Effect of ankle braces on lower extremity joint energetics in single-leg landings.

PubMed

Gardner, Jacob K; McCaw, Steven T; Laudner, Kevin G; Smith, Peter J; Stafford, Lindsay N

2012-06-01

Ankle sprains are one of the most common injuries in competitive and recreational athletics. Studies have shown that the use of prophylactic ankle braces effectively reduces the frequency of ankle sprains in athletes. However, although it is generally accepted that the ankle braces are effective at reducing frontal plane motion, some researchers report that the design of the brace may also reduce ankle sagittal plane motion. The purpose of this study was to quantify lower extremity joint contributions to energy absorption during single-legged drop landings in three ankle brace conditions (no brace, boot brace, and hinged brace). Eleven physically active females experienced in landing and free of lower extremity injury (age = 22.3 ± 1.7 yr, height = 1.66 ± 0.04 m, mass = 58.43 ± 5.83 kg) performed 10 single-leg drop landings in three conditions (one unbraced, two braced) from a 0.33-m height. Measurements taken were hip, knee, and ankle joint impulse; hip, knee, ankle, and total work; and hip, knee, and ankle joint relative work. Total energy absorption remained consistent across the braced conditions (P = 0.057). Wearing the boot brace reduced relative ankle work (P = 0.04, Cohen d = 0.43) but did not change relative knee (P = 0.08, Cohen d = 0.32) or hip (P = 0.14, Cohen d = 0.20) work compared with the no-brace condition. In an ankle-braced condition, ankle, knee, and hip energetics may be altered depending on the design of the brace.

Combined versus individual effects of a valgus knee brace and lateral wedge foot orthotic during stair use in patients with knee osteoarthritis.

PubMed

Moyer, Rebecca; Birmingham, Trevor; Dombroski, Colin; Walsh, Robert; Giffin, J Robert

2017-05-01

The aim of this study was to investigate the combined and individual biomechanical effects of a valgus knee brace and a lateral wedge foot orthotic during stair ascent and descent in patients with knee osteoarthritis (OA). Thirty-five patients with varus alignment and medial knee OA were prescribed a custom valgus knee brace and lateral wedge foot orthotic. Knee angles and moments in the frontal and sagittal planes were determined from 3D gait analysis completed under four randomized conditions: (1) control (no knee brace or foot orthotic), (2) knee brace, (3) foot orthotic, and (4) combined knee brace and foot orthotic. Additional measures included the vertical ground reaction force, trunk lean, toe out and gait speed. During the combined use of a knee brace and foot orthotic, significant decreases in the knee adduction angle (2.17, 95%CI: 0.50-3.84, p=0.013) and 2nd peak EKAM (0.35, 95%CI: 0.17-0.52, p<0.001) were observed during stair descent; and significant increases in the EKFM were observed during stair ascent (0.54, 95%CI: 0.30-0.78, p<0.001) and descent (1stpk: 0.48, 95%CI: 0.15-0.80, p=0.005; 2ndpk: 0.55, 95%CI: 0.34-0.76, p<0.001). Fewer gait compensations were observed between conditions during stair descent compared to ascent, except for toe out. Findings suggest greater effects on gait when both knee brace and foot orthotic are used together, resulting in a more normal gait pattern. However, whether or not a true change in knee joint load can be inferred when using these orthoses remains unclear. Further research is required to determine the clinical importance of the observed changes. Copyright © 2017. Published by Elsevier B.V.

Immediate effect of valgus bracing on knee joint moments in meniscectomised patients: An exploratory study.

PubMed

Thorning, Maria; Thorlund, Jonas B; Roos, Ewa M; Wrigley, Tim V; Hall, Michelle

2016-12-01

Patients undergoing medial arthroscopic partial meniscectomy are at increased risk of developing and/or progressing knee osteoarthritis, with increased medial compartment load being a potential contributor. The aim of this study was to evaluate the immediate effect of a valgus unloader knee brace on knee joint moments in patients following medial arthroscopic partial meniscectomy. Within-participant design. Twenty-two patients (age 35-55 years) who had undergone medial arthroscopic partial meniscectomy within the previous 8-15 months completed three-dimensional analysis of gait, forward lunge and one-leg rise during two conditions: with and without a valgus unloader knee brace. Outcome measures included the peak and impulse of the knee adduction moment and the peak knee flexion moment. The peak knee flexion moment increased during brace condition for forward lunge (mean difference [95% CI]) 0.54 [0.27-0.82] (Nm/(BW×HT)%), p<0.001 and one-leg rise (mean difference 0.45 [95% CI 0.08-0.82] (Nm/(BW×HT)%), p=0.022). No other significant differences were found between conditions in any of the included tasks. A significant effect of the knee brace was detected in terms of an increase in peak knee flexion moment during the more demanding tasks such as forward lunge and one-leg rise. This increase implies enhanced stability of the knee provided by the brace, which may induce increased knee function and knee-related confidence during strenuous tasks. Future research is required to explore the structural implications. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effects of a Knee Brace With a Patellar Hole Versus Without a Patellar Hole in Patients With Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

PubMed

Added, Marco Aurélio Nemitalla; Added, Caroline; Kasawara, Karina Tamy; Rotta, Viviane Perez; de Freitas, Diego Galace

2017-01-01

The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed. Both groups presented significant reduction in pain perception, higher function of the lower extremities, and greater mobility while wearing a knee brace. However, the patients who wore a knee brace without a patellar hole presented more favorable results than those who wore a knee brace with a patellar hole: a 1.6-point reduction was found versus 1.1 points in the VAS, the patients presented 0.7 s less time versus 0.4 s in the TUG, and the speed was reduced by 1.4 s versus 0.8 s in the 8MWT. Therefore, the knee brace without a patellar hole presented more favorable results when compared with the knee brace with a patellar hole.

The Effectiveness of a Functional Knee Brace on Joint-Position Sense in Anterior Cruciate Ligament-Reconstructed Individuals.

PubMed

Sugimoto, Dai; LeBlanc, Jessica C; Wooley, Sarah E; Micheli, Lyle J; Kramer, Dennis E

2016-05-01

It is estimated that approximately 350,000 individuals undergo anterior cruciate ligament (ACL) reconstruction surgery in each year in the US. Although ACL-reconstruction surgery and postoperative rehabilitation are successfully completed, deficits in postural control remain prevalent in ACL-reconstructed individuals. In order to assist the lack of balance ability and reduce the risk of retear of the reconstructed ACL, physicians often provide a functional knee brace on the patients' return to physical activity. However, it is not known whether use of the functional knee brace enhances knee-joint position sense in individuals with ACL reconstruction. Thus, the effect of a functional knee brace on knee-joint position sense in an ACL-reconstructed population needs be critically appraised. After systematically review of previously published literature, 3 studies that investigated the effect of a functional knee brace in ACL-reconstructed individuals using joint-position-sense measures were found. They were rated as level 2b evidence in the Centre of Evidence Based Medicine Level of Evidence chart. Synthesis of the reviewed studies indicated inconsistent evidence of a functional knee brace on joint-position improvement after ACL reconstruction. More research is needed to provide sufficient evidence on the effect of a functional knee brace on joint-position sense after ACL reconstruction. Future studies need to measure joint-position sense in closed-kinetic-chain fashion since ACL injury usually occurs under weight-bearing conditions.

The effect of a dynamic PCL brace on patellofemoral compartment pressures in PCL-and PCL/PLC-deficient knees.

PubMed

Welch, Tyler; Keller, Thomas; Maldonado, Ruben; Metzger, Melodie; Mohr, Karen; Kvitne, Ronald

2017-12-01

The natural history of posterior cruciate ligament (PCL) deficiency includes the development of arthrosis in the patellofemoral joint (PFJ). The purpose of this biomechanical study was to evaluate the hypothesis that dynamic bracing reduces PFJ pressures in PCL- and combined PCL/posterolateral corner (PLC)-deficient knees. Controlled Laboratory Study. Eight fresh frozen cadaveric knees with intact cruciate and collateral ligaments were included. PFJ pressures and force were measured using a pressure mapping system via a lateral arthrotomy at knee flexion angles of 30°, 60°, 90°, and 120° in intact, PCL-deficient, and PCL/PLC-deficient knees under a combined quadriceps/hamstrings load of 400 N/200 N. Testing was then repeated in PCL- and PCL/PLC-deficient knees after application of a dynamic PCL brace. Application of a dynamic PCL brace led to a reduction in peak PFJ pressures in PCL-deficient knees. In addition, the brace led to a significant reduction in peak pressures in PCL/PLC-deficient knees at 60°, 90°, and 120° of flexion. Application of the dynamic brace also led to a reduction in total PFJ force across all flexion angles for both PCL- and PCL/PLC-deficient knees. Dynamic bracing reduces PFJ pressures in PCL- and combined PCL/PLC-deficient knees, particularly at high degrees of knee flexion.

Investigation of the nonlinear seismic behavior of knee braced frames using the incremental dynamic analysis method

NASA Astrophysics Data System (ADS)

Sheidaii, Mohammad Reza; TahamouliRoudsari, Mehrzad; Gordini, Mehrdad

2016-06-01

In knee braced frames, the braces are attached to the knee element rather than the intersection of beams and columns. This bracing system is widely used and preferred over the other commonly used systems for reasons such as having lateral stiffness while having adequate ductility, damage concentration on the second degree convenience of repairing and replacing of these elements after Earthquake. The lateral stiffness of this system is supplied by the bracing member and the ductility of the frame attached to the knee length is supplied through the bending or shear yield of the knee member. In this paper, the nonlinear seismic behavior of knee braced frame systems has been investigated using incremental dynamic analysis (IDA) and the effects of the number of stories in a building, length and the moment of inertia of the knee member on the seismic behavior, elastic stiffness, ductility and the probability of failure of these systems has been determined. In the incremental dynamic analysis, after plotting the IDA diagrams of the accelerograms, the collapse diagrams in the limit states are determined. These diagrams yield that for a constant knee length with reduced moment of inertia, the probability of collapse in limit states heightens and also for a constant knee moment of inertia with increasing length, the probability of collapse in limit states increases.

Influence of a knee brace intervention on perceived pain and patellofemoral loading in recreational athletes.

PubMed

Sinclair, Jonathan K; Selfe, James; Taylor, Paul J; Shore, Hannah F; Richards, Jim D

2016-08-01

The current investigation aimed to investigate the effects of an intervention using knee bracing on pain symptoms and patellofemoral loading in male and female recreational athletes. Twenty participants (11 males & 9 females) with patellofemoral pain were provided with a knee brace which they wore for a period of 2weeks. Lower extremity kinematics and patellofemoral loading were obtained during three sport specific tasks, jog, cut and single leg hop. In addition their self-reported knee pain scores were examined using the Knee injury and Osteoarthritis Outcome Score. Data were collected before and after wearing the knee brace for 2weeks. Significant reductions were found in the run and cut movements for peak patellofemoral force/pressure and in all movements for the peak knee abduction moment when wearing the brace. Significant improvements were also shown for Knee injury and Osteoarthritis Outcome Score subscale symptoms (pre: male=70.27, female=73.22 & post: male=85.64, female=82.44), pain (pre: male=72.36, female=78.89 & post: male=85.73, female=84.20), sport (pre: male=60.18, female=59.33 & post: male=80.91, female=79.11), function and daily living (pre: male=82.18, female=86.00 & post: male=88.91, female=90.00) and quality of life (pre: male=51.27, female=54.89 & post: male=69.36, female=66.89). Male and female recreational athletes who suffer from patellofemoral pain can be advised to utilise knee bracing as a conservative method to reduce pain symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of patellofemoral bracing on pain, knee extensor torque, and gait function in females with patellofemoral pain.

PubMed

Powers, Christopher M; Doubleday, Kathryn L; Escudero, Carina

2008-01-01

Our purpose was to evaluate the effects of a patellofemoral brace on pain response, knee extensor torque production, and gait function in females with patellofemoral pain (PFP). Sixteen females between the ages of 14 and 46 with diagnosis of PFP participated. Knee extensor torque was measured by using a LIDO isokinetic dynamometer. Pain levels were documented by using the Visual Analog Pain Scale. Stride characteristics during the conditions of free walk, fast walk, ascend stairs, descend stairs, ascend ramp, and descend ramp were obtained with a stride analyzer unit. EMG activity of the vasti musculature was recorded by using indwelling, bipolar, wire electrodes. Knee joint motion was assessed by using a VICON motion analysis system. All testing was performed with and without the Bauerfeind Genutrain P3 patellofemoral brace. There were no significant differences in torque production, pain levels, and stride characteristics between braced and non-braced trials. In addition, there were no significant differences in mean vasti EMG between braced and non-braced trials. When averaged across all conditions, a small but statistically significant increase in knee flexion was found during the braced trials. Although the current study did not find significant improvements in the clinical measures evaluated, 8 of the 16 subjects did experience a decrease in knee pain. This finding suggests that certain patients with PFP may respond favorably to bracing, and criteria must be established to determine which patients would best benefit from such an intervention.

Bracing can partially limit tibial rotation during stressful activities after anterior crucial ligament reconstruction with a hamstring graft.

PubMed

Giotis, D; Paschos, N K; Zampeli, F; Pappas, E; Mitsionis, G; Georgoulis, A D

2016-09-01

Hamstring graft has substantial differences with BPTB graft regarding initial mechanical strength, healing sequence, and vascularization, which may imply that a different approach during rehabilitation period is required. The purpose of this study was to investigate the influence of knee bracing on tibial rotation in ACL-reconstructed patients with a hamstring autograft during high loading activities. The hypothesis was that there would be a decrease in tibial rotation in the ACL-reconstructed braced knee as compared to the unbraced knee. Twenty male patients having undergone unilateral ACL reconstruction with a semitendinosus/gracilis autograft were assessed. Kinematic data were collected with an eight-camera optoelectronic system during two stressful tasks: (1) descending from a stair and subsequent pivoting; and (2) landing from a platform and subsequent pivoting. In each patient, three different experimental conditions were evaluated: (A) wearing a prophylactic brace (braced condition); (B) wearing a patellofemoral brace (sleeved condition); (C) without brace (unbraced condition). The intact knee without brace served as a control. Tibial rotation was significantly lower in the intact knee compared to all three conditions of the ACL-reconstructed knee (P≤0.01 for both tasks). Presence of a brace or sleeve resulted in lower tibial rotation than in the unbraced condition (p=0.003 for descending/pivot and P=0.0004 for landing/pivot). The braced condition resulted in lower rotation than the sleeved condition for descending/pivoting (P=0.031) while no differences were found for landing/pivoting (P=0.230). Knee bracing limited the excessive tibial rotation during pivoting under high loading activities in ACL-reconstructed knees with a hamstring graft. This partial restoration of normal kinematics may have a potential beneficial effect in patients recovering from ACL reconstruction with a hamstring autograft. Level III, case-control therapeutic study. Copyright �

Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge.

PubMed

Jalali, Maryam; Farahmand, Farzam; Mousavi, Seyed Mohammad Ebrahim; Golestanha, Seyed Ali; Rezaeian, Tahmineh; Shirvani Broujeni, Shahram; Rahgozar, Mehdi; Esfandiarpour, Fateme

2015-07-01

Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information. In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients. For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur. Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant. Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge

PubMed Central

Jalali, Maryam; Farahmand, Farzam; Mousavi, Seyed Mohammad Ebrahim; Golestanha, Seyed Ali; Rezaeian, Tahmineh; Shirvani Broujeni, Shahram; Rahgozar, Mehdi; Esfandiarpour, Fateme

2015-01-01

Background: Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information. Objectives: In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients. Patients and Methods: For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur. Results: Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant. Conclusion: Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient

Quantification of functional brace forces for posterior cruciate ligament injuries on the knee joint: an in vivo investigation.

PubMed

LaPrade, Robert F; Smith, Sean D; Wilson, Katharine J; Wijdicks, Coen A

2015-10-01

Counteracting posterior translation of the tibia with an anterior force on the posterior proximal tibia has been demonstrated clinically to improve posterior knee laxity following posterior cruciate ligament (PCL) injury. This study quantified forces applied to the posterior proximal tibia by two knee braces designed for treatment of PCL injuries. The forces applied by two knee braces to the posterior proximal tibia and in vivo three-dimensional knee kinematics of six adult, male, healthy volunteer subjects (mean ± standard deviation: height, 182.5 ± 5.2 cm; body mass, 83.2 ± 9.3 kg; body mass index, 24.9 ± 1.5 kg/m(2); age, 25.8 ± 2.9 years) were measured using a custom pressure mapping technique and traditional surface marker motion capture techniques, while subjects performed three functional activities. The activities included seated unloaded knee flexion, squatting, and stair descent in a new generation dynamic force (DF) PCL brace and a static force (SF) PCL brace. During unloaded flexion at the lowest force level setting, the force applied by the DF brace increased as a function of flexion angle (slope = 0.7 N/°; p < 0.001) compared to the SF brace effect. Force applied by the SF brace did not significantly change as a function of flexion angle (slope = 0.0 N/°; n.s.). By 45° of flexion, the average force applied by the DF brace (48.1 N) was significantly larger (p < 0.001) than the average force applied by the SF brace (25.0 N). The difference in force continued to increase as flexion angle increased. During stair descent, average force (mean ± standard deviation) at toe off was significantly higher (p = 0.013) for the DF brace (78.7 ± 21.6 N) than the SF brace (37.3 ± 7.2 N). Similar trends were observed for squatting and for the higher force level settings. The DF brace applied forces to the posterior proximal tibia that dynamically increased with increased flexion angle. Additionally, the DF brace applied

ORTHOPEDIC LEG BRACE

NASA Technical Reports Server (NTRS)

Myers, William Neil (Inventor)

2005-01-01

Knee braces generally have been rigid in both the knee bending direction and in the knee straightening direction unless a manually operated release is incorporated in them to allow the knee to bend. Desirably a braced knee joint should effectively duplicate the compound, complex, actions of a normal knee. The key to knee braces is the knee joint housing. The housing herein carries a number of cam action pawls. with teeth adapted to engage the internal teeth of a ratchet ring mounted in the housing. Cam action return springs and the shape of the cam action pawl teeth allow rotation of the ratchet ring in a leg straightening direction while still supporting a load. The leg can then be extended during walking while at the same time being prevented by the cam action pawls from buckling in the knee bending direction.

Automatic locking knee brace joint

NASA Technical Reports Server (NTRS)

Weddendorf, Bruce (Inventor)

1995-01-01

This invention is an apparatus for controlling the pivotal movement of a knee brace comprising a tang-and-clevis joint that has been uniquely modified. Both the tang and the clevis have a set of teeth that, when engaged, can lock the tang and the clevis together. In addition, the tang is biased away from the clevis. Consequently, when there is no axial force (i.e., body weight) on the tang, the tang is free to pivot within the clevis. However, when an axial force is exerted on the tang, the tang is pushed into the clevis, both sets of teeth engage, and the tang and the clevis lock together.

Post-operative bracing after ACL reconstruction has no effect on knee joint effusion. A prospective, randomized study.

PubMed

Lindström, Maria; Wredmark, Torsten; Wretling, Marie-Louise; Henriksson, Marketta; Felländer-Tsai, Li

2015-12-01

It is unclear what factors contribute to knee joint effusion after anterior cruciate ligament (ACL) injury and reconstruction. Knee homeostasis after injury and surgery is crucial for rehabilitation and knee well-being. We examined if effusion was affected by post-operative bracing, and if patients with effusion fit into a common profile. Patients were randomized to wearing or not wearing a post-operative brace for three weeks after ACL reconstruction with semitendinosus-gracilis tendons. Knee joint effusion was detected by computed tomography in 60 patients (22 women), before and three and 12 months after surgery. Joint effusion, clinical and subjective tests were analyzed. This is the first prospective, randomized study on post-operative bracing for patients with a semitendinosus-gracilis graft showed that bracing had no effect on three-months presence of joint effusion. Excessive joint effusion was present in 68% of the patients three months after surgery and was associated to prior meniscus injury (p=0.05) and higher prior Tegner activity level (p=0.006). We found a positive association between longer time from injury to surgery and joint effusion three months post-operatively (rho=0.29, p<0.05). Twelve months post-operatively, joint effusion had diminished to baseline levels. Subjective scores and activity levels were lower for women. Three-months joint effusion predicted lower final outcome scores in women. Prior meniscus injury and pre-injury Tegner activity levels are predictive significant variables for excessive knee joint effusion after ACL reconstruction. Post-operative bracing had no effect. A larger clinical cohort is needed to confirm findings of this logistic regression. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of External Ankle Support on Ankle and Knee Biomechanics During the Cutting Maneuver in Basketball Players.

PubMed

Klem, Nardia-Rose; Wild, Catherine Y; Williams, Sian A; Ng, Leo

2017-03-01

basketball population during a cutting task. Compared with the lace-up brace, the hinged brace may be a better choice of prophylactic ankle support for female basketball players from a biomechanical perspective. However, both braces increased knee internal rotation and knee abduction angles, which may be problematic for a population that already has a high prevalence of knee injuries.

Effect of brace design on patients with ACL-ruptures.

PubMed

Strutzenberger, G; Braig, M; Sell, S; Boes, K; Schwameder, H

2012-11-01

Different designs of functional knee braces for ACL-injury rehabilitation exist. In addition to the mechanical stabilization provided by rigid shell braces, sleeve braces also address proprioceptive mechanisms, but little is known if this leads to benefits for ACL-deficient subjects. Therefore the aim of this study was to investigate the effect of 2 different functional brace designs (shell and sleeve brace) on functional achievements in ACL-deficient patients. 28 subjects with ACL-ruptured knees performed tests for knee joint laxity, joint position sense, static and dynamic balance and isometric and dynamic lower limb extension strength in non-braced, sleeve braced and shell braced condition. The results showed a significant decrease in knee joint laxity for sleeve (33%; p<0.001) and rigid shell bracing (14%, p=0.039). The sleeve brace revealed a significant increase in dynamic balance after perturbation (20%; p=0.024) and a significant increase in dynamic lower limb peak rate of force development (17%; p=0.015) compared to the non-braced condition. The effects might be caused by the flexible area of support and the incorporated mechanisms to address proprioceptive aspects. Braces might not be needed in simple daily life tasks, but could provide beneficial support in more dynamic settings when patients return to sporting activities after an ACL-injury. © Georg Thieme Verlag KG Stuttgart · New York.

Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

PubMed

Di Miceli, Riccardo; Marambio, Carlotta Bustos; Zati, Alessandro; Monesi, Roberta; Benedetti, Maria Grazia

2017-12-01

Purpose  The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods  We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups. Subjective IKDC score was obtained at follow-up. Statistical analysis was performed to compare the two groups for IKDC score. Subgroup analysis was performed to assess the effect of postoperative regimen (knee bracing and weight bearing) on functional outcomes. Results  The mean age of patients was 30.8 ± 10.6 years. Mean IKDC score was 87.4 ± 13.9. The mean follow-up was 3.5 ± 1.8 years. Twenty-two (53.7%) patients underwent ACLR only, while 19 (46.3%) also received other interventions, such as meniscal repair and/or collateral ligament suture. Analysis of overall data showed no differences between the groups for IKDC score. Patients in the ACLR group exhibited a significantly better IKDC score when no brace and full weight bearing after 4 weeks from surgery was prescribed in comparison with patients who worn a brace and had delayed full weight bearing. No differences were found with respect to the use of brace and postoperative weight bearing regimen in the ACLR-OI group. Conclusion  Brace and delayed weight bearing after ACLR have a negative influence on long-term functional outcomes. Further research is required to explore possible differences in the patients operated on ACLR and other intervention with respect to the use of a brace and the timing of full weight bearing to identify optimal recovery strategies. Level of Evidence  Level III, retrospective observational

Knee braces - unloading

MedlinePlus

... most people talk about the arthritis in their knees, they are referring to a type of arthritis ... is caused by wear and tear inside your knee joints. Cartilage, the firm, rubbery tissue that cushions ...

Design and testing of a regenerative magnetorheological actuator for assistive knee braces

NASA Astrophysics Data System (ADS)

Ma, Hao; Chen, Bing; Qin, Ling; Liao, Wei-Hsin

2017-03-01

In this paper, a multifunctional magneto-rheological actuator with power regeneration capability, named regenerative magnetorheological actuator (RMRA), is designed for gait assistance in the knee joint. RMRA has motor and magnetorheological (MR) brake parts working in parallel that can harvest energy through regenerative braking. This novel design provides multiple functions with good energy efficiency. The configuration and basic design of the RMRA are first introduced. Then geometrical optimization of the MR brake is conducted based on a parameterized model, and multiple factors are considered in the design objectives: braking torque, weight, and power consumption. After the optimal design is obtained, an RMRA prototype is fabricated and associated driver circuits are designed. Finally, multiple functions of the RMRA, especially three different braking modes, are modeled and tested. Experimental results of RMRA output performances in all working modes match the modeling and simulation. Assistive knee braces with the developed RMRA are promising for future applications in gait assistance and rehabilitation.

Prophylactic Ankle Bracing in Military Settings: A Review of the Literature.

PubMed

Newman, Thomas M; Gay, Michael R; Buckley, W E

2017-03-01

Within athletics and the military, ankle sprains are one of the most common injuries with the potential for long-term functional deficits. Incidence rates for ankle sprains within the military are one of the leading causes of limited duty days, especially during basic combat training, parachute training exercises, and in cadet populations. In 2008, the Department of Defense U.S. Army Center for Health Promotion and Preventative Medicine report recommended that military personnel should wear semirigid ankle braces during parachuting, basketball, soccer, and other similar high-risk activities to reduce ankle sprain injuries. This recommendation was developed using a majority of athletic references with limited data stemming from military works. Of these included military studies, none presented data on ankle braces and their effects on performance, especially in military-specific environments. The purpose of this review was to provide an up-to-date account on the use of ankle braces in military populations and effects on performance measures. A comprehensive online systematic review of the literature was conducted to delineate the current use of ankle braces in the military and how they specifically affect functional performance measures. The scope of this study eliminated military studies that were not prospective in nature or did not incorporate subjects wearing military equipment (i.e., combat boots). It was determined that little progress has been made in validating the use of semirigid ankle braces in military populations other than in instances such as parachuting and only in reducing the number ankle injuries. To date, only one study has looked specifically at the use of ankle braces and its effects on performance measures in a military sample. With the high incidence rate and increased risk for subsequent reinjury, ankle sprains are an economic and force readiness burden to the U.S. Armed Forces. This study was conducted to determine whether additional

Effect of Kınesıotapıng and Knee Brace on Functıonal Performance in Recreatıonal Athletes

PubMed Central

Ulusoy, Burak; İldiz, Bülent; Tunay, Volga Bayrakçı

2014-01-01

Objectives: Kinesiotaping is a popular taping method that is used for both therapeutic and performance enchancement purposes. Knee braces are widely used for prevention in sport injuries but their performance effectiveness is still controversial. The aim of this study was to determine whether kinesiotape or brace was more effective on functional performance. Methods: A total twenty male recreational football players (Mean±Standart Deviation (SD) age: 22.5±0.68 years, height: 175.15±3.37 cm, body weight: 74.52±12.41 kg), voluntarily participated in this study. Participants were tested with kinesiotape, with brace and without kinesiotape and brace. Tests were applied one day after patellar kinesiotaping (correction technique). Balance property measured with Modified Y balance Test (dynamic test), agility measured by T test, muscle strength and anaerobic power assessed by vertical jump and triple hop tests. Wilcoxon signed rank test was employed for determining the statistical significance of tests with kinesiotape, with brace and without kinesiotape and brace. Results: In analysis; There were statistically significant differences found in Triple hop test with kinesiotaping and without kinesiotaping and brace, in T test with bracing and kinesiotaping, in vertical jump with kinesiotaping and without kinesiotaping and brace (p<0.001) (in the favour of kinesiotaping in all tests) No statistically significant difference was found in modified Y balance test all groups (p> 0.05). Conclusion: Consequently, kinesiotaping had positive effects on agility and muscle strength but had no effects on balance in football players. On the other hand, brace had no effects on functional performance tests.

The Effect of Lace-up Ankle Braces on Injury Rates in High School Football Players

PubMed Central

McGuine, Timothy A.; Hetzel, Scott; Wilson, John; Brooks, Alison

2013-01-01

Background Although a nkle injuries occur frequently in high school football players no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes. Purpose Determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players. Design Cluster randomized controlled trial. Methods 2081 players from 50 high schools were randomly-assigned to braced or control group. Braced group subjects wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athletic exposures and injuries. Cox Proportional Hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon Rank Sum. Results The rate of acute ankle injury (per 1,000 exposures) was 0.48 in the braced group compared to 1.12 in the control group (Cox Hazard Ratio (HR)=0.39, 95% Confidence Interval [CI] 0.24, 0.65, p<0.001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (p=0.985). The rate of acute knee injury was 0.70 in the braced group compared to 0.69 in the control group, (HR=0.92 [0.57, 1.47], p=0.721). There was no difference (p=0.242) in the severity of knee injuries between the groups (controls 11.5 days, braced =17 days. The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group, (HR=0.72 [0.48, 1.09], p=0.117) while the severity was similar in both groups (6 days versus 7 days, p=0.295). Conclusions Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee or other lower extremity injuries. PMID:21926383

Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study

PubMed Central

LaPrade, Robert F.; Venderley, Melanie B.; Dahl, Kimi D.; Dornan, Grant J.; Turnbull, Travis Lee

2017-01-01

Background: A need exists for a functional anterior cruciate ligament (ACL) brace that dynamically supports the knee joint to match the angle-dependent forces of a native ACL, especially in the early postoperative period. Purpose/Hypothesis: The purpose of this study was to quantify the posteriorly directed external forces applied to the anterior proximal tibia by both a static and a dynamic force ACL brace. The proximal strap forces applied by the static force brace were hypothesized to remain relatively constant regardless of knee flexion angle compared with those of the dynamic force brace. Study Design: Controlled laboratory study. Methods: Seven healthy adult males (mean age, 27.4 ± 3.4 years; mean height, 1.8 ± 0.1 m; mean body mass, 84.1 ± 11.3 kg) were fitted with both a static and a dynamic force ACL brace. Participants completed 3 functional activities: unloaded extension, sit-to-stand, and stair ascent. Kinematic data were collected using traditional motion-capture techniques while posteriorly directed forces applied to the anterior aspect of both the proximal and distal tibia were simultaneously collected using a customized pressure-mapping technique. Results: The mean posteriorly directed forces applied to the proximal tibia at 30° of flexion by the dynamic force brace during unloaded extension (80.2 N), sit-to-stand (57.5 N), and stair ascent (56.3 N) activities were significantly larger, regardless of force setting, than those applied by the static force brace (10.1 N, 9.5 N, and 11.9 N, respectively; P < .001). Conclusion: The dynamic force ACL brace, compared with the static force brace, applied significantly larger posteriorly directed forces to the anterior proximal tibia in extension, where the ACL is known to experience larger in vivo forces. Further studies are required to determine whether the physiological behavior of the brace will reduce anterior knee laxity and improve long-term patient outcomes. Clinical Relevance: ACL braces that

Locking mechanism for orthopedic braces

NASA Technical Reports Server (NTRS)

Chao, J. I.; Epps, C. H., Jr.

1981-01-01

An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

Combined effects of knee brace, laterally wedged insoles and toe-in gait on knee adduction moment and balance in moderate medial knee osteoarthritis patients.

PubMed

Khan, Saad Jawaid; Khan, Soobia Saad; Usman, Juliana; Mokhtar, Abdul Halim; Abu Osman, Noor Azuan

2018-03-01

To test the hypothesis that toe-in gait (TI) will further reduce first peak (Knee Adduction Moment) KAM and decrease balance when combined with a knee brace (KB) and laterally wedged insoles (LWI) in medial knee osteoarthritis (kOA) patients. Twenty patients with bilateral symptomatic medial kOA. 4-point leverage-based KB, full-length LWI with 5° inclination and toe-in gait (TI). First and second peak knee adduction moment (fKAM and sKAM respectively), balance and pain. The fKAM and sKAM were determined from 3-dimensional gait analysis with six randomized conditions: (1) N (without any intervention), (2) KB, (3) KB + TI, (4) LWI, (5) LWI + TI, (6) KB + LWI + TI. Balance was assessed by Biodex Balance System using three stability settings, (i) Static (ii) Moderate dynamic setting for fall risk (FR12) and (iii) High dynamic setting for fall risk (FR8). The reduction in fKAM and sKAM was greatest (19.75% and 12%) when TI was combined with KB and LWI respectively. No change in balance was observed when TI combined with KB, and LWI and when used concurrently with both the orthosis at static and FR12 conditions. Significant balance reduction was found at FR8 for KB + TI (22.22%), and KB + LWI + TI (35.71%). Pain increased significantly for KB (258%), KB + TI (305%), LWI + TI (210%) and KB + LWI + TI (316%). LWI showed no effect on pain. There is a synergistic effect of TI when combined with KB and LWI concurrently in sKAM reduction. However, the concurrent use of TI, KB and LWI decreases balance and pain as assessed on a highly dynamic platform. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical Outcomes of a Pneumatic Unloader Brace for Kellgren-Lawrence Grades 3 to 4 Osteoarthritis: A Minimum 1-Year Follow-Up Study.

PubMed

Chughtai, Morad; Bhave, Anil; Khan, Sabahat Z; Khlopas, Anton; Ali, Osman; Harwin, Steven F; Mont, Michael A

2016-11-01

The use of a pneumatic unloader brace has been shown in pilot studies to decrease pain and increase muscle strength in patients with knee osteoarthritis (OA). Therefore, we analyzed patients who had knee OA, and either received a pneumatic unloader brace and conventional treatment or conventional treatment alone. Specifically, we assessed: (1) use of pain relieving injections; (2) opioid consumption; and (3) the eventual need for total knee arthroplasty (TKA) in the above-mentioned cohort. We performed an analysis of a longitudinally maintained database of patients from a prospective, randomized, single center study. This study randomized patients who had Kellgren-Lawrence grades 3 to 4 to receive either a pneumatic unloader brace and conventional treatment or conventional treatment alone. The brace cohort comprised 11 patients with a mean age of 55 years (range, 37-70 years). The final matched cohort comprised 25 patients with a mean age of 63 years (range, 41-86 years). The minimum follow-up was 1 year. There was a lower proportion of patients who underwent an eventual TKA in the bracing cohort as compared with the nonbracing cohort (18 vs. 36%). The mean time to TKA was longer in the bracing cohort as compared with the nonbracing cohort (482 vs. 389 days). The proportion of patients who used opioids was similar in both groups (27 vs. 22%). There was a significantly lower number of patients who received injections in the bracing cohort as compared with the nonbracing cohort (46 vs. 83%, p  = 0.026). The bracing cohort had received a significantly lower number of injections and a lower rate of subsequent TKA as compared with the nonbracing cohort. The mean time to TKA was also longer among the bracing cohort. These results may demonstrate the potential of this brace to reduce the need for and prolonging the time to TKA. Performing larger prospective randomized studies, with built-in compliance monitors is warranted. This brace may be a valuable adjunct to the

Astym® Therapy for the Management of Recalcitrant Knee Joint Stiffness after Total Knee Arthroplasty.

PubMed

Bhave, Anil; Corcoran, James; Cherian, Jeffery J; Mont, Michael A

2016-01-01

Knee stiffness is a common complication after total knee arthroplasty (TKA). Despite studies published on the surgical management of reduced range of motion (ROM) after TKA, there is limited evidence on the nonoperative management of joint and soft tissue imbalances possibly contributing to reduced knee ROM. This report assesses changes in ROM, pain, function, and patellar tendon length after Astym® joint mobilization use. A 38-year-old male professional skier had a right TKA 3 months before presentation with 2 subsequent manipulations under anesthesia secondary to persistent knee stiffness. He had patellar baja on radiograph, a reduced arc of ROM, reduced patellar mobility and muscular extensibility, and pain to palpation along the patellar tendon. He had 12 visits of physical therapy with the use of Astym®, patellar mobilization, and tibio-femoral mobilizations with movement. The patient also used a customized knee device at home for prolonged knee extension stretching. The patient was treated for 12 visits, along with home use of customized bracing for knee extension. Significant improvements were seen in pain, function, and ROM. He returned to work full-time, ambulated prolonged distances, and negotiated stairs pain-free. He also demonstrated resolution of patellar baja radiographically. Conservative management of recalcitrant knee joint stiffness after primary TKA can be effective in restoring knee mobility and reducing pain and activity limitation. A multimodal approach using Astym® treatment, customized knee bracing, and targeted joint mobilization can be effective in resolving knee joint stiffness.

Reforming the Belgian market for orthotic braces: what can we learn from the international experience?

PubMed

Simoens, Steven; De Coster, Sandra; Moldenaers, Ingrid; Guillaume, Paul; Depoorter, Antony; Van den Steen, Dirk; Van de Sande, Stefaan; Debruyne, Hans; Ramaekers, Dirk; Lona, Murielle

2008-05-01

This article aims to review regulation governing outpatient orthotic braces (neck, wrist and knee braces) in France, the Netherlands and Sweden with a view to reforming the Belgian market. Information about the regulatory framework was derived from an analysis of legal texts and a survey completed by national experts. Strategies to keep down prices include public procurement in Sweden, maximum prices in France, and exclusion of expensive braces from reimbursement in the Netherlands. Reimbursement is linked to a medical indication or a chronic condition in France, the Netherlands and Sweden. To gain reimbursement, the cost-effectiveness of orthotic braces needs to be demonstrated in France and the Netherlands. Orthotic braces tend to be initially prescribed by a specialist physician and distributed by orthotists, medical equipment shops and/or community pharmacies. Extensive government intervention exists in the outpatient orthotic brace market in the countries studied. Our recommendations to reform the Belgian market for prefabricated orthotic braces are to separate reimbursement for service provision from reimbursement for braces; to set prices by means of a tendering process or an international price comparison; and to make reimbursement conditional on effectiveness and cost-effectiveness of braces.

Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking.

PubMed

Hall, Emily A; Simon, Janet E; Docherty, Carrie L

2016-04-01

Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated. To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking. Crossover study. Research laboratory. A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered. Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition. Main Outcome Measure(s) Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale. Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape conditions provided more perceived stability (0.98 cm and 0.94 cm, respectively) than the control condition (2.38 cm; both P

A functional comparison of conventional knee-ankle-foot orthoses and a microprocessor-controlled leg orthosis system based on biomechanical parameters.

PubMed

Schmalz, Thomas; Pröbsting, Eva; Auberger, Roland; Siewert, Gordon

2016-04-01

The microprocessor-controlled leg orthosis C-Brace enables patients with paretic or paralysed lower limb muscles to use dampened knee flexion under weight-bearing and speed-adapted control of the swing phase. The objective of the present study was to investigate the new technical functions of the C-Brace orthosis, based on biomechanical parameters. The study enrolled six patients. The C-Brace orthosis is compared with conventional leg orthoses (four stance control orthoses, two locked knee-ankle-foot orthoses) using biomechanical parameters of level walking, descending ramps and descending stairs. Ground reaction forces, joint moments and kinematic parameters were measured for level walking as well as ascending and descending ramps and stairs. With the C-Brace, a nearly natural stance phase knee flexion was measured during level walking (mean value 11° ± 5.6°). The maximum swing phase knee flexion angle of the C-Brace approached the normal value of 65° more closely than the stance control orthoses (66° ± 8.5° vs 74° ± 6.4°). No significant differences in the joint moments were found between the C-Brace and stance control orthosis conditions. In contrast to the conventional orthoses, all patients were able to ambulate ramps and stairs using a step-over-step technique with C-Brace (flexion angle 64.6° ± 8.2° and 70.5° ± 12.4°). The results show that the functions of the C-Brace for situation-dependent knee flexion under weight bearing have been used by patients with a high level of confidence. The functional benefits of the C-Brace in comparison with the conventional orthotic mechanisms could be demonstrated most clearly for descending ramps and stairs. The C-Brace orthosis is able to combine improved orthotic function with sustained orthotic safety. © The International Society for Prosthetics and Orthotics 2014.

Spanish validation of Bad Sobernheim Stress Questionnaire (BSSQ (brace).es) for adolescents with braces

PubMed Central

2010-01-01

Background As a result of scientific and medical professionals gaining interest in Stress and Health Related Quality of Life (HRQL), the aim of our research is, thus, to validate into Spanish the German questionnaire Bad Sobernheim Stress Questionnaire (BSSQ) (mit Korsett), for adolescents wearing braces. Methods The methodology used adheres to literature on trans-cultural adaptation by doing a translation and a back translation; it involved 35 adolescents, ages ranging between 10 and 16, with Adolescent Idiopathic Scoliosis (AIS) and wearing the same kind of brace (Rigo System Chêneau Brace). The materials used were a socio-demographics data questionnaire, the SRS-22 and the Spanish version of BSSQ(brace).es. The statistical analysis calculated the reliability (test-retest reliability and internal consistency) and the validity (convergent and construct validity) of the BSSQ (brace).es. Results BSSQ(brace).es is reliable because of its satisfactory internal consistency (Cronbach's alpha coefficient was 0.809, p < 0.001) and temporal stability (test-retest method with a Pearson correlation coefficient of 0.902 (p < 0.01)). It demonstrated convergent validity with SRS-22 since the Pearson correlation coefficient was 0.656 (p < 0.01). By undertaking an Exploratory Principal Components Analysis, a latent structure was found based on two Components which explicate the variance at 60.8%. Conclusions BSSQ (brace).es is reliable and valid and can be used with Spanish adolescents to assess the stress level caused by the brace. PMID:20633253

The effect of external ankle support on knee and ankle joint movement and loading in netball players.

PubMed

Vanwanseele, Benedicte; Stuelcken, Max; Greene, Andrew; Smith, Richard

2014-09-01

External ankle support has been successfully used to prevent ankle sprains. However, some recent studies have indicated that reducing ankle range of motion can place larger loads on the knee. The aim of this study was to investigate the effect of external ankle support (braces and high-top shoes) on the ankle and knee joint loading during a netball specific landing task. A repeated measure design. High performance netball players with no previously diagnosed severe ankle or knee injury (n=11) were recruited from NSW Institute of Sport netball programme. The kinematic and kinetic data were collected simultaneously using a 3-D Motion Analysis System and one Kistler force plate to measure ground reaction forces. Players performed a single leg landing whilst receiving a pass while wearing a standard netball shoe, the same shoe with a lace-up brace and a high-top shoe. Only the brace condition significantly reduced the ankle range of motion in the frontal plane (in/eversion) by 3.95 ± 3.74 degrees compared to the standard condition. No changes were found for the knee joint loading in the brace condition. The high-top shoes acted to increase the peak knee internal rotation moment by 15%. Both the brace and high-top conditions brought about increases in the peak ankle plantar flexion moment during the landing phase. Lace-up braces can be used by netball players to restrict ankle range of motion during a single leg landing while receiving a pass without increasing the load on the knee joint. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Healing of the Acutely Injured Anterior Cruciate Ligament: Functional Treatment with the ACL-Jack, a Dynamic Posterior Drawer Brace

PubMed Central

Reischl, Nikolaus; Rönn, Karolin; Magnusson, Robert A.; Gautier, Emanuel; Jakob, Roland P.

2016-01-01

Background. The injured anterior cruciate ligament (ACL) has a limited healing capacity leading to persisting instability. Hypothesis/Purpose. To study if the application of a brace, producing a dynamic posterior drawer force, after acute ACL injury reduces initial instability. Study Design. Cohort study. Methods. Patients treated with the ACL-Jack brace were compared to controls treated with primary ACL reconstruction und controls treated nonsurgically with functional rehabilitation. Measurements included anterior laxity (Rolimeter), clinical scores (Lysholm, Tegner, and IKDC), and MRI evaluation. Patients were followed up to 24 months. Results. Patients treated with the ACL-Jack brace showed a significant improvement of anterior knee laxity comparable to patients treated with ACL reconstruction, whereas laxity persisted after nonsurgical functional rehabilitation. The failure risk (secondary reconstruction necessary) of the ACL-Jack group was however 21% (18 of 86) within 24 months. Clinical scores were similar in all treatment groups. Conclusion. Treatment of acute ACL tears with the ACL-Jack brace leads to improved anterior knee laxity compared to nonsurgical treatment with functional rehabilitation. PMID:28053787

Horizontal Cross Bracing Detail, Vertical Cross Bracing Detail, Horizontal Cross ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Horizontal Cross Bracing Detail, Vertical Cross Bracing Detail, Horizontal Cross Bracing Detail, Vertical Cross Bracing-End Detail - Cumberland Covered Bridge, Spanning Mississinewa River, Matthews, Grant County, IN

Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking

PubMed Central

Hall, Emily A.; Simon, Janet E.; Docherty, Carrie L.

2016-01-01

Context:  Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated. Objective:  To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking. Design:  Crossover study. Setting:  Research laboratory. Patients or Other Participants:  A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered. Intervention(s):  Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition. Main Outcome Measure(s):  Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale. Results:  Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape

Horizontal Cross Bracing Detail, Vertical Cross Bracing Detail, Horizontal Cross ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Horizontal Cross Bracing Detail, Vertical Cross Bracing Detail, Horizontal Cross Bracing Joint, Vertical Cross Bracing End Detail - Ceylon Covered Bridge, Limberlost Park, spanning Wabash River at County Road 900 South, Geneva, Adams County, IN

The Effects of the Swede-O, New Cross, and McDavid Ankle Braces and Adhesive Ankle Taping on Speed, Balance, Agility, and Vertical Jump

PubMed Central

Paris, David L.

