the BrQ (F-BrQ) is reliable and reproducible, and can therefore be used to evaluate the quality of life of children and adolescents treated with a brace for idiopathic scoliosis.

The use of a photogrammetric method for the three-dimensional evaluation of spinal correction in scoliosis

PurposeClinical parameters, characterizing the spinal deformations due to scoliosis, are still directly measured on the spinal curve plane projections.MethodsA 3D spinal curve has been reconstructed from its two projections, using photogrammetric techniques. Each spinal curve is a compound of several plane regions, where it is purely flexed, and short zones of connection, where abduction and axial rotation components are concentrated. All spinal curves are represented as linear chains of regional planes articulated together. The regional plane is represented by a triangle, where one summit corresponds to the point of maximum offset. The set of weight forces, representing pelvis and spine, forms a bundle of vertical forces. The dispersion of the bundle illustrates the postural stability of patients.Results and ConclusionsThe first objective was to numerically describe the changes of the 3D spinal feature, due to the correcting treatment. Changes are calculated from the comparison between 3D radiologic situations, between before and after treatment. The second objective was to determine the direction of the external force, which would be the most efficient for correcting the patient set spine/rib cage. A mild mechanical analysis is proposed, for representing the transit of the external force, from rib cage to thoracic regional plane.

Analysis of pelvic motion during gait with bivalve brace

Materials and methods 2 asymptomatic adults, with similar physical feature. They wear a thoracolumbar bivalve brace, made with the same protocol (using CAD CAM) for reproducibility. We design the braces according to the principles of the brace immobilization: a good grip on the waist and overall tightening supports on the abdomen, thorax and lumbar. We use the gait analysis system Vicon. To use this system, we make holes in the brace at the location of the markers. Each person walks 6-8 trials in the gait analysis system with and without the brace.

Interest of standardization of feet position during 3-dimensional trunk capture

Methods a. Bare skin acquisition. b. Cutaneous benchmark: the first sacral piece (S1), the anterior superior iliac spine (ASIS). c. First acquisition in standard position, feet spread natural, hands at shoulder height into vertical bars, elbows drooping. d. Second acquisition in the same position but with feet in a board position with heels spaced 19cm apart [3]. e. A single operator. f. Measuring the angle S1, ASIS right relative to the horizontal and the angle S1, ASIS left relative to the horizontal on the acquisition software Orten file. An average is taken, the angle (S1, ASIS) relative to the horizontal. g. Comparing 24 samples (20 women and 4 men) with two acquisitions. h. Nine samples (7 women and 2 men) are reacquired three days later.

Pelvic-Spinal Analysis and the Impact of Onabotulinum toxin A Injections on Spinal Balance in one Child With Cerebral Palsy

Background: In children with cerebral palsy, primary (eg, abnormal muscle tone and weakness) and secondary impairments (eg, contractures) can modify pelvic-spinal alignment. The main aim of this article was to establish a new approach to pelvic-spinal analysis in children with cerebral palsy, taking into account the whole pelvis-spine complex, illustrated by a case study. Methods: This is a case study of an ambulatory child with cerebral palsy (spastic diplegia) who underwent analysis of the pelvic-spine complex from X-ray images taken in standing position from C2 to the proximal femur. Pelvic shape was characterized by the pelvic incidence angle, which is the sum of sacral slope and pelvic tilt, before and after the treatment by regular onabotulinumtoxinA injections into the hip flexors, and the use of soft lumbar brace over 5 years. Results: The sagittal balance of the spine was improved following the treatment, with a reduction in lumbar lordosis and sacral slope. The reduction in lumbar hyperextension likely reduced the risk of spondylolysis, low back pain, and degenerative spondylolisthesis in adulthood. Conclusion: A biomechanical approach to the evaluation of the pelvic-spinal complex offers new perspectives to increase the understanding of spinal balance in children with cerebral palsy, providing more options for treatment, such as onabotulinumtoxinA.

GMFCS and spino-pelvi-femoral complex in ambulating or walking cerebral palsy children. retrospective study.

We have performed a radiological evaluation of static data of spine-pelvis-femur complex in walking children with cerebral palsy (CP). The data are discussed about GMFCS and after about radiological data in asymptomatic subjects.

Effects of orthopaedic treatments upon 3D radiologic morphologies and equilibrated postures in adolescent idiopathic scoliosis

In case of scoliosis, spinal deformations are measured upon frontal radiographs. However, these deformations are developed in 3D space. Recent studies have been proposed to access to 3D features of spine and pelvis in upstanding patients.

Educational therapy of adolescent idiopathic scoliosis treated by brace.

Adolescent idiopathic scoliosis treated by brace assent with The Patient Educational Therapy (PET) according to the “ARS” in 2013.