1992-01-01

Scores from motor performance tests were compared using subjects with taped and untaped ankles. Previous studies have shown that taped ankle support may be detrimental in vertical and standing broad jumping performance. Conflicting data have been published on the effects of commercial ankle braces on various motor tasks. The performances of 18 elite soccer players in selected tests of speed, balance, agility, and vertical jumping were compared under conditions of untaped, nonelastic adhesive taped, Swede-O-braced, New Cross-braced, and McDavid-braced ankles. Vertical jump performance was significantly reduced when subjects wore New Cross braces. There were no significant differences in tests of speed, balance, and agility among any of the support conditions. Until now, nonelastic adhesive tape has been the preferred method of prophylactic ankle support. I conclude that certain commercial ankle braces may be used as a support alternative during selected activities. ImagesFig 1. PMID:16558170

The carbon brace

PubMed Central

2013-01-01

Background The CMCR brace (Corset MonocoqueCarbone respectant la Respiration –which means Monoshell Carbon Brace respecting Breathing) is an innovative brace, used in orthopaedic treatment for progressive thoracic, thoraco-lumbar or combined scoliosis, whatever their etiology. It can be used at the very young age without disrupting the chest growth, but should be kept for reducible scoliosis in older teenagers. Brace description and principles The CMCR brace is monoshell while retaining the corrective principle of the polyvalve Lyon brace with one or two supports (brace “pads”) located on hump(s).In contrast to Lyon brace made of plexidur and structured by metal reinforcement with adjustable but fixed localized supports, the CMCR brace is made of polyethylene and carbon with adjustable and mobile supports. This mobility provides a permanent pressure, which varies depending on ribs and spine movements. The correction is obtained without spinal extension so that each respiratory movement takes part in a gradual return to dorsal kyphosis. Results Results were presented in two published analysis: • In the first retrospective study about 115 patients, French-published in the Annals of Physical Medicine and Rehabilitation (2005), the CMCR brace stabilized moderate scoliosis, decreased the vital capacity (VC) of 13% compared to the VC without brace, and did not have sufficient impact on the hump reduction. Treatment had better results when started at Risser 3 or 4 than Risser 0, 1, 2. The brace was then modified to increase the dorsal pad pressure and the location of correction forces was defined more precisely through the use of 3D analysis. • The second study published in Scoliosis (2011) mainly focused on the impact on VC at brace setting up and followed a cohort of 90 patients treated with CMCR. Girls as well as boys increased VC during treatment, and at brace definitive removal, VC had increased of 21% from the initial value, whereas the theoretical VC

Braces

MedlinePlus

... straightens your teeth faster and easier. The rubber bands that go along with braces come in funky ... just need regular braces with wires and rubber bands doing their jobs to keep pressure on the ...

Knee flexion deformity from poliomyelitis treated by supracondylar femoral extension osteotomy.

PubMed

de Moraes Barros Fucs, Patricia M; Svartman, Celso; de Assumpção, Rodrigo Montezuma César

2005-12-01

Between April 1979 and August 1993, we treated 39 patients (49 knees) with knee flexion deformity after Poliomyelitis. All were subjected to fractional hamstring lengthening and supracondylar femoral extension osteotomy in the same surgical procedure. The goal was to correct the deformity and fit the lower extremities in long braces to improve or promote gait. Patients' mean age was 19.5 (6.5-39) years and the mean knee flexion deformity was 65 degrees (24-158 degrees). The mean follow-up was 15.5 (11.5-25) years. Postoperatively, 22 knees had full extension, in 26 there was an extension lag between -1 and -10 degrees and in one a lag greater than 10 degrees. There were no neurovascular complications and all patients were fitted with long leg braces. Surgical planning is important, especially in severe deformities, where shortening of the femur is necessary to facilitate the osteotomy and relax the neurovascular structures.

Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent-Taped Conditions.

PubMed

Willeford, Kristin; Stanek, Justin M; McLoda, Todd A

2018-01-01

  Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players.   To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice.   Crossover study.   Collegiate athletic training room.   Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg).   Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice).   Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points.   Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions.   Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.

Managing the pain of knee osteoarthritis.

PubMed

Hrnack, Scott A; Barber, F Alan

2014-09-01

Pain from knee osteoarthritis creates a significant burden for symptomatic patients, who are often forced to change their lifestyle because of their symptoms. Activity modification, therapy, weight loss, nonsteroidal anti-inflammatory drugs, shoe orthotics, bracing, and injections are the nonoperative options available. New technologies are also emerging in the treatment of knee osteoarthritis. Ultimately, these therapeutic modalities should reduce pain and increase the overall functioning of patients. These nonoperative modalities give the clinician several effective options before surgical management is considered.

Locking mechanism for orthopedic braces

NASA Technical Reports Server (NTRS)

I-Lechao, J.; Epps, C. H., Jr. (Inventor)

1976-01-01

A locking mechanism for orthopedic braces is described which automatically prevents or permits the relative pivotable movement between a lower brace member and an upper brace member. The upper and lower brace members are provided with drilled bores within which a slidable pin is disposed, and depending upon the inclination of the brace members with respect to a vertical plane, the slidable pin will be interposed between both brace members. The secondary or auxiliary latching device includes a spring biased, manually operable lever bar arrangement which is manually unlatched and automatically latched under the influence of the spring.

11. Detail of sway braces, struts and top lateral braces' ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Detail of sway braces, struts and top lateral braces' view to north-northwest - Milk River Bridge, Spanning Milk River approximately one mile north of Tampico on Tampico North Road, Tampico, Valley County, MT

Lockable Knee Brace Speeds Rehabilitation

NASA Technical Reports Server (NTRS)

2008-01-01

Marshall Space Flight Center develops key transportation and propulsion technologies for the Space Agency. The Center manages propulsion hardware and technologies of the space shuttle, develops the next generation of space transportation and propulsion systems, oversees science and hardware development for the International Space Station, manages projects and studies that will help pave the way back to the Moon, and handles a variety of associated scientific endeavors to benefit space exploration and improve life here on Earth. It is a large and diversified center, and home to a great wealth of design skill. Some of the same mechanical design skill that made its way into the plans for rocket engines and advanced propulsion at this Alabama-based NASA center also worked its way into the design of an orthotic knee joint that is changing the lives of people with weakened quadriceps.

User Survey of 3 Ankle Braces in Soccer, Volleyball, and Running: Which Brace Fits Best?

PubMed

Janssen, Kasper; Van Den Berg, Anjulie; Van Mechelen, Willem; Verhagen, Evert

2017-08-01

  Recurrence rates for ankle sprains are high. Therefore, preventive measures such as ankle bracing during sports are recommended.   To systematically evaluate the perceived ease of use, quality, comfort, stability, and hindrance of and the overall satisfaction with 3 contemporary brace types in 3 types of sports.   Randomized comparative user survey.   Recreational sports: soccer, volleyball, and running.   Young adult recreational athletes (29 soccer players, 26 volleyball players, and 31 runners).   Compression brace (CB), lace-up brace (LB), and semirigid brace (SB).   Rating of perceived ease of use, quality, comfort, stability, and hindrance of and overall satisfaction with the brace types during sports on a 5-point Likert scale. The secondary outcome measure was participants' willingness to buy the tested brace.   Overall, the 3 brace types received high mean scores for ease of use and quality. Soccer players preferred the CB over both alternatives, considering the higher scores for comfort (CB = 4.0, LB = 3.5, SB = 2.8), hindrance (CB = 3.7, LB = 2.9, SB = 2.8), overall satisfaction (CB = 3.6, LB = 3.0, SB = 2.5), and greatest willingness to buy this brace. Volleyball players preferred the LB over both alternatives, considering the higher scores for stability (LB = 4.2, CB = 3.2, SB = 3.3), overall satisfaction (LB = 3.8, CB = 3.0, SB = 3.0), and greatest willingness to buy this brace. Runners preferred the CB over both alternatives considering the better score for hindrance (CB = 3.6, LB = 2.8, SB = 2.9) and greatest willingness to buy this brace.   All 3 ankle-brace types scored high on perceived ease of use and quality. Regarding the brace types, soccer players, volleyball players, and runners differed in their assessments of subjective evaluation of comfort, stability, hindrance, overall satisfaction, and willingness to buy the brace. Soccer players and runners preferred the CB, whereas volleyball players preferred the LB.

Invisible Braces

NASA Technical Reports Server (NTRS)

1989-01-01

Ceradyne, Inc., and 3M Unitek were assisted in the development of Ceramic braces by NIAC/USC. The braces are marketed by Unitek/3M, and are made from translucent polycrystalline alumina (TPA). They are designed for each tooth, connected by a thin metal wire, are strong, aesthetically appealing and as effective clinically as plastic or metal appliances.

Use of a shoulder abduction brace after arthroscopic rotator cuff repair: A study on gait performance and falls.

PubMed

Sonoda, Yuma; Nishioka, Takashi; Nakajima, Ryo; Imai, Shinji; Vigers, Piers; Kawasaki, Taku

2018-04-01

Fall prevention is essential in patients after arthroscopic rotator cuff repair because of the high risk of re-rupture. However, there are no reports related to falls that occur during the early postoperative period, while the affected limb is immobilized. This study assessed gait performance and falls in patients using a shoulder abduction brace after arthroscopic rotator cuff repair. Prospective cohort and postoperative repeated measures. This study included 29 patients (mean age, 67.1 ± 7.4 years) who underwent arthroscopic rotator cuff repair followed by rehabilitation. The timed up and go test, Geriatric Depression Scale, and Falls Efficacy Scale were measured, and the numbers of falls were compared between those shoulder abduction brace users and patients who had undergone total hip or knee arthroplasty. In arthroscopic rotator cuff repair patients, there were significant improvements in timed up and go test and Geriatric Depression Scale, but no significant differences in Falls Efficacy Scale, between the second and fifth postoperative weeks ( p < 0.05). Additionally, arthroscopic rotator cuff repair patients fell more often than patients with total hip arthroplasty or total knee arthroplasty during the same period. The findings suggest that rehabilitation in arthroscopic rotator cuff repair patients is beneficial, but decreased gait performance due to the immobilizing shoulder abduction brace can lead to falls. Clinical relevance Although rehabilitation helps motor function and mental health after arthroscopic rotator cuff repair, shoulder abduction brace use is associated with impaired gait performance, high Falls Efficacy Scale scores, and risk of falls, so awareness of risk factors including medications and lower limb dysfunctions is especially important after arthroscopic rotator cuff repair.

Scoliosis brace (image)

MedlinePlus

... on the back and ribs to push the spine in a straighter position. The brace usually fits snugly around the torso and can come in many styles. In a child who is still growing, bracing is usually recommended ...

"Brace Technology" Thematic Series - The ScoliOlogiC® Chêneau light™ brace in the treatment of scoliosis.

PubMed

Weiss, Hans-Rudolf; Werkmann, Mario

2010-09-06

Bracing concepts in use today for the treatment of scoliosis include symmetric and asymmetric hard braces usually made of polyethylene (PE) and soft braces. The plaster cast method worldwide seems to be the most practiced technique for the construction of hard braces at the moment. CAD (Computer Aided Design) systems are available which allow brace adjustments without plaster. Another possibility is the use of the ScoliOlogiC™ off the shelf system enabling the Certified Prosthetist and Orthotist (CPO) to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This Chêneau light™ brace, developed according to the Chêneau principles, promises a reduced impediment of quality of life in the brace. The correction effects of the first 81 patients (main diagnosis Adolescent Idiopathic Scoliosis (AIS) [n = 64] or Early Onset Scoliosis (EOS) [n = 15]), treated according to the principles of the Chêneau light™ brace have shown a satisfactory in-brace correction exceeding 50% of the initial Cobb angle. The ScoliOlogiC® off the shelf bracing system enables the CPO to construct a light brace for scoliosis correction from a variety of pattern specific shells to be connected to an anterior and a posterior upright. This brace, when finally adjusted is called Chêneau light™ brace. The advantage of this new bracing system is that the brace is available immediately, is easily adjustable and that it can also be easily modified. This avoids construction periods of sometimes more than 6 weeks, where the curve may drastically increase during periods of fast growth. The disadvantage of this bracing system is that there is a wide variability of possibilities to arrange the different shells during adjustment. The Cobb angle in the whole group was reduced by an average of 16,4°, which corresponds to a correction effect of 51%. The differences were highly significant in the T-test (T = 17

Brace related stress in scoliosis patients – Comparison of different concepts of bracing

PubMed Central

Weiss, Hans-Rudolf; Werkmann, Mario; Stephan, Carola

2007-01-01

Background The BSSQbrace questionnaire has been shown to be reliable with good internal consistency and reproducibility estimating the stress scoliosis patients have whilst wearing their brace. Eight questions are provided focussing on this topic. A max. score of 24 can be achieved (from 0 for most stress to 24 for no stress). The subdivision of the score values is: 0–8 (strong stress), 9–16 (medium stress) and 17–24 (little stress). Study design Two BSSQbrace questionnaires have been posted to 65 patients under brace treatment from our Cheneau light data base. All patients had another kind of brace prior to the Cheneau light. The patients have been asked to rate their stress level using one questionnaire for the current brace and the other for the previous one. Results 63 Patients (59 girls and 4 boys) returned their fully completed questionnaires (average age 13,6 years, average Cobb angle 43,7 degrees). Stress level in the previous brace was 11,04 and in the Cheneau light(r) 13,87. The differences were highly significant in the t-test; t = -4,67; p < 0,001. Conclusion The use of the Cheneau light® brace leads to reduced stress and/or impairment for the patients under treatment compared to heavier brace models used so far. PMID:17708766

Ankle Bracing, Fatigue, and Time to Stabilization in Collegiate Volleyball Athletes

PubMed Central

Shaw, Megan Y; Gribble, Phillip A; Frye, Jamie L

2008-01-01

Context: Fatigue has been shown to disrupt dynamic stability in healthy volunteers. It is not known if wearing prophylactic ankle supports can improve dynamic stability in fatigued athletes. Objective: To determine the type of ankle brace that may be more effective at providing dynamic stability after a jump-landing task during normal and fatigued conditions. Design: Two separate repeated-measures analyses of variance with 2 within-subjects factors (condition and time) were performed for each dependent variable. Setting: Research laboratory. Patients or Other Participants: Ten healthy female collegiate volleyball athletes participated (age  =  19.5 ± 1.27 years, height  =  179.07 ± 7.6 cm, mass  =  69.86 ± 5.42 kg). Intervention(s): Athletes participated in 3 separate testing sessions, applying a different bracing condition at each session: no brace (NB), Swede-O Universal lace-up ankle brace (AB), and Active Ankle brace (AA). Three trials of a jump-landing task were performed under each condition before and after induced functional fatigue. The jump-landing task consisted of a single-leg landing onto a force plate from a height equivalent to 50% of each participant's maximal jump height and from a starting position 70 cm from the center of the force plate. Main Outcome Measure(s): Time to stabilization in the anterior-posterior (APTTS) and medial-lateral (MLTTS) directions. Results: For APTTS, a condition-by-time interaction existed (F2,18  =  5.55, P  =  .013). For the AA condition, Tukey post hoc testing revealed faster pretest (2.734 ± 0.331 seconds) APTTS than posttest (3.817 ± 0.263 seconds). Post hoc testing also revealed that the AB condition provided faster APTTS (2.492 ± 0.271 seconds) than AA (3.817 ± 0.263 seconds) and NB (3.341 ± 0.339 seconds) conditions during posttesting. No statistically significant findings were associated with MLTTS. Conclusions: Fatigue increased APTTS for the AA condition. Because the

Treatment of knee osteoarthritis.

PubMed

Ringdahl, Erika; Pandit, Sandesh

2011-06-01

Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acetaminophen, glucosamine, ginger, S-adenosylmethionine (SAM-e), capsaicin cream, topical nonsteroidal anti-inflammatory drugs, acupuncture, and tai chi may offer some benefit. Tramadol has a poor trade-off between risks and benefits and is not routinely recommended. Opioids are being used more often in patients with moderate to severe pain or diminished quality of life, but patients receiving these drugs must be carefully selected and monitored because of the inherent adverse effects. Intra-articular corticosteroid injections are effective, but evidence for injection of hyaluronic acid is mixed. Arthroscopic surgery has been shown to have no benefit in knee osteoarthritis. Total joint arthroplasty of the knee should be considered when conservative symptomatic management is ineffective.

Brace technology thematic series - The Sforzesco and Sibilla braces, and the SPoRT (Symmetric, Patient oriented, Rigid, Three-dimensional, active) concept

PubMed Central

2011-01-01

Background Bracing is an effective strategy for scoliosis treatment, but there is no consensus on the best type of brace, nor on the way in which it should act on the spine to achieve good correction. The aim of this paper is to present the family of SPoRT (Symmetric, Patient-oriented, Rigid, Three-dimensional, active) braces: Sforzesco (the first introduced), Sibilla and Lapadula. Methods The Sforzesco brace was developed following specific principles of correction. Due to its overall symmetry, the brace provides space over pathological depressions and pushes over elevations. Correction is reached through construction of the envelope, pushes, escapes, stops, and drivers. The real novelty is the drivers, introduced for the first time with the Sforzesco brace; they allow to achieve the main action of the brace: a three-dimensional elongation pushing the spine in a down-up direction. Brace prescription is made plane by plane: frontal (on the "slopes", another novelty of this concept, i.e. the laterally flexed sections of the spine), horizontal, and sagittal. The brace is built modelling the trunk shape obtained either by a plaster cast mould or by CAD-CAM construction. Brace checking is essential, since SPoRT braces are adjustable and customisable according to each individual curve pattern. Treatment time and duration is individually tailored (18-23 hours per day until Risser 3, then gradual reduction). SEAS (Scientific Exercises Approach to Scoliosis) exercises are a key factor to achieve success. Results The Sforzesco brace has shown to be more effective than the Lyon brace (matched case/control), equally effective as the Risser plaster cast (prospective cohort with retrospective controls), more effective than the Risser cast + Lyon brace in treating curves over 45 degrees Cobb (prospective cohort), and is able to improve aesthetic appearance (prospective cohort). Conclusions The SPoRT concept of bracing (three-dimensional elongation pushing in a down-up direction

Evaluating the Ergonomic Benefit of a Wrist Brace on Wrist Posture, Muscle Activity, Rotational Stiffness, and Peak Shovel-Ground Impact Force During a Simulated Tree-Planting Task.

PubMed

Sheahan, Peter J; Cashaback, Joshua G A; Fischer, Steven L

2017-09-01

Background Tree planters are at a high risk for wrist injury due to awkward postures and high wrist loads experienced during each planting cycle, specifically at shovel-ground impact. Wrist joint stiffness provides a measure that integrates postural and loading information. Objective The purpose of this study was to evaluate wrist joint stiffness requirements at the instant of shovel-ground impact during tree planting and determine if a wrist brace could alter muscular contributions to wrist joint stiffness. Method Planters simulated tree planting with and without wearing a brace on their planting arm. Surface electromyography (sEMG) from six forearm muscles and wrist kinematics were collected and used to calculate muscular contributions to joint rotational stiffness about the wrist. Results Wrist joint stiffness increased with brace use, an unanticipated and negative consequence of wearing a brace. As a potential benefit, planters achieved a more neutrally oriented wrist angle about the flexion/extension axis, although a less neutral wrist angle about the ulnar/radial axis was observed. Muscle activity did not change between conditions. Conclusion The joint stiffness analysis, combining kinematic and sEMG information in a biologically relevant manner, revealed clear limitations with the interface between the brace grip and shovel handle that jeopardized the prophylactic benefits of the current brace design. This limitation was not as evident when considering kinematics and sEMG data independently. Application A neuromechanical model (joint rotational stiffness) enhanced our ability to evaluate the brace design relative to kinematic and sEMG parameter-based metrics alone.

Deployable M-braced truss structure

NASA Technical Reports Server (NTRS)

Mikulas, M. M., Jr. (Inventor); Rhodes, M. D. (Inventor)

1986-01-01

A deployable M-braced truss structure, efficiently packaged into a compact stowed position and expandable to an operative position at the use site is described. The M-braced configuration effectively separates tension compression and shear in the structure and permits efficient structural design. Both diagonals and longerons telescope from an M-braced base unit and deploy either pneumatically, mechanically by springs or cables, or by powered reciprocating mechanisms. Upon full deployment, the diagonals and longerons lock into place with a simple latch mechanism.

[Dynamic compression brace for pectus carinatum].

PubMed

de Beer, Sjoerd A; de Jong, Justin R; Heij, Hugo A

2013-01-01

Pectus carinatum occurs in one of 1500-1700 people and may lead to physical, cosmetic and psychosocial problems. Surgical treatment of pectus carinatum is performed using the 'Ravitch procedure'. An alternative and less invasive treatment consists of external compression with a brace. Results are often disappointing because of skin complications, a low level of comfort of the brace and low compliance. Nowadays a new brace (dynamic compression brace) exists with which the comfort and thus the compliance can be increased by measuring and regulating the pressure of correction during the treatment. This leads to better results and fewer complications. In 80-90% of patients the results are good to excellent and an operation can be avoided. This new brace is therefore a less invasive, cheap and safe alternative to the Ravitch procedure in the treatment of pectus carinatum in children.

Abdominal Hollowing Reduces Lateral Trunk Displacement During Single-Leg Squats in Healthy Females But Does Not Affect Peak Hip Abduction Angle or Knee Abductio Angle/Moment.

PubMed

Linde, Lukas D; Archibald, Jessica; Lampert, Eve C; Srbely, John Z

2017-07-17

Females suffer 4-6 times more non-contact anterior cruciate ligament (ACL) injuries than males due to neuromuscular control deficits of the hip musculature leading to increases in hip adduction angle, knee abduction angle, and knee abduction moment during dynamic tasks such as single-leg squats. Lateral trunk displacement has been further related to ACL injury risk in females, leading to the incorporation of core strength/stability exercises in ACL preventative training programs. However, the direct mechanism relating lateral trunk displacement and lower limb ACL risk factors is not well established. To assess the relationship between lateral trunk displacement and lower limb measures of ACL injury risk by altering trunk control through abdominal activation techniques during single-leg squats in healthy females. Interventional Study Setting: Movement and Posture Laboratory Participants: 13 healthy females (21.3±0.88y, 1.68±0.07m, 58.27±5.46kg) Intervention: Trunk position and lower limb kinematics were recorded using an optoelectric motion capture system during single-leg squats under differing conditions of abdominal muscle activation (abdominal hollowing, abdominal bracing, control), confirmed via surface electromyography. Lateral trunk displacement, peak hip adduction angle, peak knee abduction angle/moment, and average muscle activity from bilateral internal oblique, external oblique, and erector spinae muscles. No differences were observed for peak lateral trunk displacement, peak hip adduction angle or peak knee abduction angle/moment. Abdominal hollowing and bracing elicited greater muscle activation than the control condition, and bracing was greater than hollowing in four of six muscles recorded. The lack of reduction in trunk, hip, and knee measures of ACL injury risk during abdominal hollowing and bracing suggests that these techniques alone may provide minimal benefit in ACL injury prevention training.

Physiotherapy management of knee osteoarthritis.

PubMed

Page, Carolyn J; Hinman, Rana S; Bennell, Kim L

2011-05-01

Knee osteoarthritis (OA) is a prevalent chronic joint disease causing pain and disability. Physiotherapy, which encompasses a number of modalities, is a non-invasive treatment option in the management of OA. This review summarizes the evidence for commonly used physiotherapy interventions. There is strong evidence to show short-term beneficial effects of exercise on pain and function, although the type of exercise does not seem to influence treatment outcome. Delivery modes, including individual, group or home exercise are all effective, although therapist contact may improve benefits. Attention to improving adherence to exercise is needed to maximize outcomes in the longer-term. Knee taping applied with the aim of realigning the patella and unloading soft tissues can reduce pain. There is also evidence to support the use of knee braces in people with knee OA. Biomechanical studies show that lateral wedge shoe insoles reduce knee load but clinical trials do not support symptomatic benefits. Recent studies suggest individual shoe characteristics also affect knee load and there is current interest in the effect of modified shoe designs. Manual therapy, while not to be used as a stand-alone treatment, may be beneficial. In summary, although the research is not equivocal, there is sufficient evidence to indicate that physiotherapy interventions can reduce pain and improve function in those with knee OA. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

The SPoRT concept of bracing for idiopathic scoliosis.

PubMed

Zaina, Fabio; Fusco, Claudia; Atanasio, Salvatore; Negrini, Stefano

2011-01-01

The SPoRT (acronym: Symmetrical, Patient-oriented, Rigid, Three-dimensional, active) concept of bracing is a new way to build braces based on our 20 years of experience and the biomechanical principles of scoliosis correction, inclusive of the Sibilla and Sforzesco braces. The concept always requires a custom brace, which is made according to the patient's individual requirements. New technologies such as CAD-CAM can be applied, and often for better results, without the customary use of prebuilt forms whose measurements are stored in databases. Once the initial draft brace is completed, a final test must be made on the patient to modify and adapt it, depending on his or her real interaction between the body and the brace. The results that are today available on the SPoRT concept relate to the Sforzesco brace and are necessarily short-term, because the first treated patients are now reaching the fourth-year follow-up examination and haven't yet completed their treatments. On the basis of the initial evaluations, we can state that the Sforzesco brace is more effective than the Lyon brace after 6 months of treatment and that the Sforzesco brace is equally effective as the Risser Plast brace.

Performance of Healthy Braced Participants During Aerobic and Anaerobic Capacity Tasks

PubMed Central

Rishiraj, Neetu; Taunton, Jack E.; Niven, Brian; Lloyd-Smith, Robert; Regan, William; Woollard, Robert

2011-01-01

Context: Knee braces were introduced in sports approximately 30 years ago. However, the effects of a functional knee brace (FKB) on aerobic and anaerobic performance after fatigue are unknown. Objective: To investigate whether FKB use in noninjured participants hindered performance during aerobic (Léger beep test) and anaerobic (repeated high-intensity shuttle test [RHIST]) tasks. Design: Crossover study. Setting: Laboratory. Patients or Other Participants: Twenty-seven healthy male provincial and national basketball and field hockey athletes (age = 19.4 ± 3.0 years, range, 17–26 years; height = 182.6 ± 6.8 cm, range, 168–196 cm; mass = 80.0 ± 9.1 kg, range, 66–108 kg). Interventions : Each participant was provided a custom-fitted FKB and performed 5 nonbraced (NBR) testing sessions over 3 days, followed by 5 braced (BR) testing sessions over 3 days, for a total of 17.5 hours of testing per condition. During each testing session, participants performed 1 trial of the Léger beep test and 1 trial of the RHIST in each condition. Main Outcome Measure(s): Predicted maximal oxygen consumption (V˙o2max) and time performance measures were recorded for each NBR and BR trial. Results: Initial performance levels were lower for BR than NBR for both the Léger beep test (BR = 44.3 mL/kg/min, NBR = 47.3 mL/kg/min; F1,26 = 8.726; P = .007) and the RHIST (BR = 16.5 seconds, NBR = 16.2 seconds; F1,26 = 13.98, P = .001). However, with continued FKB use, the aerobic performance measure remained higher for only the first 2 BR testing sessions (NBR = 46.9 mL/kg/min, BR = 42.4 mL/kg/min; F3.0,79.8 = 4.95, P = .003). For the anaerobic test, no performance difference was noted between the testing conditions (NBR = 16.2 seconds, BR = 16.4 seconds; P = .7), whereas fatigue levels were lower during BR testing sessions (NBR = 33%, BR = 31%). After 14.0 hours of FKB use, performance levels were almost equal between the testing conditions (NBR = 47.6 mL/kg/min, BR = 46.1 m

Speaking Tongues Are Actively Braced

ERIC Educational Resources Information Center

Gick, Bryan; Allen, Blake; Roewer-Després, François; Stavness, Ian

2017-01-01

Purpose: Bracing of the tongue against opposing vocal-tract surfaces such as the teeth or palate has long been discussed in the context of biomechanical, somatosensory, and aeroacoustic aspects of tongue movement. However, previous studies have tended to describe bracing only in terms of contact (rather than mechanical support), and only in…

Safety and walking ability of KAFO users with the C-Brace® Orthotronic Mobility System, a new microprocessor stance and swing control orthosis.

PubMed

Pröbsting, Eva; Kannenberg, Andreas; Zacharias, Britta

2017-02-01

There are clear indications for benefits of stance control orthoses compared to locked knee ankle foot orthoses. However, stance control orthoses still have limited function compared with a sound human leg. The aim of this study was to evaluate the potential benefits of a microprocessor stance and swing control orthosis compared to stance control orthoses and locked knee ankle foot orthoses in activities of daily living. Survey of lower limb orthosis users before and after fitting of a microprocessor stance and swing control orthosis. Thirteen patients with various lower limb pareses completed a baseline survey for their current orthotic device (locked knee ankle foot orthosis or stance control orthosis) and a follow-up for the microprocessor stance and swing control orthosis with the Orthosis Evaluation Questionnaire, a new self-reported outcome measure devised by modifying the Prosthesis Evaluation Questionnaire for use in lower limb orthotics and the Activities of Daily Living Questionnaire. The Orthosis Evaluation Questionnaire results demonstrated significant improvements by microprocessor stance and swing control orthosis use in the total score and the domains of ambulation ( p = .001), paretic limb health ( p = .04), sounds ( p = .02), and well-being ( p = .01). Activities of Daily Living Questionnaire results showed significant improvements with the microprocessor stance and swing control orthosis with regard to perceived safety and difficulty of activities of daily living. The microprocessor stance and swing control orthosis may facilitate an easier, more physiological, and safer execution of many activities of daily living compared to traditional leg orthosis technologies. Clinical relevance This study compared patient-reported outcomes of a microprocessor stance and swing control orthosis (C-Brace) to those with traditional knee ankle foot orthosis and stance control orthosis devices. The C-Brace offers new functions including controlled

[Bracing in Adolescent Idiopathic Scoliosis].

PubMed

Lo, Yi-Fang; Huang, Yu-Chu

2017-04-01

Scoliosis is a common medical problem, with an incidence of between 0.47% and 5.2% in the general population globally. Adolescent idiopathic scoliosis (AIS) accounts for nearly 80% of all scoliosis. Young people with AIS often experience negative social consequences in association with their condition. Without proper and timely treatment, the potential resulting disabilities range from trunk deformity, pain, and neurological complications to compromised cardiopulmonary function, all of which may cause lifelong suffering. Scoliosis may be treated either conservatively or surgically, based on the severity of the disease. Bracing is the most widely adopted method of conservative treatment. However, the main goal of bracing is to inhibit the progression of the spinal curvature rather than to cure scoliosis. The clinical effectiveness of bracing in Taiwan has often been underutilized as a result of financial or other factors such as the availability of the treatment. The purpose of the present review is to clarify the effectiveness of bracing for AIS by elucidating the pathophysiology of scoliosis and examining the recent clinical evidence. The importance of preventative care and the unique contribution of nursing care to treatment has to date been under-recognized. The positive support that nurses provide to the families of the patients during the early phases of treatment as well as to the patients themselves, including helping them exercise appropriately and wear the brace correctly, is an essential component of effective treatment. Learning how to work with and to adapt to the brace being part of the body is an important part of the treatment as well as a way to avoid pain. Nurses are in an ideal position to facilitate this learning process and, overall, to provide health education.

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

Curve progression 25 years after bracing for adolescent idiopathic scoliosis: long term comparative results between two matched groups of 18 versus 23 hours daily bracing.

PubMed

Pellios, Stavros; Kenanidis, Eustathios; Potoupnis, Michael; Tsiridis, Eleftherios; Sayegh, Fares E; Kirkos, John; Kapetanos, George A

2016-01-01

Scoliotic curves do not necessarily stop progressing at skeletal maturity. The factors that influence curve behavior following bracing are not fully determined. Our objectives were to evaluate the loss of the scoliotic curve correction in a cohort of patients treated with bracing during adolescence and to compare the outcomes of 18 versus 23 h of bracing at a mean of 25 years post brace removal. Seventy-seven patients, who were successfully treated for Adolescent Idiopathic Scoliosis with Βoston brace, were re-evaluated 25 years after the end of their treatment. Patients were further divided in 2 matched groups; those wearing the brace for 23 h and those not wearing the brace at school-time, limiting the application of the brace to 18 h. The mean scoliotic curve was compared between groups before, during, just after bracing and 25 years post bracing. Validated in patients' native language forms of Short Form 36 and Oswestry Disability Index questionnaires were used to compare the quality of life between groups 25 years post bracing. The mean age of the cohort was 40.4 (±3.2) years. They underwent long term follow up at a mean of 25.16 (±2.69) years after brace removal. The mean cohort scoliotic curve increased by 3.9 (±6.69) at 25 years since brace removal. There was however no significant difference in the mean Cobb angle of the cohort between pre brace and long term follow up period (p = 0.307). The 18 and 23 h application groups were comparable according to demographics and several bracing and scoliotic curve parameters. There was no significant difference in the mean curve magnitude between 18 and 23 h application groups at brace removal (p = 0.512) and at 25 years follow-up (p = 0.878). There was also no significant difference in the mean score of Quality of Life questionnaires between groups at long term follow up. Scoliotic curves do not necessarily stop progressing after bracing. Bracing is effective treatment method with good

Effects of Bracing in Adult With Scoliosis: A Retrospective Study.

PubMed

Palazzo, Clémence; Montigny, Jean-Paul; Barbot, Frédéric; Bussel, Bernard; Vaugier, Isabelle; Fort, Didier; Courtois, Isabelle; Marty-Poumarat, Catherine

2017-01-01

To assess the effectiveness of bracing in adult with scoliosis. Retrospective cohort study. Outpatients followed in 2 tertiary care hospitals. Adults (N=38) with nonoperated progressive idiopathic or degenerative scoliosis treated by custom-molded lumbar-sacral orthoses, with a minimum follow-up time of 10 years before bracing and 5 years after bracing. Progression was defined as a variation in Cobb angle ≥10° between the first and the last radiograph before bracing. The brace was prescribed to be worn for a minimum of 6h/d. Not applicable. Rate of progression of the Cobb angle before and after bracing measured on upright 3-ft full-spine radiographs. At the moment of bracing, the mean age was 61.3±8.2 years, and the mean Cobb angle was 49.6°±17.7°. The mean follow-up time was 22.0±11.1 years before bracing and 8.7±3.3 years after bracing. For both types of scoliosis, the rate of progression decreased from 1.28°±.79°/y before to .21°±.43°/y after bracing (P<.0001). For degenerative and idiopathic scoliosis, it dropped from 1.47°±.83°/y before to .24°±.43°/y after bracing (P<.0001) and .70°±.06°/y before to .24°±.43°/y after bracing (P=.03), respectively. For the first time, to our knowledge, this study suggests that underarm bracing may be effective in slowing down the rate of progression in adult scoliosis. Further prospective studies are needed to confirm these results. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of a surrogate biomodel for the investigation of clubfoot bracing.

PubMed

Dimeo, Andrew J; Lalush, David S; Grant, Edward; Morcuende, Jose A

2012-01-01

Congenital talipes equinovarus (clubfoot) is a complex deformity of the lower extremity and foot occurring in 1/1000 live births. Regardless of treatment, whether conservative or surgical, clubfoot has a stubborn tendency to relapse, thus requiring postcorrection bracing. However, to date, there are no investigations specifically focused on clubfoot bracing from a bioengineering perspective. This study applied engineering principles to clubfoot bracing through construction of a surrogate biomodel. The surrogate was developed to represent an average 5-year-old human subject capable of biomechanical characteristics including joint articulation and kinematics. The components include skeleton, articulating joints, muscle-tendon systems, and ligaments. A protocol was developed to measure muscle-tendon tension in resting and braced positions of the surrogate. Measurement error ranged from 1% to 6% and was considered variance due to brace and investigator. In conclusion, this study shows that surrogate biomodeling is an accurate and repeatable method to investigate clubfoot bracing. The methodology is an effective means to evaluate wide ranging brace options and can be used to assist in future brace development and the tuning of brace parameters. Such patient-specific brace tuning may also lead to advanced braces that increase compliance.

Brace Compression for Treatment of Pectus Carinatum

PubMed Central

Jung, Joonho; Chung, Sang Ho; Cho, Jin Kyoung; Park, Soo-Jin; Choi, Ho

2012-01-01

Background Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Materials and Methods Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results Thirteen (72.2%) patients completed the treatment (mean time, 4.9±1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73±0.39. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC. PMID:23275922

Brace compression for treatment of pectus carinatum.

PubMed

Jung, Joonho; Chung, Sang Ho; Cho, Jin Kyoung; Park, Soo-Jin; Choi, Ho; Lee, Sungsoo

2012-12-01

Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Thirteen (72.2%) patients completed the treatment (mean time, 4.9±1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73±0.39. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.

Treatment of Osteoarthritis of the Knee (Nonarthroplasty)

PubMed Central

Richmond, John; Hunter, David; Irrgang, Jay; Jones, Morgan H.; Levy, Bruce; Marx, Robert; Snyder-Mackler, Lynn; Watters, William C.; Haralson, Robert H.; Turkelson, Charles M.; Wies, Janet L.; Boyer, Kevin M.; Anderson, Sara; Andre, St. Justin St.; Sluka, Patrick; McGowan, Richard

2011-01-01

The clinical practice guideline was explicitly developed to include only treatments less invasive than knee replacement (ie, arthroplasty). Patients with symptomatic osteoarthritis of the knee are to be encouraged to participate in self-management educational programs and to engage in self-care, as well as to lose weight and engage in exercise and quadriceps strengthening. The guideline recommends taping for short-term relief of pain as well as analgesics and intra-articular corticosteroids, but not glucosamine and/or chondroitin. Patients need not undergo needle lavage or arthroscopy with débridement or lavage. Patients may consider partial meniscectomy or loose body removal or realignment osteotomy, as conditions warrant. Use of a free-floating interpositional device should not be considered for symptomatic unicompartmental osteoarthritis of the knee. Lateral heel wedges should not be prescribed for patients with symptomatic medial compartmental osteoarthritis of the knee. The work group was unable either to recommend or not recommend the use of braces with either valgus- or varus-directing forces for patients with medial unicompartmental osteoarthritis; the use of acupuncture or of hyaluronic acid; or osteotomy of the tibial tubercle for isolated symptomatic patellofemoral osteoarthritis. PMID:19726743

Effect of the compressive brace in pectus carinatum.

PubMed

Lee, Seock Yeol; Lee, Seung Jin; Jeon, Cheol Woo; Lee, Cheol Sae; Lee, Kihl Rho

2008-07-01

Patients with pectus carinatum complain of cosmetic problems because they stand out in spite of wearing clothes. Surgical treatment of pectus carinatum is resection of the deformed cartilage but a wide operative scar, postoperative pain and complications related with the operation can occur. Therefore we have performed compressive brace therapy as a non-operative treatment of pectus carinatum, and observed the effects and the efficiency of this treatment. From January 2001 to December 2007, 119 patients with pectus carinatum were treated with a compressive brace that they wore for 24h each day. Their degree of satisfaction was measured after 6 months wearing. This was evaluated with a score of 1-4. A score of 1 was assigned when the status was worse, 2 when it was same, 3 when partially improved, and 4 when a remarkable improvement was observed. Satisfaction was assessed subjectively by a parent if the patient was a child, and patients older than middle school age assessed the score themselves. The mean overall satisfaction score was 3.95+/-0.4. Recurrence of pectus carinatum after removal of the compressive brace occurred in 6 (5.0%) of the total 119 patients. Four of these six patients stopped wearing the compressive brace against our advice. These six patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed it. Complications were discomfort at initial wearing of the brace, which occurred in all patients, skin rash due to compression for 84 patients (70.6%) and skin discoloration due to excessive compression for 18 patients (15.1%). The skin rash and discoloration disappeared within a few months after removal of the brace. This study demonstrated that non-surgical treatment using a compressive brace in patients with pectus carinatum was effective, especially in children and teenagers. Non-surgical treatment using a compressive brace in patients with pectus carinatum would be helpful for those who dislike surgery

49 CFR 195.208 - Welding of supports and braces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Welding of supports and braces. 195.208 Section 195.208 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Construction § 195.208 Welding of supports and braces. Supports or braces may...

49 CFR 195.208 - Welding of supports and braces.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Welding of supports and braces. 195.208 Section 195.208 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Construction § 195.208 Welding of supports and braces. Supports or braces may...

49 CFR 195.208 - Welding of supports and braces.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Welding of supports and braces. 195.208 Section 195.208 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Construction § 195.208 Welding of supports and braces. Supports or braces may...

49 CFR 195.208 - Welding of supports and braces.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Welding of supports and braces. 195.208 Section 195.208 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Construction § 195.208 Welding of supports and braces. Supports or braces may...

49 CFR 195.208 - Welding of supports and braces.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Welding of supports and braces. 195.208 Section 195.208 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Construction § 195.208 Welding of supports and braces. Supports or braces may...

BRACING IN THE TREATMENT OF CHILDREN WITH CLUBFOOT: PAST, PRESENT, AND FUTURE

PubMed Central

Desai, Lajja; Oprescu, Florin; DiMeo, Andrew; Morcuende, Jose A

2010-01-01

Bracing is a critical component of the current standard of treatment for clubfoot. Adherence to the bracing protocol is the main factor for the long-term success of the treatment The purpose of this paper is to provide a review of clubfoot braces, best practices in brace design and recommendations for bracing in order to improve adherence with the bracing phase of the clubfoot treatment. There are a number of designs and offerings of braces available in various regions of the world. Although many new brace designs are being proposed and developed, evidence in the literature regarding biomechanical effects, clinical outcomes, functionality and patient adherence is limited. The current research that is available regarding brace design focuses on increasing patient comfort and satisfaction to improve adherence. Although the currently available braces are widely distributed in developed countries, access is limited to many parts of the world. When considering the future of the clubfoot treatment and prevention of relapses, since 80% of the cases are in developing countries with limited resources, brace cost and availability needs to be assessed. PMID:21045966

The 2011 ABJS Nicolas Andry Award: 'Lab'-in-a-knee: in vivo knee forces, kinematics, and contact analysis.

PubMed

D'Lima, Darryl D; Patil, Shantanu; Steklov, Nicolai; Colwell, Clifford W

2011-10-01

Tibiofemoral forces are important in the design and clinical outcomes of TKA. We developed a tibial tray with force transducers and a telemetry system to directly measure tibiofemoral compressive forces in vivo. Knee forces and kinematics traditionally have been measured under laboratory conditions. Although this approach is useful for quantitative measurements and experimental studies, the extrapolation of results to clinical conditions may not always be valid. We therefore developed wearable monitoring equipment and computer algorithms for classifying and identifying unsupervised activities outside the laboratory. Tibial forces were measured for activities of daily living, athletic and recreational activities, and with orthotics and braces, during 4 years postoperatively. Additional measurements included video motion analysis, EMG, fluoroscopic kinematic analysis, and ground reaction force measurement. In vivo measurements were used to evaluate computer models of the knee. Finite element models were used for contact analysis and for computing knee kinematics from measured knee forces. A third-generation system was developed for continuous monitoring of knee forces and kinematics outside the laboratory using a wearable data acquisition hardware. By using measured knee forces and knee flexion angle, we were able to compute femorotibial AP translation (-12 to +4 mm), mediolateral translation (-1 to 1.5 mm), axial rotation (-3° to 12°), and adduction-abduction (-1° to +1°). The neural-network-based classification system was able to identify walking, stair-climbing, sit-to-stand, and stand-to-sit activities with 100% accuracy. Our data may be used to improve existing in vitro models and wear simulators, and enhance prosthetic designs and biomaterials.

Safety and walking ability of KAFO users with the C-Brace® Orthotronic Mobility System, a new microprocessor stance and swing control orthosis

PubMed Central

Pröbsting, Eva; Kannenberg, Andreas; Zacharias, Britta

2016-01-01

Background: There are clear indications for benefits of stance control orthoses compared to locked knee ankle foot orthoses. However, stance control orthoses still have limited function compared with a sound human leg. Objectives: The aim of this study was to evaluate the potential benefits of a microprocessor stance and swing control orthosis compared to stance control orthoses and locked knee ankle foot orthoses in activities of daily living. Study design: Survey of lower limb orthosis users before and after fitting of a microprocessor stance and swing control orthosis. Methods: Thirteen patients with various lower limb pareses completed a baseline survey for their current orthotic device (locked knee ankle foot orthosis or stance control orthosis) and a follow-up for the microprocessor stance and swing control orthosis with the Orthosis Evaluation Questionnaire, a new self-reported outcome measure devised by modifying the Prosthesis Evaluation Questionnaire for use in lower limb orthotics and the Activities of Daily Living Questionnaire. Results: The Orthosis Evaluation Questionnaire results demonstrated significant improvements by microprocessor stance and swing control orthosis use in the total score and the domains of ambulation (p = .001), paretic limb health (p = .04), sounds (p = .02), and well-being (p = .01). Activities of Daily Living Questionnaire results showed significant improvements with the microprocessor stance and swing control orthosis with regard to perceived safety and difficulty of activities of daily living. Conclusion: The microprocessor stance and swing control orthosis may facilitate an easier, more physiological, and safer execution of many activities of daily living compared to traditional leg orthosis technologies. Clinical relevance This study compared patient-reported outcomes of a microprocessor stance and swing control orthosis (C-Brace) to those with traditional knee ankle foot orthosis and stance control orthosis

A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria.

PubMed

Guo, Jing; Lam, Tsz Ping; Wong, Man Sang; Ng, Bobby Kin Wah; Lee, Kwong Man; Liu, King Lok; Hung, Lik Hang; Lau, Ajax Hong Yin; Sin, Sai Wing; Kwok, Wing Kwan; Yu, Fiona Wai Ping; Qiu, Yong; Cheng, Jack Chun Yiu

2014-12-01

SpineCor is a relatively innovative brace for non-operative treatment of adolescent idiopathic scoliosis (AIS). However, the effectiveness of SpineCor still remains controversial. The objective of the current study was to compare the treatment outcomes of SpineCor brace with that of rigid brace following the standardized Scoliosis Research Society (SRS) criteria on AIS brace study. Females subjects with AIS and aged 10-14 were randomly allocated into two groups undergoing treatment of SpineCor (S Group, n = 20) or rigid brace (R Group, n = 18). During SpineCor treatment, patients who had curve progression of >5° would be required to switch to rigid brace treatment. The effectiveness of the two brace treatments was assessed using the SRS standardized criteria. Before skeletal maturity, 7 (35.0%) patients in the S Group and 1 (5.6%) patient in the R Group had curve progression >5° (P = 0.026). At skeletal maturity, 5 of the 7 (71.4%) patients who failed with SpineCor bracing showed control from further progression by changing to rigid bracing. At the latest follow-up with a mean duration of 45.1 months after skeletally maturity, 29.4% of patients who were successfully treated by rigid brace showed further curve progression beyond skeletal maturity, versus 38.5% of patients in the SpineCor group (P > 0.05). For both groups, the primary curves were slightly improved at the time of brace weaning, but additionally increased at the latest follow-up, with a rate of 1.5° per year for post-maturity progression. Curve progression rate was found to be significantly higher in the SpineCor group when compared with the rigid brace group. Changing to rigid bracing could control further curve progression for majority of patients who previously failed with SpineCor bracing. For both SpineCor and rigid brace treatments, 30-40% of patients who were originally successfully treated by bracing would exhibit further curve progression beyond skeletal maturity. The post

Psychologic management of brace therapy for patients with idiopathic scoliosis.

PubMed

Matsunaga, Shunji; Hayashi, Kyoji; Naruo, Tetsuro; Nozoe, Shin-ichi; Komiya, Setsuro

2005-03-01

A trial of brace therapy modified by a measured personality pattern of patients with idiopathic scoliosis was performed. To evaluate the effectiveness of performing personality tests for patients with idiopathic scoliosis who undergo brace therapy. Brace therapy has often been used for the treatment of scoliosis. However, emotional distress can result from this therapy. Few attempts have been made to reduce such stress. A test using the Maudsley Personality Inventory was performed on 145 adolescent females with idiopathic scoliosis, treated with brace therapy alone, before the start of brace therapy and 1 month after the start of brace therapy. On the basis of test results, the patients were rated as normal type and four abnormal types. Brace therapy was continued considering the personality pattern of patients. For all patients, changes in psychologic test results, compliance with braces wearing instructions, and correction of scoliosis were analyzed. Of the 134 patients rated as normal before the start of therapy, 108 patients were rated as abnormal pattern when tested 1 month after the start of therapy. After performing autogenic training for patients with E-N+ and E-N- personalities, and giving advice to school teachers to decrease the emotional stress for patients with E+N+ personality, 47 patients were finally rated as abnormal pattern. In total, 12 (8%) of the 145 patients dropped out. In dropouts, the average pretreatment deformity of 29 degrees (range: 21 degrees -37 degrees ) had increased to an average of 37 degrees (range, 31 degrees -48 degrees ). Psychologic tests may be useful and provide a means of modifying brace therapy tailored to the psychologic conditions of individual patients.

A less intensive bracing protocol for pectus carinatum.

PubMed

Wahba, George; Nasr, Ahmed; Bettolli, Marcos

2017-11-01

Despite the widespread use of bracing to correct Pectus carinatum (PC) there is no consensus in the number of hours per day patients are instructed to wear the brace. In our practice, we use a less rigorous protocol of 8-12h/day. We sought to evaluate our results and those in the literature to determine whether more intensive usage is necessary. We reviewed the outcomes of patients with PC treated at our institution between 2012 and 2015. We searched MEDLINE, EMBASE and Web of Science for studies describing the use of bracing to correct PC. Seventy-five patients presented with PC at our institution. Among those who were offered bracing and had adequate follow-up (n=32), the success rate (full correction or improvement) was 90.6%. The compliance rate was 93.8%. Fifteen studies met our inclusion criteria. Our pooled data combining our results with those of other published data showed that less intensive brace usage (<12h/day), when compared to more intensive usage (≥12h/day), is associated with higher patient compliance (89.6% vs. 81.1%) with a similar time to correction (7.3 vs 7.1months) and success rate (85.3% vs. 83.5%). Implementing a less intensive bracing protocol for PC is successful, efficient and improves compliance. Clinical Research. Oxford Centre for Evidence-Based Medicine Level-of-Evidence rating: Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

An Investigation into a Gear-Based Knee Joint Designed for Lower Limb Prosthesis.

PubMed

Bhuiyan, M S H; Choudhury, I A; Dahari, M; Nukman, Y; Dawal, S Z

2017-01-01

A gear-based knee joint is designed to improve the performance of mechanical-type above-knee prostheses. The gear set with the help of some bracing, and bracket arrangement, is used to enable the prosthesis to follow the residual limb movement. The motion analysis and finite-element analysis (FEA) of knee joint components are carried out to assess the feasibility of the design. The maximum stress of 29.74 MPa and maximum strain of 2.393e-004 are obtained in the gear, whereas the maximum displacement of 7.975 mm occurred in the stopper of the knee arrangement. The factor of safety of 3.5 obtained from the FE analysis indicated no possibility of design failure. The results obtained from the FE analysis are then compared with the real data obtained from the literature for a similar subject. The pattern of motion analysis results has shown a great resemblance with the gait cycle of a healthy biological limb.

An Investigation into a Gear-Based Knee Joint Designed for Lower Limb Prosthesis

PubMed Central

2017-01-01

A gear-based knee joint is designed to improve the performance of mechanical-type above-knee prostheses. The gear set with the help of some bracing, and bracket arrangement, is used to enable the prosthesis to follow the residual limb movement. The motion analysis and finite-element analysis (FEA) of knee joint components are carried out to assess the feasibility of the design. The maximum stress of 29.74 MPa and maximum strain of 2.393e−004 are obtained in the gear, whereas the maximum displacement of 7.975 mm occurred in the stopper of the knee arrangement. The factor of safety of 3.5 obtained from the FE analysis indicated no possibility of design failure. The results obtained from the FE analysis are then compared with the real data obtained from the literature for a similar subject. The pattern of motion analysis results has shown a great resemblance with the gait cycle of a healthy biological limb. PMID:28584518

Scoliosis brace design: influence of visual aesthetics on user acceptance and compliance.

PubMed

Law, Derry; Cheung, Mei-Chun; Yip, Joanne; Yick, Kit-Lun; Wong, Christina

2017-06-01

Adolescent idiopathic scoliosis is a common condition found in adolescents. A rigid brace is often prescribed as the treatment for this spinal deformity, which negatively affects user compliance due to the discomfort caused by the brace, and the psychological distress resulting from its appearance. However, the latter, which is the impact of visual aesthetics, has not been thoroughly studied for scoliosis braces. Therefore, a qualitative study with in-depth interviews has been carried out with 10 participants who have a Cobb angle of 20°-30° to determine the impact of visual aesthetics on user acceptance and compliance towards the brace. It is found that co-designing with patients on the aesthetic aspects of the surface design of the brace increases the level of user compliance and induces positive user perception. Therefore, aesthetic preferences need to be taken into consideration in the design process of braces. Practitioner Summary: The impact of visual aesthetics on user acceptance and compliance towards a rigid brace for scoliosis is investigated. The findings indicate that an aesthetically pleasing brace and the involvement of patients in the design process of the brace are important for increasing user compliance and addressing psychological issues during treatment.

Workflow of CAD / CAM Scoliosis Brace Adjustment in Preparation Using 3D Printing.

PubMed

Weiss, Hans-Rudolf; Tournavitis, Nicos; Nan, Xiaofeng; Borysov, Maksym; Paul, Lothar

2017-01-01

High correction bracing is the most effective conservative treatment for patients with scoliosis during growth. Still today braces for the treatment of scoliosis are made by casting patients while computer aided design (CAD) and computer aided manufacturing (CAM) is available with all possibilities to standardize pattern specific brace treatment and improve wearing comfort. CAD / CAM brace production mainly relies on carving a polyurethane foam model which is the basis for vacuuming a polyethylene (PE) or polypropylene (PP) brace. Purpose of this short communication is to describe the workflow currently used and to outline future requirements with respect to 3D printing technology. Description of the steps of virtual brace adjustment as available today are content of this paper as well as an outline of the great potential there is for the future 3D printing technology. For 3D printing of scoliosis braces it is necessary to establish easy to use software plug-ins in order to allow adding 3D printing technology to the current workflow of virtual CAD / CAM brace adjustment. Textures and structures can be added to the brace models at certain well defined locations offering the potential of more wearing comfort without losing in-brace correction. Advances have to be made in the field of CAD / CAM software tools with respect to design and generation of individually structured brace models based on currently well established and standardized scoliosis brace libraries.

Bracing in pediatric patients with pectus carinatum is effective and improves quality of life.

PubMed

Colozza, Sara; Bütter, Andreana

2013-05-01

The purpose of this study was to examine the effectiveness and patient satisfaction with bracing for pectus carinatum (PC). Twenty-five PC patients were treated between August 2007 and October 2011. Most patients were male (21/25,84%) with a mean age of 14.4 ± 2.0 yrs. A lightweight, patient controlled, external brace (Braceworks, Calgary, AB) was used. Monthly follow-up with anterior-posterior (AP) width measurements occurred until bracing was completed. Three quality of life (QOL) questionnaires were used: SF-36, SSQ, and PEEQ. Group 1 involved twenty patients who successfully completed bracing (12/25,56%) or who are still bracing (8/25,32%). Group 2 comprised five patients who failed bracing (2/25,8%) or who were noncompliant (3/25,12%). One patient who failed bracing underwent successful Ravitch repair. AP width decreased more in those with successful bracing (2.31 vs 0.64 cm, p=0.05). Questionnaires were completed by 19/25 (76%) patients. Pre-bracing, the SF-36, and PEEQ revealed that few patients were symptomatic, although most still avoided activities which showed their chest. The SSQ revealed that the majority of patients were very satisfied with their post-bracing appearance, experienced minimal discomfort while bracing, and would use the brace again. Self-esteem increased significantly after bracing (7.5 vs 8.7, p=0.01). Bracing in PC patients is very effective in a compliant patient with close follow-up. Surgical repair remains feasible if bracing fails. Copyright © 2013 Elsevier Inc. All rights reserved.

Ankle Ranges of Motion During Extended Activity Periods While Taped and Braced

PubMed Central

Paris, David L.; Kokkaliaris, Jimmy; Vardaxis, Vassilios

1995-01-01

Tape has traditionally been used to support the ankle during activity. More recently, commercial ankle braces have been worn as an alternative. The cumulative information on the effects of taped versus braced ankle support or interbrace comparisons is inconclusive. With few exceptions, ankle brace studies have collected data soon after support conditions were administered. Plantar-dorsiflexion and inversion-eversion ranges of motion (ROM) of 30 subjects were compared under conditions of unsupported, nonelastic adhesivetaped, and Swede-O and Sub Talar Support-braced ankles. We recorded measurements before activity and after periods of 15, 30, 45, and 60 minutes of selected activity on a motorized treadmill. All support conditions significantly reduced preactivity ROM in all directions compared to unsupported ankles. Results showed that the ankle significantly increased in plantarflexion ROM 15 minutes after the initiation of activity with tape or the SubTalar Support-brace, and after 30 minutes with the Swede-O brace. Tape showed further significant increases in plantarflexion ROM after 15-minute intervals of 30, 45, and 60 minutes of activity. All three support conditions had increased significantly in inversion ROM by 15 minutes of activity. The SubTalar Support brace showed a further significant inversion ROM increase between 15 and 30 minutes postactivity. We conclude that the Swede-O and SubTalar Support braces and tape offer significant preactivity ankle support in all four directions of movement. We also conclude that both braces offer longer postactivity support than tape. In inversion ROM and plantarflexion ROM, actions prevalent in ankle sprains, the Swede-O brace retained support longer than the SubTalar Support brace. ImagesFig 1.Fig 2.Fig 3. PMID:16558340

The Ponseti Method of Treatment for Clubfoot in Brazil: Barriers to Bracing Compliance

PubMed Central

Nogueira, Monica Paschoal; Fox, Mark; Miller, Kathleen; Morcuende, Jose

2013-01-01

Background Clubfoot is the most common extremity birth defect. It causes the feet of affected individuals to point inward and downward, preventing them from walking normally. Neglected clubfoot causes disabilities that result in a lack of social integration, creating a psychological and financial burden for the family and community. Clubfoot has been effectively treated through the Ponseti method, a treatment utilizing serial casts to correct the deformity followed by use of an abduction brace for approximately 2-4 years. sustained use of the brace is necessary to prevent relapse and ensure a successful outcome. Brace compliance in the setting of limited resources in the developing world can be challenging. The purpose of this study was to identify the barriers to bracing compliance in southeastern Brazil. In addition to socioeconomic and cultural barriers, this study also looked at improper prescribing practices by physicians as a potential cause of noncompliance. The study sought to identify the role of physician education in the use of the Ponseti method and physicians’ knowledge of the bracing process. Purpose of the study Identify the barriers to bracing adherence that could negatively impact the treatment of children with clubfoot. Methods Forty-five orthopedists from several centers in southeastern Brazil were interviewed. Physicians were asked about their training in the Ponseti method, their protocol when prescribing the brace, their evaluation of its importance, and a series of open-ended questions designed to identify the positive and negative qualities of local braces. They were also asked what they perceived to be the biggest challenges to sustained brace use. Results sixteen of the physicians interviewed were orthopedic residents, and 29 had completed their residencies. Of these two groups, only 25% and 65%, respectively, appropriately prescribe the abduction brace for patients, with the majority recommending use of the brace for an inadequate

The Ponseti method of treatment for clubfoot in Brazil: barriers to bracing compliance.

PubMed

Nogueira, Monica Paschoal; Fox, Mark; Miller, Kathleen; Morcuende, Jose

2013-01-01

Clubfoot is the most common extremity birth defect. It causes the feet of affected individuals to point inward and downward, preventing them from walking normally. Neglected clubfoot causes disabilities that result in a lack of social integration, creating a psychological and financial burden for the family and community. Clubfoot has been effectively treated through the Ponseti method, a treatment utilizing serial casts to correct the deformity followed by use of an abduction brace for approximately 2-4 years. sustained use of the brace is necessary to prevent relapse and ensure a successful outcome. Brace compliance in the setting of limited resources in the developing world can be challenging. The purpose of this study was to identify the barriers to bracing compliance in southeastern Brazil. In addition to socioeconomic and cultural barriers, this study also looked at improper prescribing practices by physicians as a potential cause of noncompliance. The study sought to identify the role of physician education in the use of the Ponseti method and physicians' knowledge of the bracing process. Identify the barriers to bracing adherence that could negatively impact the treatment of children with clubfoot. Forty-five orthopedists from several centers in southeastern Brazil were interviewed. Physicians were asked about their training in the Ponseti method, their protocol when prescribing the brace, their evaluation of its importance, and a series of open-ended questions designed to identify the positive and negative qualities of local braces. They were also asked what they perceived to be the biggest challenges to sustained brace use. sixteen of the physicians interviewed were orthopedic residents, and 29 had completed their residencies. Of these two groups, only 25% and 65%, respectively, appropriately prescribe the abduction brace for patients, with the majority recommending use of the brace for an inadequate period of time. The high costs and delays in

NASA Technology Benefits Orthotics

NASA Technical Reports Server (NTRS)

Myers, Neill; Shadoan, Michael

1998-01-01

Engineers at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama have designed a knee brace to aid in the rehabilitation of medical patients. The device, called the Selectively Lockable Knee Brace, was designed for knee injury and stroke patients but may potentially serve in many more patient applications. Individuals with sports related injuries, spinal cord injuries and birth defects, such as spina bifida, may also benefit from the device. The Selectively Lockable Knee Brace is designed to provide secure support to the patient when weight is applied to the leg; however; when the leg is not supporting weight, the device allows free motion of the knee joint. Braces currently on the market lock the knee in a rigid, straight or bent position, or by manually pulling a pin, allow continuous free joint motion.

The AAHKS Clinical Research Award: What Are the Costs of Knee Osteoarthritis in the Year Prior to Total Knee Arthroplasty?

PubMed

Bedard, Nicholas A; Dowdle, Spencer B; Anthony, Christopher A; DeMik, David E; McHugh, Michael A; Bozic, Kevin J; Callaghan, John J

2017-09-01

Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status. The Humana database was reviewed from 2007 to 2015 for primary TKA patients. Costs for hyaluronic acid (HA) and corticosteroid injections, physical therapy, braces, wedge insoles, opioids, non-steroidal anti-inflammatories, and tramadol in the year prior to TKA were calculated. Cost was defined as reimbursement paid by the insurance provider. Costs were analyzed relative to the overall non-inpatient costs for knee OA and categorized based on CPG recommendations. In total 86,081 primary TKA patients were analyzed and 65.8% had at least one treatment in the year prior to TKA. Treatments analyzed made up 57.6% of the total non-inpatient cost of knee OA in the year prior to TKA. Only 3 of the 8 treatments studied have a strong recommendation for their use (physical therapy, non-steroidal anti-inflammatories, tramadol) and costs for these interventions represented 12.2% of non-inpatient knee OA cost. In contrast, 29.3% of the costs are due to HA injections alone, which are not supported by CPGs. In the year prior to TKA, over half of the non-inpatient costs associated with knee OA are from injections, therapy, prosthetics, and prescriptions. Approximately 30% of this is due to HA injections alone. If only interventions recommend by the CPG are utilized then costs associated with knee OA could be decreased by 45%. Copyright © 2017 Elsevier Inc. All rights reserved.

Acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis.

PubMed

Gur, Gozde; Turgut, Elif; Ayhan, Cigdem; Baltaci, Gul; Yakut, Yavuz

2017-08-01

Bracing is the most common nonsurgical treatment for adolescent idiopathic scoliosis. Spinal braces affect glenohumeral and scapulothoracic motion because they restrict trunk movements. However, the potential spinal-bracing effects on scapular kinematics are unknown. The present study aimed to investigate the acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis. Scapular kinematics, including scapular internal/external rotation, posterior/anterior tilting, and downward/upward rotation during scapular plane elevation, were evaluated in 27 in-brace and out-of-brace adolescent idiopathic scoliosis patients with a three-dimensional electromagnetic tracking system. Data on the position and orientation of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation were used for statistical comparisons. The paired t-test was used to assess the differences between the mean values of in-brace and out-of-brace conditions. The in-brace condition showed significantly increased (P<0.05) scapular anterior tilting and decreased internal rotation in the resting position on the convex and concave sides; increased scapular downward rotation at 120° humerothoracic elevation on the convex side and at 30°, 60°, 90°, and 120° humerothoracic elevation on the concave side; increased scapular anterior tilt at 30°, 60°, 90°, and 120° humerothoracic elevation on the convex and concave sides; and decreased (P<0.05) maximal humerothoracic elevation of the arm. Spinal bracing affects scapular kinematics. Observed changes in scapular kinematics with brace may also affect upper extremity function for adolescents with idiopathic scoliosis. Therefore, clinicians should include assessments of the glenohumeral and scapulothoracic joints when designing rehabilitation protocols for patients with adolescent idiopathic scoliosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Peroneus longus stretch reflex amplitude increases after ankle brace application

PubMed Central

Cordova, M; Ingersoll, C

2003-01-01

Background: The use of external ankle support is widespread throughout sports medicine. However, the application of ankle bracing to a healthy ankle over a long period has been scrutinised because of possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus. Objective: To investigate the immediate and chronic effects of ankle brace application on the amplitude of peroneus longus stretch reflex. Methods: Twenty physically active college students (mean (SD) age 23.6 (1.7) years, height 168.7 (8.4) cm, and mass 69.9 (12.0) kg) who had been free from lower extremity pathology for the 12 months preceding the study served as subjects. None had been involved in a strength training or conditioning programme in the six months preceding the study. A 3 x 3 x 2 (test condition x treatment condition x time) design with repeated measures on the first and third factor was used. The peroneus longus stretch reflex (% of maximum amplitude) during sudden foot inversion was evaluated under three ankle brace conditions (control, lace up, and semi-rigid) before and after eight weeks of ankle brace use. Results: A 3 x 3 x 2 repeated measures analysis of variance showed that peroneus longus stretch reflex amplitude increased immediately after application of a lace up brace (67.1 (4.4)) compared with the semi-rigid (57.9 (4.3)) and control (59.0 (5.2)) conditions (p<0.05). Peroneus longus stretch reflex also increased after eight weeks of use of the semi-rigid brace compared with the lace up and control conditions (p<0.05). Conclusions: Initial application of a lace up style ankle brace and chronic use of a semi-rigid brace facilitates the amplitude of the peroneus longus stretch reflex. It appears that initial and long term ankle brace use does not diminish the magnitude of this stretch reflex in the healthy ankle. PMID:12782553

Benefit from NASA

NASA Image and Video Library

1996-12-17

A knee brace that uses Space Shuttle propulsion technology has moved a step closer to being available to help knee injury and stroke patients and may possibly benefit patients with birth defects, spinal cord injuries, and post-polio conditions. After years of hard work, inventors at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama, have turned over the final design and prototype to industry partners at Horton's Orthotic Lab in Little Rock, Arkansas for further clinical testing. The device, called the Selectively Lockable Knee Brace, may mean faster, less painful rehabilitation for patients by allowing the knee to move when weight is not on the heel. Devices currently on the market lock the knee in a rigid, straight-leg position, or allow continuous free motion. Pictured here is a knee brace prototype being tested and fitted at Horton's Orthotic Lab. The knee brace is just one example of how space technology is being used to improve the lives of people on Earth. NASA's MSFC inventors Michael Shadoan and Neill Myers are space propulsion engineers who use the same mechanisms and materials to build systems for rockets that they used to design and develop the knee brace.

Efficacy of an ankle brace with a subtalar locking system in inversion control in dynamic movements.

PubMed

Zhang, Songning; Wortley, Michael; Chen, Qingjian; Freedman, Julia

2009-12-01

Controlled laboratory study. To examine effectiveness of an ankle brace with a subtalar locking system in restricting ankle inversion during passive and dynamic movements. Semirigid ankle braces are considered more effective in restricting ankle inversion than other types of brace, but a semirigid brace with a subtalar locking system may be even more effective. Nineteen healthy subjects with no history of major lower extremity injuries were included in the study. Participants performed 5 trials of an ankle inversion drop test and a lateral-cutting movement without wearing a brace and while wearing either the Element (with the subtalar locking system), a Functional ankle brace, or an ASO ankle brace. A 2-way repeated-measures analysis of variance (ANOVA) was used to assess brace differences (P?.05). All 3 braces significantly reduced total passive ankle frontal plane range of motion (ROM), with the Element ankle brace being the most effective. For the inversion drop the results showed significant reductions in peak ankle inversion angle and inversion ROM for all 3 braces compared to the no brace condition; and the peak inversion velocity was also reduced for the Element brace and the Functional brace. In the lateral-cutting movement, a small but significant reduction of the peak inversion angle in early foot contact and the peak eversion velocity at push-off were seen when wearing the Element and the Functional ankle braces compared to the no brace condition. Peak vertical ground reaction force was reduced for the Element brace compared to the ASO brace and the no brace conditions. These results suggest that the tested ankle braces, especially the Element brace, provided effective restriction of ankle inversion during both passive and dynamic movements.

Tridimensional morphology and kinetics of etch pit on the {l_brace}0 0 0 1{r_brace} plane of sapphire crystal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang Lunyong; Sun Jianfei, E-mail: jfsun_hit@263.net; Zuo Hongbo

2012-08-15

The tridimensional morphology and etching kinetics of the etch pit on the C-{l_brace}0 0 0 1{r_brace} plane of sapphire crystal ({alpha}-Al{sub 2}O{sub 3}) in molten KOH were studied experimentally. It was shown that the etch pit takes on tridimensional morphologies with triangular symmetry same as the symmetric property of the sapphire crystal. Pits like centric and eccentric triangular pyramid as well as hexagonal pyramid were observed, but the latter is less in density. In-depth analyses show the side walls of the etch pits belong to the {l_brace}1 1{sup Macron} 0 2{sup Macron }{r_brace} family, and the triangular pit contains edgesmore » full composed by Al{sup 3+} ions on the etching surface so it is more stable than the hexagonal pit since its edges on the etching surface contains Al{sup 2+} ions. The etch pits developed in a manner of kinematic wave by the step moving with constant speed, which is controlled by the chemical reaction with activation energy of 96.6 kJ/mol between Al{sub 2}O{sub 3} and KOH. - Graphical abstract: Schematic showing the atomic configuration of the predicted side walls of regular triangular pyramid shaped etch pit on the C-{l_brace}0 0 0 1{r_brace} plane of sapphire crystal. Highlights: Black-Right-Pointing-Pointer Observed the tridimensional morphology of etch pits. Black-Right-Pointing-Pointer Figured out the atomic configuration origin of the etch pits. Black-Right-Pointing-Pointer Quantitatively determined the etch rates of the etch pits.« less

Bracing is an effective therapy for pectus carinatum: interim results.

PubMed

Lee, Richy T; Moorman, Scott; Schneider, Marc; Sigalet, David L

2013-01-01

Pectus Carinatum is a common congenital chest wall malformation. Until recently the mainstay of treatment was surgical remodeling of the deformed chest wall. Initial results suggest that non-operative bracing may be an effective therapy, but the optimal strategy for correction is not known. Herein we report the results of a self-adjustable low profile bracing system worn continuously until the defect is corrected (correction phase), then worn at night (8 h/day) until completion of axial growth (maintenance phase)-the Calgary Protocol. Patients referred to a pediatric surgery chest wall clinic were prospectively asked to join an IRB approved outcomes monitoring study. 124 patients were evaluated from 2007 to 2011, and 98 were prescribed a brace and counseled to follow the protocol. 98 patients consented to follow-up at starting bracing age: 14.4 ± 1.9 years, Tanner stage: 3.6 ± 0.5, protrusion: 2.1 ± 1.0 cm, self-rating of appearance: 2.9 ± 1.1, and exercise tolerance: 4.4 ± 1.1 (1-5 with 5 = normal). 10 patients are in correction phase, and 44 patients have completed correction after 7.0 ± 7.3 months: Tanner stage: 3.8 ± 0.1, protrusion: 0.5 ± 0.6 cm*, appearance: 4.3 ± 0.3* and exercise tolerance 4.6 ± 1.0. Correction occurred more quickly in patients prior to achieving Tanner stage IV (4.2 ± 0.9 months) vs. Tanner stage IV (8.0 ± 7.1 months) at the beginning of bracing. 21 patients completed maintenance bracing after 17.9 ± 19.0 months: Tanner stage: 3.9 ± 0.2, protrusion 0.5 ± 0.7 cm*, appearance: 4.3 ± 0.9*, and exercise tolerance: 4.8 ± 1.4. Average follow-up after bracing is 13.9 ± 16.0 months (mean ± S.D., *P < .05). There was one recurrence, likely due to early discontinuation of maintenance. This responded to an additional 6 months of bracing. 42 patients failed therapy secondary to non-compliance or were lost in follow up, while 2 patients did not respond to bracing and required open operation. If patients are compliant, a self

Chord Splicing & Joining Detail; Chord & CrossBracing Joint Details; ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Chord Splicing & Joining Detail; Chord & Cross-Bracing Joint Details; Cross Bracing Center Joint Detail; Chord & Diagonal Joint Detail - Vermont Covered Bridge, Highland Park, spanning Kokomo Creek at West end of Deffenbaugh Street (moved to), Kokomo, Howard County, IN

The effect of bracing availability on one-hand isometric force exertion capability.

PubMed

Jones, Monica L H; Reed, Matthew P; Chaffin, Don B

2013-01-01

Environmental obstructions that workers encounter can kinematically limit the postures that they can achieve. However, such obstructions can also provide an opportunity for additional support by bracing with the hand, thigh or other body part. The reaction forces on bracing surfaces, which are in addition to those acting at the feet and task hand, are hypothesised to improve force exertion capability, and become required inputs to biomechanical analysis of tasks with bracing. The effects of kinematic constraints and associated bracing opportunities on isometric hand force were quantified in a laboratory study of 22 men and women. Analyses of one-hand maximal push, pull and lift tasks demonstrated that bracing surfaces available at the thighs and non-task hand enabled participants to exert an average of 43% more force at the task hand. Task hand force direction deviated significantly from the nominal direction for exertions performed with bracing at both medium and low task hand locations. This study quantifies the effect of bracing on kinematically constrained force exertions. Knowledge that appropriate bracing surfaces can substantially increase hand force is critical to the evaluation of task-oriented strength capability. Force estimates may also involve large off-axis components, which have clear implications for ergonomic analyses of manual tasks.

Intramedullary rod and cement static spacer construct in chronically infected total knee arthroplasty.

PubMed

Kotwal, Suhel Y; Farid, Yasser R; Patil, Suresh S; Alden, Kris J; Finn, Henry A

2012-02-01

Two-stage reimplantation, with interval antibiotic-impregnated cement spacer, is the preferred treatment of prosthetic knee joint infections. In medically compromised hosts with prior failed surgeries, the outcomes are poor. Articulating spacers in such patients render the knee unstable; static spacers have risks of dislocation and extensor mechanism injury. We examined 58 infected total knee arthroplasties with extensive bone and soft tissue loss, treated with resection arthroplasty and intramedullary tibiofemoral rod and antibiotic-laden cement spacer. Thirty-seven patients underwent delayed reimplantation. Most patients (83.8%) were free from recurrent infection at mean follow-up of 29.4 months. Reinfection occurred in 16.2%, which required debridement. Twenty-one patients with poor operative risks remained with the spacer for 11.4 months. All patients, during spacer phase, had brace-free ambulation with simulated tibiofemoral fusion, without bone loss or loss of limb length. Copyright © 2012 Elsevier Inc. All rights reserved.

A Single-Center Experience with Dynamic Compression Bracing for Children with Pectus Carinatum.

PubMed

Poola, Ashwini Suresh; Pierce, Amy L; Orrick, Beth A; Peter, Shawn David St; Snyder, Charles L; Juang, David; Aguayo, Pablo; Fraser, Jason D; Holcomb, George W

2018-02-01

 Bracing for pectus carinatum (PC) has emerged as an alternative to surgical correction. However, predictive factors for bracing remain poorly understood, as much of the data have been reported from small series.  We reviewed a prospective dataset in patients with PC who underwent dynamic compression bracing (DCB) from July 2011 to July 2016. Bracing was initiated in patients > 10 years of age with a significant PC and desire for bracing. Data were analyzed for those observed two or more times after the brace was fitted to the patient.  A total of 503 patients were evaluated for PC and 340 (68%) underwent DCB. Eighty-five percent were males with an average age of 14 ± 2 years. There was a positive correlation of age with pressure of initial correction (PIC, r  = 0.2). One patient underwent operative correction as the initial therapy. Two hundred seventeen patients had two or more visits after the patient was fitted for the brace. The mean PIC in this cohort was 4 psi (range: 1.5-7.8), and the median duration of bracing in this group was 16 months (IQR: 7-23 months). One hundred three patients (47%) achieved complete correction after an average bracing time of 7.5 months and were then placed in the retainer mode. Thirty patients successfully completed bracing therapy and required an average of 23 months of therapy (2 months-4 years). No patient recurred after bracing was completed, but one failed bracing and required operative correction. Complications included mechanical problems (8%), skin complications (10%), complaints of tightness (3%), and pain (2%).  DCB has both early and lasting effects in the correction of PC with minimal complications. Predictive factors for successful resolution of the PC include increased duration of DCB and lower initial PIC. Georg Thieme Verlag KG Stuttgart · New York.

Design and characterization of a torque-controllable actuator for knee assistance during sit-to-stand.

PubMed

Shepherd, Max K; Rouse, Elliott J

2016-08-01

Individuals with post-stroke hemiparesis often have difficulty standing out of a chair. One way to potentially improve sit-to-stand is to provide knee extension assistance using a powered knee exoskeleton. An exoskeleton providing unilateral, partial assistance during sit-to-stand would need to be torque-controllable. There are no knee exoskeletons on the market suitable for conducting experiments assisting stroke patients with sit-to-stand, so to enable such experiments a research device was developed. The purpose of this report is to present the design of a novel knee exoskeleton actuator that uses a fiberglass leaf spring in series to improve torque-controllability, and present a characterization of the actuator performance. The actuator is capable of the required torque and speed for sit-to-stand, has high bandwidth (25 Hz), low output impedance at low frequencies (<;0.5 Nm), and excellent torque tracking. An orthotic brace built upon this actuator will enable an in-depth study on the biomechanical effects of providing stroke subjects with knee extension assistance during sit-to-stand.

Development of a Wearable Assist Robot for Walk Rehabilitation After Knee Arthroplasty Surgery

NASA Astrophysics Data System (ADS)

Terada, H.; Zhu, Y.; Horiguchi, K.; Nakamura, M.; Takahashi, R.

In Japan, it is popular that the disease knee joints will be replaced to artificial joints by surgery. And we have to assist so many patients for walk rehabilitation. So, the wearable assist robot has been developed. This robot includes the knee motion assist mechanism and the hip joint support mechanism. Especially, the knee motion assist mechanism consists of a non-circular gear and grooved cams. This mechanism rotates and slides simultaneously, which has two degree-of-freedom. Also, the hip joint support mechanism consists of a hip brace and a ball-joint. This mechanism can avoid motion constraints which are the internal or external rotation and the adduction or abduction. Then, the control algorithm, which considers an assisting timing for the walk rehabilitation, has been proposed. A sensing system of a walk state for this control system uses a heel contacts sensor and knee and hip joint rotation angle sensors. Also, the prototype robot has been tested. And it is confirmed that the assisting system is useful.

Effects of Ankle Braces Upon Agility Course Performance in High School Athletes

PubMed Central

Beriau, Mark R.; Cox, William B.; Manning, James

1994-01-01

The purpose of this study was to compare the effects of wearing the AircastTM Sports Stirrup, AircastTM Training brace, Swede-OTM brace, and DonJoyTM Ankle Ligament Protector while running an agility course. Eighty-five high school athletes with no history of ankle injury and no experience in wearing any ankle support served as subjects. Each subject participated in four separate testing sessions. During sessions 1 and 4, subjects ran the agility course under the control (unbraced) conditions. Sessions 2 and 3 consisted of randomly wearing the ankle braces while running the agility course. A questionnaire concerning support, comfort, and restriction was completed by each subject after wearing each of the braces. An analysis of variance (ANOVA) with repeated measures revealed that a significant difference existed between the agility times. Tukey's post hoc test indicated that a significant difference existed between each ankle brace and the control 2 agility times as well as a control 1 and control 2 time difference. The control time difference was attributed to a learning effect. An ANOVA with repeated measures of only the four braces revealed that a significant difference existed between the agility times. Tukey's post hoc test showed the only difference was between the DonJoy Ankle Ligament Protector and the Aircast Training brace. We concluded: 1) there is limited practical performance effect upon agility while wearing an ankle brace; and 2) an athlete's perceived comfort, support, and performance restriction are contributing factors that may directly influence the effectiveness of ankle bracing. PMID:16558284

The Basics of Braces

MedlinePlus

... that attaches to the back teeth, providing stronger force to move the teeth. The orthodontist also might recommend that your child have one or more teeth removed to create more space in his or her mouth. Once the braces ...

A quantitative method for measuring forces applied by nail braces.

PubMed

Erdogan, Fatma G

2011-01-01

Nail bracing is a conservative method used for ingrown nails; however, lack of objective measurements limits its use for various nails. Double-string nail braces with extra metal springs were applied to 12 patients with 21 chronic, thick, and overcurved ingrown nails. Force was measured with a force gauge meter. Treatment was stopped once patients stood on their tiptoes and walked in shoes pain free without braces. A force gauge meter was also used on a model nail to show the forces applied by various nail braces and to compare their pulling forces. After 6 to 10 months of treatment, all of the patients were pain free; 600 to 1,000 centi Newtons of force were applied to the nails. As the width of the nail increased, so did the force. Braces exert more force on larger nails, which may shorten treatment durations. By measuring forces, it may be possible to standardize force and duration of treatment according to variables such as nail thickness, nail width, angle of ingrown nail, and duration of symptoms.

A Survey of Parachute Ankle Brace Breakages

DTIC Science & Technology

2008-01-10

experience an ankle fracture , and 1.75 times more likely to experience an ankle injury of any type. Injuries to other parts of the lower body...A SURVEY OF PARACHUTE ANKLE BRACE BREAKAGES USACHPPM REPORT NO. 12-MA01Q2A-08 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704...CONTRACT NUMBER 5b. GRANT NUMBER 4. TITLE AND SUBTITLE A Survey of Parachute Ankle Brace Breakages 5c. PROGRAM ELEMENT NUMBER 5d. PROJECT NUMBER

Cervical bracing practices after degenerative cervical surgery: a survey of cervical spine research society members.

PubMed

Lunardini, David J; Krag, Martin H; Mauser, Nathan S; Lee, Joon Y; Donaldson, William H; Kang, James D

2018-05-21

Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures. The overall bracing rate was 67%. This included 8.4% who used a hard collar in each scenario. Twenty-two percent of surgeons never used a hard collar, while 34% never used a soft collar, and 3.6% (3 respondents) did not use a brace in any surgical scenario. Bracing frequency for specific surgical scenarios varied from 39% after foraminotomy to 88% after multi-level corpectomy with anterior & posterior fixation. After one, two and three level anterior cervical discectomy & fusion (ACDF), bracing rates were 58%, 65% and 76% for an average of 3.3, 4.3 and 5.3 weeks, respectively. After single level corpectomy, 77% braced for an average of 6.2 weeks. After laminectomy and fusion, 72% braced for an average of 5.4 weeks. Significant variation persists among surgeons on the type and length of post-operative brace usage after cervical spine surgeries. Overall rates of bracing have not changed significantly with time. Given the lack evidence in the literature to support bracing, reconsidering use of a brace after certain surgeries may be warranted. Copyright © 2018. Published by Elsevier Inc.

Chord Panel Post, Vertical X Bracing & Horizontal Tie Joint ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Chord Panel Post, Vertical X Bracing & Horizontal Tie Joint Detail; Chord Joining Block & Spacer Block Detail; Cross Bracing Joint Detail; Chord Panel Post Diagonal & Horizontal Tie Joint Detail - Jackson Covered Bridge, Spanning Sugar Creek, CR 775N (Changed from Spanning Sugar Creek), Bloomingdale, Parke County, IN

Biomechanical Comparison of 3 Ankle Braces With and Without Free Rotation in the Sagittal Plane

PubMed Central

Alfuth, Martin; Klein, Dieter; Koch, Raphael; Rosenbaum, Dieter

2014-01-01

Context: Various designs of braces including hinged and nonhinged models are used to provide external support of the ankle. Hinged ankle braces supposedly allow almost free dorsiflexion and plantar flexion of the foot in the sagittal plane. It is unclear, however, whether this additional degree of freedom affects the stabilizing effect of the brace in the other planes of motion. Objective: To investigate the dynamic and passive stabilizing effects of 3 ankle braces, 2 hinged models that provide free plantar flexion–dorsiflexion in the sagittal plane and 1 ankle brace without a hinge. Design: Crossover study. Setting: University Movement Analysis Laboratory. Patients or Other Participants: Seventeen healthy volunteers (5 women, 12 men; age = 25.4 ± 4.8 years; height = 180.3 ± 6.5 cm; body mass = 75.5 ± 10.4 kg). Intervention(s): We dynamically induced foot inversion on a tilting platform and passively induced foot movements in 6 directions via a custom-built apparatus in 3 brace conditions and a control condition (no brace). Main Outcome Measure(s): Maximum inversion was determined dynamically using an in-shoe electrogoniometer. Passively induced maximal joint angles were measured using a torque and angle sensor. We analyzed differences among the 4 ankle-brace conditions (3 braces, 1 control) for each of the dependent variables with Friedman and post hoc tests (P < .05). Results: Each ankle brace restricted dynamic foot-inversion movements on the tilting platform as compared with the control condition, whereas only the 2 hinged ankle braces differed from each other, with greater movement restriction caused by the Ankle X model. Passive foot inversion was reduced with all ankle braces. Passive plantar flexion was greater in the hinged models as compared with the nonhinged brace. Conclusions: All ankle braces showed stabilizing effects against dynamic and passive foot inversion. Differences between the hinged braces and the nonhinged brace did not appear to be

Review of Research and Application of Reinforced Concrete Structures Strengthened by Braces

NASA Astrophysics Data System (ADS)

Gong, Jing; Zhu, Zezhong; Zeng, Cong

2017-06-01

Many of RC frame structures are urgently needed to be strengthened and maintained due to the increase of service life, the change of use function, and the impact of natural disasters. This paper reviews the research status of strengthening RC structures with braces; introduces the features and connection forms of joints connecting with braces; summarizes the engineering application of buckling-restrained braces, pointing out that buckling-restrained brace is an effective means to strengthen the RC frame structures with more reliable performance and broad application prospect.

The Dynamic Compression Brace for Pectus Carinatum: Intermediate Results in 286 Patients.

PubMed

de Beer, Sjoerd A; Gritter, Martin; de Jong, Justin R; van Heurn, Ernst L W

2017-06-01

Dynamic brace compression is a novel treatment for patients with pectus carinatum. The dynamic compression system contains a device to measure the flexibility of the thoracic wall and regulate the pressure of the brace. Patients referred to our pediatric surgical center were screened for treatment with the dynamic compression brace. Patients with a pressure of initial correction (PIC) of 10.0 pounds per square inch or less were offered treatment with the brace. Patients with a PIC above 10.0 pounds per square inch were offered surgical correction. Between March 2013 and April 2016, 286 patients were treated with the brace; 260 were male (91%) and 26 were female (9%). Their mean age was 14 years (range, 4 to 21 years). Seventy-eight patients completed brace treatment; the mean treatment time was 14 months. Twenty-seven patients abandoned treatment because of lack of motivation, loss to follow-up, persistent protrusion of the sternal bone or flaring that required surgical correction, failure of treatment because of a bifid rib, fear of locking the brace, and delayed correction. One hundred eighty-one patients are still wearing the brace, either in the active or in the retainer phase. Patients with a high PIC also showed improvement when they were compliant. Adverse events were minor and included skin lesions (n = 4, 1%) and vasovagal reactions at the start of therapy (n = 3, 1%). These data show that brace therapy can be considered a valuable treatment option to correct pectus carinatum in patients with a flexible thorax. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Successful brace treatment of Scheuermann's kyphosis with different angles

PubMed Central

Etemadifar, Mohammad Reza; Jamalaldini, Mohammad Hossein; Layeghi, Rasoul

2017-01-01

Background: Scheuermann's disease is regarded as the most common cause of structural hyperkyphosis within adolescents without any proper treatment. It may lead to progressive deformity and back pain which influences patient's quality of life during adolescence and adulthood. Treatment approach to Scheuermann's kyphosis has not been clearly defined due to its different definitions and obscure natural history. The goal of treatment is not only to prevent progression but also to obtain permanent correction. Bracing, especially Milwaukee brace and physiotherapy are two of the common nonoperative treatment modalities. Hence, the present study intended to evaluate the effectiveness of Milwaukee brace on progression control as well as correction of Scheuermann's kyphosis. Materials and Methods: In a retrospective, observational study, all the patients diagnosed with Scheuermann's kyphosis were reviewed in 2003–2013, who were treated by Milwaukee brace at a single center. There was a minimum of 2-year follow-up after completion of bracing, during which clinical and radiological parameters were identified and recorded. Results: The mean angle of kyphosis in these patients at the presentation was 63.24 ± 9.96 and at the end of this study was 36.5° ± 13.4° (P < 0.001). Moreover, mean improved angle in those patients with <75° of kyphosis was 25.26° ± 7.78° and in those with 75° or more than 75° of kyphosis was 26.77° ± 19.76° (P < 0.001). Conclusion: Conservative treatment with Milwaukee brace and physiotherapy was effective in our hand for halting kyphosis progression in 97.5% of Scheuermann's kyphosis, which could be advised for cases up to 90° of kyphosis before skeletal maturity. As a result, a trial of brace treatment could be recommended in patients with severe kyphosis (up to 90°) which can open a new insight in conservative treatment of Scheuermann's kyphosis. PMID:28694598

Behaviour of Strengthened RC Frames with Eccentric Steel Braced Frames

NASA Astrophysics Data System (ADS)

Kamanli, Mehmet; Unal, Alptug

2017-10-01

After devastating earthquakes in recent years, strengthening of reinforced concrete buildings became an important research topic. Reinforced concrete buildings can be strengthened by steel braced frames. These steel braced frames may be made of concentrically or eccentrically indicated in Turkish Earthquake Code 2007. In this study pushover analysis of the 1/3 scaled 1 reinforced concrete frame and 1/3 scaled 4 strengthened reinforced concrete frames with internal eccentric steel braced frames were conducted by SAP2000 program. According to the results of the analyses conducted, load-displacement curves of the specimens were compared and evaluated. Adding eccentric steel braces to the bare frame decreased the story drift, and significantly increased strength, stiffness and energy dissipation capacity. In this strengthening method lateral load carrying capacity, stiffness and dissipated energy of the structure can be increased.

Spinal Bracing

NASA Technical Reports Server (NTRS)

1991-01-01

Dr. Arthur Copes of the Copes Foundation, Baton Rouge, LA, says that 35 percent of the 50 technical reports he received from the NASA/Southern University Industrial Applications Center in Baton Rouge and the Central Industrial Applications Center, Durant, OK, were vital to the development of his Copes Scoliosis Braces, which are custom designed and feature a novel pneumatic bladder that exerts constant corrective pressure to the torso to slowly reduce or eliminate the spinal curve.

Factors affecting patient compliance with compressive brace therapy for pectus carinatum.

PubMed

Kang, Du-Young; Jung, Junho; Chung, Sangho; Cho, Jinkyung; Lee, Sungsoo

2014-12-01

The aim of this study was to identify factors affecting patient compliance with brace therapy for pectus carinatum. Eighty-six pectus carinatum patients who started brace therapy from August 2008 to November 2011 were included in this study. Patients were divided into two groups: patients who wore the brace for ≥6 months (compliance group) or patients who wore the brace for <6 months (non-compliance group). Factors affecting patient compliance were assessed at the last day of follow-up with a multiple-choice questionnaire. The questionnaire comprised seven items: pain at compression site, skin problems on compression area, confidence in brace treatment, shame, discomfort, initial result of bracing treatment and total number of factors affecting patient compliance. Eighty-six patients completed the survey, including seven (8.1%) female patients and 79 (91.9%) male patients, with a mean age of 12.0 years at the time of treatment (range, 3-20 years). The initial result of the compression period (P <0.001) and total number of factors affecting patient compliance (P <0.05) were significant predictors of patient compliance. An initial successful result of the compression period may increase patient compliance during treatment for pectus carinatum. Additional efforts to decrease pain, skin problems, shame and discomfort, and to give confidence may be beneficial in increasing compliance with bracing treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

A piezoelectric brace for passive suppression of structural vibration and energy harvesting

NASA Astrophysics Data System (ADS)

Yang, Chuang-Sheng Walter; Lai, Yong-An; Kim, Jin-Yeon

2017-08-01

Power outage after an earthquake would cause an additional chaos to the existing aftermath, greatly aggravating the situation if the outage lasts for an extended period. This research aims at developing an innovative piezoelectric brace, which provides both passive energy-dissipating and energy-harvesting capabilities—a passive suppression of structural vibrations and conversion of vibration energy into reusable electricity. The piezoelectric brace has compression modules that exert compressive loads on the piezoelectric material regardless if the brace is in compression or in tension. The compression module consists of a piezoelectric stack and rubber pads. The rubber pads are used to limit the maximum strain in the piezoelectric material below the allowable operational strain. The electro-mechanical equations of motion are derived for a 1-story and a 3-story frame model with the piezoelectric braces. To evaluate the structural behavior and the energy harvesting performance, numerical simulations are executed for the two model buildings (in downtown Los Angeles) that are equipped with the piezoelectric braces. The effects of design parameters including the geometry of the piezoelectric stack and rubber pads and the electric resistance in the electro-mechanical conversion circuit on the performance are investigated. The numerical results indicate that the piezoelectric braces passively dissipate energy through inclined oval-shaped hysteretic loops. The harvested energy is up to approximately 40% of the input energy. The structural displacements are significantly reduced, as compared to the original frames without the piezoelectric braces. Finally, a design procedure for a frame with the proposed passive piezoelectric braces is also presented.

Evaluation of Shoulder-Stabilizing Braces: Can We Prevent Shoulder Labrum Injury in Collegiate Offensive Linemen?

PubMed

Baker, Hayden P; Tjong, Vehniah K; Dunne, Kevin F; Lindley, Tory R; Terry, Michael A

2016-12-01

Shoulder injuries remain one of the most common injuries among collegiate football athletes. Offensive linemen in particular are prone to posterior labral pathology. To evaluate the efficacy of shoulder bracing in collegiate offensive linemen with respect to injury prevention, severity, and lost playing time. Cohort study; Level of evidence, 3. Offensive linemen at a single collegiate institution wore bilateral shoulder-stabilizing braces for every contact practice and game beginning in the spring of 2013. Between spring of 2007 and fall of 2012, offensive linemen did not wear any shoulder braces. Player injury data were collected for all contact practices and games throughout these time periods to highlight differences with brace use. Forty-five offensive linemen (90 shoulders) participated in spring and fall college football seasons between 2007 and 2015. There were 145 complete offensive linemen seasons over the course of the study. Offensive linemen not wearing shoulder braces completed 87 seasons; offensive linemen wearing shoulder braces completed 58 seasons. Posterior labral tear injury rates were calculated for players who wore the shoulder braces (0.71 per 1000 athlete-exposures) compared with shoulders of players who did not wear the braces (1.90 per 1000 athlete-exposures). The risk ratio was 0.46 (95% CI, 0.16-1.30; P = .14). Mean time (contact practices and games) missed due to injury was significant, favoring less time missed by players who used braces (8.7 vs 36.60 contact practices and games missed due to injury; P = .0019). No significant difference in shoulder labral tears requiring surgery was found for brace use compared with no brace use. Shoulder-stabilizing braces were shown not to prevent posterior labral tears among collegiate offensive lineman, although they were associated with less time lost to injury. The results of this study have clinical significance, indicating that wearing a shoulder brace provides a protective factor for offensive

Experimental and analytical studies on the seismic behavior of conventional and hybrid braced frames

NASA Astrophysics Data System (ADS)

Lai, Jiun-Wei

This dissertation summarizes both experimental and analytical studies on the seismic response of conventional steel concentrically braced frame systems of the type widely used in North America, and preliminary studies of an innovative hybrid braced frame system: the Strong-Back System. The research work is part of NEES small group project entitled "International Hybrid Simulation of Tomorrow's Braced Frames." In the experimental phase, a total of four full-scale, one-bay, two-story conventional braced frame specimens with different bracing member section shapes and gusset plate-to-beam connection details were designed and tested at the NEES Berkeley Laboratory. Three braced frame specimens were tested quasi-statically using the same predefined loading protocol to investigate the inelastic cyclic behavior of code-compliant braced frames at both the global and local level. The last braced frame specimen was nearly identical to one of those tested quasi-statically. However, it was tested using hybrid simulation techniques to examine the sensitivity of inelastic behavior on loading sequence and to relate the behavior observed to different levels of seismic hazard. Computer models of the test specimens were developed using two different computer software programs. In the software framework OpenSees fiber-based line elements were used to simulate global buckling of members and yielding and low-cycle fatigue failure at sections. The LS-DYNA analysis program was also used to model individual struts and the test specimens using shell elements with adaptive meshing and element erosion features. This program provided enhanced ability to simulate section local buckling, strain concentrations and crack development. The numerical results were compared with test results to assess and refine and the ability of the models to predict braced frame behavior. A series of OpenSees numerical cyclic component simulations were then conducted using the validated modeling approach. Two

Professional opinion concerning the effectiveness of bracing relative to observation in adolescent idiopathic scoliosis.

PubMed

Dolan, Lori A; Donnelly, Melanie J; Spratt, Kevin F; Weinstein, Stuart L

2007-01-01

To determine if community equipoise exists concerning the effectiveness of bracing in adolescent idiopathic scoliosis. Bracing is the standard of care for adolescent idiopathic scoliosis despite the lack of strong reasearch evidence concerning its effectiveness. Thus, some researchers support the idea of a randomized trial, whereas others think that randomization in the face of a standard of care would be unethical. A random of Scoliosis Research Society and Pediatric Orthopaedic Society of North America members were asked to consider 12 clinical profiles and to give their opinion concerning the radiographic outcomes after observation and bracing. An expert panel was created from the respondents. They expressed a wide array of opinions concerning the percentage of patients within each scenario who would benefit from bracing. Agreement was noted concerning the risk due to bracing for post-menarchal patients only. : This study found a high degree of variability in opinion among clinicians concerning the effectiveness of bracing, suggesting that a randomized trial of bracing would be ethical.

Comparison of complete distal release of the medial collateral ligament and medial epicondylar osteotomy during ligament balancing in varus knee total knee arthroplasty.

PubMed

Sim, Jae Ang; Lee, Yong Seuk; Kwak, Ji Hoon; Yang, Sang Hoon; Kim, Kwang Hui; Lee, Beom Koo

2013-12-01

During ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed. This study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively. There were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely. Medial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.

Bracing in Ponseti Clubfoot Treatment: Improving Parental Adherence Through an Innovative Health Education Intervention.

PubMed

Seegmiller, Laura; Burmeister, Rebecca; Paulsen-Miller, Maria; Morcuende, Jose

2016-01-01

Clubfoot is the most common musculoskeletal birth defect, characterized by abnormal tendon and muscle development, leading to abnormal bone alignment of the feet. The Ponseti method is considered the gold standard in clubfoot treatment, and consists of a series of plaster castings, followed by 4 years of brace use. The most common cause of clubfoot relapse is nonadherence with the bracing protocol by the child's caretakers. The purpose of this study was to design, implement, and evaluate an educational bracing program for parents of children with clubfoot in an effort to improve bracing adherence. The educational bracing program for parents of children with clubfoot was designed with incorporation of findings from previous research, adult teaching methodology, and parental feedback. An educational brochure and a practice doll were created for use in educational sessions with parents during routine treatment visits. Two educational sessions were conducted with a health educator, employing identical questionnaires to assess changes in parental knowledge and skills upon completion of the program. Thirty parents completed the educational bracing program, and the majority reported increased knowledge and self-efficacy regarding the bracing protocol of the Ponseti method. In addition, the health practitioners who conducted the educational sessions witnessed an improved ability of all parents to apply the brace as directed, and to recognize and correct improper fit. Completion of the educational program by the parents resulted in immediate improvements in knowledge and skills related to clubfoot bracing. Given that noncompliance to the bracing protocol is the most common cause of clubfoot relapse, these immediate effects of the educational program are promising not only because they encourage proper brace use, but because these immediate improvements have the potential to reduce future rates of clubfoot relapse.

Benefit from NASA

NASA Image and Video Library

2000-07-11

A knee brace that uses Space Shuttle propulsion technology has moved a step closer to being available to help knee injury and stroke patients and may possibly benefit patients with birth defects, spinal cord injuries, and post-polio conditions. After years of hard work, inventors at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama, have turned over the final design and prototype to industry partners at Horton's Orthotic Lab in Little Rock, Arkansas for further clinical testing. The device, called the Selectively Lockable Knee Brace, may mean faster, less painful rehabilitation for patients by allowing the knee to move when weight is not on the heel. Devices currently on the market lock the knee in a rigid, straight-leg position, or allow continuous free motion. The knee brace is just one example of how space technology is being used to improve the lives of people on Earth. NASA's MSFC inventors Michael Shadoan and Neill Myers are space propulsion engineers who use the same mechanisms and materials to build systems for rockets that they used to design and develop the knee brace.

3D correction of AIS in braces designed using CAD/CAM and FEM: a randomized controlled trial.

PubMed

Cobetto, Nikita; Aubin, Carl-Éric; Parent, Stefan; Barchi, Soraya; Turgeon, Isabelle; Labelle, Hubert

2017-01-01

Recent studies showed that finite element model (FEM) combined to CAD/CAM improves the design of braces for the conservative treatment of adolescent idiopathic scoliosis (AIS), using 2D measurements from in-brace radiographs. We aim to assess the immediate effectiveness on curve correction in all three planes of braces designed using CAD/CAM and numerical simulation compared to braces designed with CAD/CAM only. SRS standardized criteria for bracing were followed to recruit 48 AIS patients who were randomized into two groups. For both groups, 3D reconstructions of the spine and patient's torso, respectively built from bi-planar radiographs and surface topography, were obtained and braces were designed using the CAD/CAM approach. For the test group, 3D reconstructions of the spine and patient's torso were additionally used to generate a personalized FEM to simulate and iteratively improve the brace design with the objective of curve correction maximization in three planes and brace material minimization. For the control group (CtrlBraces), average Cobb angle prior to bracing was 29° (thoracic, T) and 25° (lumbar, L) with the planes of maximal curvature (PMC) respectively oriented at 63° and 57° on average with respect to the sagittal plane. Average apical axial rotation prior to bracing was 7° (T) and 9° (L). For the test group (FEMBraces), initial Cobb angles were 33° (T) and 28° (L) with the PMC at 68° (T) and 56° (L) and average apical axial rotation prior to bracing at 9° (T and L). On average, FEMBraces were 50% thinner and had 20% less covering surface than CtrlBraces while reducing T and L curves by 47 and 48%, respectively, compared to 25 and 26% for CtrlBraces. FEMBraces corrected apical axial rotation by 46% compared to 30% for CtrlBraces. The combination of numerical simulation and CAD/CAM approach allowed designing more efficient braces in all three planes, with the advantages of being lighter than standard CAD/CAM braces. Bracing in AIS may

48 CFR 52.247-58 - Loading, Blocking, and Bracing of Freight Car Shipments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Bracing of Freight Car Shipments. 52.247-58 Section 52.247-58 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.247-58 Loading, Blocking, and Bracing of Freight Car Shipments. As... be shipped in carload lots by rail: Loading, Blocking, and Bracing of Freight Car Shipments (APR 1984...

48 CFR 52.247-58 - Loading, Blocking, and Bracing of Freight Car Shipments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Bracing of Freight Car Shipments. 52.247-58 Section 52.247-58 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.247-58 Loading, Blocking, and Bracing of Freight Car Shipments. As... be shipped in carload lots by rail: Loading, Blocking, and Bracing of Freight Car Shipments (APR 1984...

48 CFR 52.247-58 - Loading, Blocking, and Bracing of Freight Car Shipments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Bracing of Freight Car Shipments. 52.247-58 Section 52.247-58 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.247-58 Loading, Blocking, and Bracing of Freight Car Shipments. As... be shipped in carload lots by rail: Loading, Blocking, and Bracing of Freight Car Shipments (APR 1984...

48 CFR 52.247-58 - Loading, Blocking, and Bracing of Freight Car Shipments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Bracing of Freight Car Shipments. 52.247-58 Section 52.247-58 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.247-58 Loading, Blocking, and Bracing of Freight Car Shipments. As... be shipped in carload lots by rail: Loading, Blocking, and Bracing of Freight Car Shipments (APR 1984...

48 CFR 52.247-58 - Loading, Blocking, and Bracing of Freight Car Shipments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be shipped in carload lots by rail: Loading, Blocking, and Bracing of Freight Car Shipments (APR 1984... Bracing of Freight Car Shipments. 52.247-58 Section 52.247-58 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.247-58 Loading, Blocking, and Bracing of Freight Car Shipments. As...

The effect of ankle brace type on braking response time-A randomised study.

PubMed

Dammerer, Dietmar; Waidmann, Cornelia; Haid, Christian; Thaler, Martin; Krismer, Martin; Liebensteiner, Michael C

2015-11-01

The question whether or not a patient with an ankle brace should drive a car is of obvious importance because brake response time (BRT) is considered one of the most important factors for driving safety. Applying a crossover study design, 70 healthy participants (35 women, 35 men) participated in our study. BRT was assessed using a custom-made driving simulator. We assessed BRT under six conditions: without a brace (control) (1), with a typical postoperative ankle brace with adjustable ROM and the settings: unrestricted (2), fixed at 15° (3) plantar flexion, restricted with 15°/50° (4) (dorsal/plantar flexion), a brace for ligament instabilities (5) and an elastic ankle bandage (6). Participants were instructed to apply the brake pedal exclusively with the right foot as quickly as possible on receipt of a visual stimulus. The 70 participants showed significantly impaired BRT with the ankle brace for ROM restriction in the settings: unrestricted (p<0.001), fixed at 15° plantar flexion (p<0.001) and 15°/50° dorsal/plantar flexion (p<0.001) as compared to the control group. BRT was not impaired with the brace for ankle instabilities or the elastic ankle bandage. In conclusion, right-sided ROM restricting ankle braces involve significant impairment of BRT in healthy participants. No such prolonged BRT was found for an elastic ankle bandage or the ligament brace. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multidisciplinary Design Investigation of Truss-Braced Wing Aircraft. Phase 4

NASA Technical Reports Server (NTRS)

Grossman, B.; Kapania, R. K.; Mason, W. H.; Schetz, J. A.

2000-01-01

The subject grant was in effect from 7/l/99 to 10/31/99. The objective of this grant was to complete a strut-braced wing study which began, which was in effect from 6/27/96 until 9/15/99. While the initial grant was on-going, we were also under subcontract to Lockheed-Martin, Aerospace Systems Division, Marietta, GA to do additional studies related to the strut-braced wing grant "A Structural and Aerodynamic Investigation of a Strut-Braced Wing Transonic Aircraft Concept", 4/l/98-11/15/98. Lockheed-Martin was under contract to NASA Langley. Finally the research under this grant has led to a joint proposal from NASA Langley, Locheed-Martin, Virginia Tech and NASA Dryden to develop a transonic strut-braced wing demonstration aircraft in response to Flight Research for Revolutionary Aeronautical Concepts (REVCON). This final report summarizes the research done, augmented by the additional concommitant research projects mentioned above.

Professional Opinion Concerning the Effectiveness of Bracing Relative to Observation in Adolescent Idiopathic Scoliosis

PubMed Central

Dolan, Lori A.; Donnelly, Melanie J.; Spratt, Kevin F.; Weinstein, Stuart L.

2015-01-01

Objective To determine if community equipoise exists concerning the effectiveness of bracing in adolescent idiopathic scoliosis. Background Data Bracing is the standard of care for adolescent idiopathic scoliosis despite the lack of strong reasearch evidence concerning its effectiveness. Thus, some researchers support the idea of a randomized trial, whereas others think that randomization in the face of a standard of care would be unethical. Methods A random of Scoliosis Research Society and Pediatric Orthopaedic Society of North America members were asked to consider 12 clinical profiles and to give their opinion concerning the radiographic outcomes after observation and bracing. Results An expert panel was created from the respondents. They expressed a wide array of opinions concerning the percentage of patients within each scenario who would benefit from bracing. Agreement was noted concerning the risk due to bracing for post-menarchal patients only. Conclusions This study found a high degree of variability in opinion among clinicians concerning the effectiveness of bracing, suggesting that a randomized trial of bracing would be ethical. PMID:17414008

Technology and task parameters relating to the effectiveness of the bracing strategy

NASA Technical Reports Server (NTRS)

Book, Wayne J.; Wang, J. J.

1989-01-01

The bracing strategy has been proposed in various forms as a way to improve robot performance. One version of the strategy employs independent stages of motion. The first stage, referred to as the large or bracing arm, carries the second stage of motion. After the first stage has completed its motion it is braced to provide a more rigid base of motion with a more accurate relationship to the parts to be manipulated. The hypothesis is that more rapid completion of certain tasks is possible with lighter arms using the bracing strategy. While it is easy to make conceptual arguments why this should be so, it is less easy to specify even approximately when this will be true for some reasonably generic situation. There is no relevant experience base with bracing arms to be compared to non-bracing arms. Furthermore, if one were interested in obtaining such practical experience, there would be no methodical guidance on the selection of an interesting case, one in which the unproven approach, bracing, can show its superiority. If one such case exists, only the extent of applicability of the new approach is in question. One set of interesting cases is likely to be applications in which a large workspace must be covered, but where a series of small accurate moves will remain within a smaller region of the total workspace. A prototype application with these characteristics is set up and a skeleton design of arms using the competing strategies are compared.

An innovative seismic bracing system based on a superelastic shape memory alloy ring

NASA Astrophysics Data System (ADS)

Gao, Nan; Jeon, Jong-Su; Hodgson, Darel E.; DesRoches, Reginald

2016-05-01

Shape memory alloys (SMAs) have great potential in seismic applications because of their remarkable superelasticity. Seismic bracing systems based on SMAs can mitigate the damage caused by earthquakes. The current study investigates a bracing system based on an SMA ring which is capable of both re-centering and energy dissipation. This lateral force resisting system is a cross-braced system consisting of an SMA ring and four tension-only cable assemblies, which can be applied to both new construction and seismic retrofit. The performance of this bracing system is examined through a quasi-static cyclic loading test and finite element (FE) analysis. This paper describes the experimental design in detail, discusses the experimental results, compares the performance with other bracing systems based on SMAs, and presents an Abaqus FE model calibrated on the basis of experimental results to simulate the superelastic behavior of the SMA ring. The experimental results indicate that the seismic performance of this system is promising in terms of damping and re-centering. The FE model can be used in the simulation of building structures using the proposed bracing system.

Evaluation of the treatment of pectus carinatum with compressive orthotic bracing using three dimensional body scans.

PubMed

Wong, Kaitlyn E; Gorton, George E; Tashjian, David B; Tirabassi, Michael V; Moriarty, Kevin P

2014-06-01

The purpose of this study is to measure the effectiveness of compressive orthotic brace therapy for the treatment of pectus carinatum using an adjusted Haller Index (HI) measurement calculated from 3D body scan (BS) images. Pediatric patients with pectus carinatum were treated with either compressive orthotic bracing or observation. An adjusted BS Haller index (HI) was calculated from serial 3D BS images obtained on all patients. Medical records were evaluated to determine treatment with bracing and brace compliance more than 12hours daily. Compliant patient measurements were compared to non-compliant and non-brace groups. Forty patients underwent compressive orthotic bracing, while ten were observed. Twenty-three patients were compliant with bracing, and seventeen patients were non-compliant. Compliant patients exhibited an 8.2% increase, non-compliant patients had a 1.5% increase, and non-brace patients exhibited a 2.5% increase in BS HI. The change in BS HI of compliant patients was significantly different compared to non-brace patients (p=0.004) and non-compliant patients (p<0.001). Three dimensional BS is an effective, radiation free, and objective means to evaluate patients treated with compressive orthotic bracing. Copyright © 2014 Elsevier Inc. All rights reserved.

Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor

PubMed Central

Kassem Abdelaal, Ahmed Hamed; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchi, Akihiko; Miwa, Shinji; Inatani, Hiroyuki; Tsuchiya, Hiroyuki

2015-01-01

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years. Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures. Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient's life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable. PMID:26688766

Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor.

PubMed

Kassem Abdelaal, Ahmed Hamed; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchi, Akihiko; Miwa, Shinji; Inatani, Hiroyuki; Tsuchiya, Hiroyuki

2015-01-01

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years. Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures. Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient's life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable.

Long-term results after distal rectus femoris transfer as a part of multilevel surgery for the correction of stiff-knee gait in spastic diplegic cerebral palsy.

PubMed

Dreher, Thomas; Wolf, Sebastian I; Maier, Michael; Hagmann, Sébastien; Vegvari, Dóra; Gantz, Simone; Heitzmann, Daniel; Wenz, Wolfram; Braatz, Frank

2012-10-03

The evidence for distal rectus femoris transfer as a part of multilevel surgery for the correction of stiff-knee gait in children with spastic diplegic cerebral palsy is limited because of inconsistent outcomes reported in various studies and the lack of long-term evaluations. This study investigated the long-term results (mean, nine years) for fifty-three ambulatory patients with spastic diplegic cerebral palsy and stiff-knee gait treated with standardized distal rectus femoris transfer as a part of multilevel surgery. Standardized three-dimensional gait analysis and clinical examination were carried out before surgery and at one year and nine years after surgery. Patients with decreased peak knee flexion in swing phase who had distal rectus femoris transfer to correct the decreased peak knee flexion in swing phase (C-DRFT) were evaluated separately from those with normal or increased peak knee flexion in swing phase who had distal rectus femoris transfer done as a prophylactic procedure (P-DRFT). A significantly increased peak knee flexion in swing phase was found in the C-DRFT group one year after surgery, while a significant loss (15°) in peak knee flexion in swing phase was noted in the P-DRFT group. A slight but not significant increase in peak knee flexion in swing phase in both groups was noted at the time of the long-term follow-up. A significant improvement in timing of peak knee flexion in swing phase was only found for the C-DRFT group, and was maintained after nine years. Knee motion and knee flexion velocity were significantly increased in both groups and were maintained at long-term follow-up in the C-DRFT group, while the P-DRFT showed a deterioration of knee motion. Distal rectus femoris transfer is an effective procedure to treat stiff-knee gait featuring decreased peak knee flexion in swing phase and leads to a long-lasting increase of peak knee flexion in swing phase nine years after surgery. Patients with more involvement showed a greater

Post-operative bracing after pedicle screw fixation for thoracolumbar burst fractures: A cost-effectiveness study.

PubMed

Piazza, Matthew; Sinha, Saurabh; Agarwal, Prateek; Mallela, Arka; Nayak, Nikhil; Schuster, James; Stein, Sherman

2017-11-01

While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures. Additionally, a database of neurosurgical patients operated on within the authors institution was also used in the analysis. Incidences of significant adverse events (wound revision for either dehiscence or infection or re-operation for non-union or instability due to hardware failure) were determined. Pooled means and variances of reported parameters were obtained using a random-effects, inverse variance meta-analytic model for observational data. Utilities for surgical outcome and complications were assigned using previously published values. Of the 225 abstracts reviewed, 48 articles were included in the study, yielding a total of 1957 patients. After including patients from the institutional registry, together a total of 2081 patients were included in the final analysis, 1328 of whom were braced. Non-braced patients were older then braced patients, although this only approached significance (p=0.051). Braced patients had significantly lower rates of re-operation for non-union or clinically significant hardware failure (1.3% vs. 1.8%, p<0.001) although the groups had comparable rates of operative wound dehiscence and infection (p=1.000). These two approaches yielded comparable utility scores (p=0.120). Costs between braced and non-braced patients were comparable excluding the cost of the brace (p=0.256); hence, the added cost of the brace suggests that bracing post-operatively is not a cost effective measure. Bracing following operative stabilization of

Bracing and exercise-based treatment for idiopathic scoliosis.

PubMed

Kalichman, Leonid; Kendelker, Liron; Bezalel, Tomer

2016-01-01

Various conservative therapies are available for treating adolescent idiopathic scoliosis (AIS), however, the disparities between them and the evidence of their efficacy and effectiveness is still unclear. To evaluate the effectiveness of different conservative treatments on AIS. A literature-based narrative review of the English language medical literature. The most appropriate treatment for each patient should be chosen individually and based on various parameters. Bracing has been found to be a most effective conservative treatment for AIS. There is limited evidence that specific physical exercises also an effective intervention for AIS. Exercise-based physical therapy, if correctly administered, can prevent a worsening of the curve and may decrease need for bracing. In addition, physical exercises were found to be the only treatment improving respiratory function. Combining bracing with exercise increases treatment efficacy compared with a single treatment. Additional, well-designed and good quality studies are required to assess the effectiveness of different conservative methods in treating AIS. Copyright © 2015 Elsevier Ltd. All rights reserved.

Discrepancy in clinical versus radiological parameters describing deformity due to brace treatment for moderate idiopathic scoliosis.

PubMed

Kotwicki, Tomasz; Kinel, Edyta; Stryla, Wanda; Szulc, Andrzej

2007-12-03

The shape of the torso in patients with idiopathic scoliosis is considered to reflect the shape of the vertebral column, however the direct correlation between parameters describing clinical deformity and those characterizing radiological curvature was reported to be weak. It is not clear if the management proposed for scoliosis (physiotherapy, brace, surgery) affects equally the shape of the axial skeleton and the surface of the body. The aim of the study was to compare clinical deformity of (1) idiopathic scoliosis girls being under brace treatment for radiological curves of 25 to 40 degrees and (2) non treated scoliotic girls matched for age and Cobb angle. Cross-sectional study of 24 girls wearing the brace versus 26 girls without brace treatment, matched for age and Cobb angle. Patients wearing the brace for more than 6 months, when comparing to patients without brace, may present different external morphology of the trunk, in spite of having similar Cobb angle. Material. girls, idiopathic scoliosis, growing age (10-16 years), Cobb angle minimum 25 degrees , maximum 40 degrees . The braced group consisted of girls wearing a TLSO brace (Cheneau) for more than 6 months with minimum of 16 hours per day. The non-braced group consisted of girls first seen for their spinal deformity, previously not treated. The groups presented similar curve pattern. Methods. Scoliometer exam: angle of trunk rotation at three levels of the spine: upper thoracic, main thoracic, lumbar or thoracolumbar. The maximal angle was noted at each level and the sum of three levels was calculated. Posterior trunk symmetry index (POTSI) and Hump Sum were measured using surface topography. Cobb angle was 34.9 degrees +/- 4.8 degrees in braced and 32.7 degrees +/- 4.9 degrees in un-braced patients (difference not significant). The age was 14.1 +/- 1.6 years in braced patients and 13.1 +/- 1.9 years in un-braced group (p = 0.046). The value of angle of trunk rotation in the main curvature was 8

An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique

PubMed Central

2010-01-01

This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature. PMID:20667131

Discrepancy in clinical versus radiological parameters describing deformity due to brace treatment for moderate idiopathic scoliosis

PubMed Central

Kotwicki, Tomasz; Kinel, Edyta; Stryla, Wanda; Szulc, Andrzej

2007-01-01

Background The shape of the torso in patients with idiopathic scoliosis is considered to reflect the shape of the vertebral column, however the direct correlation between parameters describing clinical deformity and those characterizing radiological curvature was reported to be weak. It is not clear if the management proposed for scoliosis (physiotherapy, brace, surgery) affects equally the shape of the axial skeleton and the surface of the body. The aim of the study was to compare clinical deformity of (1) idiopathic scoliosis girls being under brace treatment for radiological curves of 25 to 40 degrees and (2) non treated scoliotic girls matched for age and Cobb angle. Methods Cross-sectional study of 24 girls wearing the brace versus 26 girls without brace treatment, matched for age and Cobb angle. Hypothesis: Patients wearing the brace for more than 6 months, when comparing to patients without brace, may present different external morphology of the trunk, in spite of having similar Cobb angle. Material. Inclusion criteria: girls, idiopathic scoliosis, growing age (10–16 years), Cobb angle minimum 25°, maximum 40°. The braced group consisted of girls wearing a TLSO brace (Cheneau) for more than 6 months with minimum of 16 hours per day. The non-braced group consisted of girls first seen for their spinal deformity, previously not treated. The groups presented similar curve pattern. Methods. Scoliometer exam: angle of trunk rotation at three levels of the spine: upper thoracic, main thoracic, lumbar or thoracolumbar. The maximal angle was noted at each level and the sum of three levels was calculated. Posterior trunk symmetry index (POTSI) and Hump Sum were measured using surface topography. Results Cobb angle was 34.9° ± 4.8° in braced and 32.7° ± 4.9° in un-braced patients (difference not significant). The age was 14.1 ± 1.6 years in braced patients and 13.1 ± 1.9 years in un-braced group (p = 0.046). The value of angle of trunk rotation in the main

Control of a flexible bracing manipulator: Integration of current research work to realize the bracing manipulator

NASA Technical Reports Server (NTRS)

Kwon, Dong-Soo

1991-01-01

All research results about flexible manipulator control were integrated to show a control scenario of a bracing manipulator. First, dynamic analysis of a flexible manipulator was done for modeling. Second, from the dynamic model, the inverse dynamic equation was derived, and the time domain inverse dynamic method was proposed for the calculation of the feedforward torque and the desired flexible coordinate trajectories. Third, a tracking controller was designed by combining the inverse dynamic feedforward control with the joint feedback control. The control scheme was applied to the tip position control of a single link flexible manipulator for zero and non-zero initial condition cases. Finally, the contact control scheme was added to the position tracking control. A control scenario of a bracing manipulator is provided and evaluated through simulation and experiment on a single link flexible manipulator.

19. DETAIL VIEW SHOWING POINT OF CONNECTION OF SWAY BRACING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. DETAIL VIEW SHOWING POINT OF CONNECTION OF SWAY BRACING TO UPSTREAM ARCH RIB AT SPRING POINT FROM SOUTH ABUTMENT, LOOKING EAST-NORTHEAST. NOTE CRACK VISIBLE NEAR TOP OF SWAY BRACING AT LEFT CENTER, PROBABLY DUE TO RUST JACKING OF REINFORCING STEEL - Chili Bar Bridge, Spanning South Fork of American River at State Highway 193, Placerville, El Dorado County, CA

Bracing of the trunk and neck has a differential effect on head control during gait

PubMed Central

Russell, D. M.; Kelleran, K.; Walker, M. L.

2015-01-01

During gait, the trunk and neck are believed to play an important role in dissipating the transmission of forces from the ground to the head. This attenuation process is important to ensure head control is maintained. The aim of the present study was to assess the impact of externally restricting the motion of the trunk and/or neck segments on acceleration patterns of the upper body and head and related trunk muscle activity. Twelve healthy adults performed three walking trials on a flat, straight 65-m walkway, under four different bracing conditions: 1) control-no brace; 2) neck-braced; 3) trunk-braced; and 4) neck-trunk braced. Three-dimensional acceleration from the head, neck (C7) and lower trunk (L3) were collected, as was muscle activity from trunk. Results revealed that, when the neck and/or trunk were singularly braced, an overall decrease in the ability of the trunk to attenuate gait-related oscillations was observed, which led to increases in the amplitude of vertical acceleration for all segments. However, when the trunk and neck were braced together, acceleration amplitude across all segments decreased in line with increased attenuation from the neck to the head. Bracing was also reflected by increased activity in erector spinae, decreased abdominal muscle activity and lower trunk muscle coactivation. Overall, it would appear that the neuromuscular system of young, healthy individuals was able to maintain a consistent pattern of head acceleration, irrespective of the level of bracing, and that priority was placed over the control of vertical head accelerations during these gait tasks. PMID:26180113

Delayed latency of peroneal reflex to sudden inversion with ankle taping or bracing.

PubMed

Shima, N; Maeda, A; Hirohashi, K

2005-01-01

The purpose of the present study was to examine the effects of ankle taping and bracing based on the peroneal reflex in the hypermobile and normal ankle joints with and without history of ankle injury. Thirty-six ankle joints of 18 collegiate American football athletes with and without previous history of injury were studied. The angle of talar tilt (TT) was measured by stress radiograph for classifying normal (TT5 degrees ) ankles. They were tested with taping, bracing, and without any supports as a control. The latency of peroneus longus muscle was measured by a sudden inversion of 25 degrees using surface EMG signals. The results of the present study show no significant three-way Group (hypermobile or normal ankles) by History (previously injured or uninjured ankles) by Condition (control, taping, or bracing) interaction, while Condition main effect was significant (p<0.05). There were significant differences between control (80.8 ms) and taping (83.8 ms, p<0.01), between control and bracing (83.0 ms, p<0.05), but not between taping and bracing (p>0.05). In conclusion, ankle taping and bracing delayed the peroneal reflex latency not only for hypermobile ankles and/or injured ankle joints but also for intact ankle joints.

49 CFR 230.25 - Maximum allowable stress on stays and braces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Maximum allowable stress on stays and braces. 230... Boilers and Appurtenances Allowable Stress § 230.25 Maximum allowable stress on stays and braces. The maximum allowable stress per square inch of net cross sectional area on fire box and combustion chamber...

Success and duration of dynamic bracing for pectus carinatum: A four-year prospective study.

PubMed

Emil, Sherif; Sévigny, Marika; Montpetit, Kathleen; Baird, Robert; Laberge, Jean-Martin; Goyette, Jade; Finlay, Ian; Courchesne, Guylaine

2017-01-01

This study sought to establish factors that can prognosticate outcomes of bracing for pectus carinatum (PC). Prospective data were collected on all patients enrolled in a dynamic bracing protocol from July 2011 to July 2015. Pressure of correction (POC) was measured at initiation of treatment, and pressure of treatment (POT) was measured pre- and post-adjustment at every follow-up visit. Univariate and Cox regression analysis tested the following possible determinants of success and bracing duration: age, sex, symmetry, POC, and POT drop during the first two follow-up visits. Of 114 patients, 64 (56%) succeeded, 33 (29%) were still in active bracing, and 17 (15%) failed or were lost to follow-up. In successful patients, active and maintenance bracing was 5.66±3.81 and 8.80±3.94months, respectively. Asymmetry and older age were significantly associated with failure. Multivariable Cox proportional hazard analysis of time-to-maintenance showed that asymmetry (p=0.01) and smaller first drop in POT (p=0.02) were associated with longer time to reach maintenance. Pressure of correction does not predict failure of bracing, but older age, asymmetry, and smaller first drop in pressure of treatment are associated with failure and longer bracing duration. Prospective Study/Level of Evidence IV. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of Balance Ability Dependent on the Angle of the Knee Joint in Females in Their 20s

PubMed Central

Yoon, Se-Won; Lee, Jeong-Woo; Cho, Woon-Su; Kim, An-Na; Lee, Kyung-Hee

2013-01-01

The aim of this study was to investigate how balance ability according to angle of the knee joint changes in young female adults wearing a knee orthosis. [Methods] This study was conducted with 11 healthy female adults. The subjects used a knee brace that could be set to angles of 0°, 15°, and 30° of knee flexion. The ability to balance was evaluated by balance assessment. A total of four postures were used for measurements: a forward-facing posture with the eyes open on a stable surface (NO), a forward-facing posture with the eyes closed on a stable surface (NC), a forward-facing posture with the eyes open on an unstable surface (PO), and a forward-facing posture with the eyes closed on an unstable surface (PC). [Results] Regarding the weight distribution index and stability index on a stable surface, there was no interaction according to whether there was visual deprivation or not or according to knee flexion angle. Furthermore, the stability index on an unstable surface showed no interaction according to whether there was visual deprivation or not or according to knee flexion angle. But the WDI on a stable surface showed no interaction according to whether there was visual deprivation or not or according to knee flexion angle. [Conclusion] There were significant differences in the knee extension range of motion of normal elderly people and knee osteoarthritis, and the quadriceps femoris played an important role in knee function in individuals with knee osteoarthritis. PMID:24259902

Orthoses for osteoarthritis: A narrative review.

PubMed

Beaudreuil, Johann

2017-04-01

Orthoses for osteoarthritis represent splints, taping, sleeves, unloading knee braces and insoles. This review of the effectiveness of these orthoses involved a search for articles published up to 2015 in MEDLINE via PubMed, with a focus on Osteoarthritis Research Society International, American College of Rheumatology and European League Against Rheumatology international recommendations. Evidence for splinting effectiveness in patients with thumb-base osteoarthritis is now provided. Splints for thumb-base osteoarthritis decrease pain and functional disability. Weaker evidence was found for knee bracing, including taping, sleeves and unloading braces. Low rate of observance and safety results should be considered before using current unloading knee braces for knee osteoarthritis. For insoles, data remain controversial. Orthoses for interphalangeal or hip osteoarthritis have not been investigated in a randomized trial. Regardless, if indicated in daily clinical practice, bracing must be checked by a healthcare professional to insure the suitability of the device. Patients using bracing must be educated. Patient education should include knowledge of the aims and modalities of the treatment as well as knowledge of potential side effects. Patients should be encouraged to contact the therapist if adjustment is needed, with poor tolerance or with questions about the device. Copyright © 2016. Published by Elsevier Masson SAS.

Bracing of pectus carinatum: A quantitative analysis.

PubMed

Bugajski, Tomasz; Murari, Kartikeya; Lopushinsky, Steven; Schneider, Marc; Ronsky, Janet

2018-05-01

Primary treatment of pectus carinatum (PC) is performed with an external brace that compresses the protrusion. Patients are 'prescribed' a brace tightening force. However, no visual guides exist to display this force magnitude. The purpose of this study was to determine the repeatability of patients in applying their prescribed force over time and to determine whether the protrusion stiffness influences the patient-applied forces and the protrusion correction rate. Twenty-one male participants (12-17years) with chondrogladiolar PC were recruited at the time of brace fitting. Participants were evaluated on three visits: fitting, one month postfitting, and two months postfitting. Differences between prescribed force and patient-applied force were evaluated. Relationships of patient-applied force and correction rate with protrusion stiffness were assessed. Majority of individuals followed for two months (75%) had a significantly different patient-applied force (p<0.05) from their prescribed force. Protrusion stiffness had a positive relationship with patient-applied force, but no relationship with correction rate. Patients did not follow their prescribed force. Magnitudes of these differences require further investigation to determine clinical significance. Patient-applied forces were influenced by protrusion stiffness, but correction rate was not. Other factors may influence these variables, such as patient compliance. Treatment Study - Level IV. Copyright © 2018 Elsevier Inc. All rights reserved.

Chinese Adaptation of the Bad Sobernheim Stress Questionnaire for Patients With Adolescent Idiopathic Scoliosis Under Brace Treatment.

PubMed

Xu, Ximing; Wang, Fei; Yang, Mingyuan; Huang, Qikai; Chang, Yifan; Wei, Xianzhao; Bai, Yushu; Li, Ming

2015-08-01

Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity and BSSQ-Brace are the most widely used instruments for evaluating stress levels in adolescent idiopathic scoliosis (AIS) patients under brace treatment, and good reliability and validity have been demonstrated across different cultures. Great stress has been found among many adolescents, becoming a major concern for professionals. However, no previous research has addressed the cultural adaptations and psychometric testing of BSSQ-Deformity and BSSQ-Brace in China or the stress levels in AIS patients. The purposes of our study were to evaluate the cross-cultural adaptation and validation of the BSSQ-Deformity and BSSQ-Brace and to investigate stress levels in Chinese (AIS) patients under brace treatment.The original (German) versions of BSSQ-Deformity and BSSQ-Brace were cross-culturally translated according to international guidelines. Psychometric properties such as reliability and construct validity were tested. Eighty-six AIS patients were included in our study, and 50 patients paid a second visit 3 to 7 days later to test reproducibility. Cronbach α and the intraclass coefficient were determined to assess internal consistency and reproducibility. Scoliosis Research Society patient questionnaire-22 (SRS-22) was applied to evaluate construct validity.The mean BSSQ-Deformity and BSSQ-Brace scores were 15.3 and 13.4 points, respectively. Severe stress was observed in 12% of patients due to brace treatment. Item analysis demonstrated that each item was scored under a normal distribution with no redundancy. Psychometric analysis revealed excellent internal consistency (Cronbach α = 0.85 and 0.80, respectively) and reproducibility (intraclass correlation coefficient = 0.85 and 0.90, respectively) for BSSQ-Deformity and BSSQ-Brace. The correlation coefficients of BSSQ-Deformity, BSSQ-Brace and SRS-22 were 0.48 and 0.63, respectively.In conclusion, BSSQ-Deformity and BSSQ-Brace have been successfully

Chinese Adaptation of the Bad Sobernheim Stress Questionnaire for Patients With Adolescent Idiopathic Scoliosis Under Brace Treatment

PubMed Central

Xu, Ximing; Wang, Fei; Yang, Mingyuan; Huang, Qikai; Chang, Yifan; Wei, Xianzhao; Bai, Yushu; Li, Ming

2015-01-01

Abstract Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity and BSSQ-Brace are the most widely used instruments for evaluating stress levels in adolescent idiopathic scoliosis (AIS) patients under brace treatment, and good reliability and validity have been demonstrated across different cultures. Great stress has been found among many adolescents, becoming a major concern for professionals. However, no previous research has addressed the cultural adaptations and psychometric testing of BSSQ-Deformity and BSSQ-Brace in China or the stress levels in AIS patients. The purposes of our study were to evaluate the cross-cultural adaptation and validation of the BSSQ-Deformity and BSSQ-Brace and to investigate stress levels in Chinese (AIS) patients under brace treatment. The original (German) versions of BSSQ-Deformity and BSSQ-Brace were cross-culturally translated according to international guidelines. Psychometric properties such as reliability and construct validity were tested. Eighty-six AIS patients were included in our study, and 50 patients paid a second visit 3 to 7 days later to test reproducibility. Cronbach α and the intraclass coefficient were determined to assess internal consistency and reproducibility. Scoliosis Research Society patient questionnaire-22 (SRS-22) was applied to evaluate construct validity. The mean BSSQ-Deformity and BSSQ-Brace scores were 15.3 and 13.4 points, respectively. Severe stress was observed in 12% of patients due to brace treatment. Item analysis demonstrated that each item was scored under a normal distribution with no redundancy. Psychometric analysis revealed excellent internal consistency (Cronbach α = 0.85 and 0.80, respectively) and reproducibility (intraclass correlation coefficient = 0.85 and 0.90, respectively) for BSSQ-Deformity and BSSQ-Brace. The correlation coefficients of BSSQ-Deformity, BSSQ-Brace and SRS-22 were 0.48 and 0.63, respectively. In conclusion, BSSQ-Deformity and BSSQ-Brace have been

The development and use of SPIO Lycra compression bracing in children with neuromotor deficits.

PubMed

Hylton, N; Allen, C

1997-01-01

The use of flexible compression bracing in persons with neuromotor deficits offers improved possibilities for stability and movement control without severely limiting joint movement options. At the Children's Therapy Center in Kent, Washington, this treatment modality has been explored with increasing application in children with moderate to severe cerebral palsy and other neuromotor deficits over the past 6 years, with good success. Significant functional improvements using Neoprene shoulder/trunk/hip Bracing led us to experiment with much lighter compression materials. The stabilizing pressure input orthosis or SPIO bracing system (developed by Cheryl Allen, parent and Chief Designer, and Nancy Hylton, PT) is custom-fitted to the stability, movement control and sensory deficit needs of a specific individual. SPIO bracing developed for a specific child has often become part of a rapidly increasing group of flexible bracing options which appear to provide an improved base of support for functional gains in balance, dynamic stability, general and specific movement control with improved postural and muscle readiness. Both deep sensory and subtle biomechanical factors may account for the functional changes observed. This article discusses the development and current use of flexible compression SPIO bracing in this area.

Experimental Tests of a Real Building Seismically Retrofitted by Special Buckling-Restrained Braces

NASA Astrophysics Data System (ADS)

D'Aniello, Mario; Corte, Gaetano Della; Mazzolani, Federico M.

2008-07-01

Buckling Restrained Braces (BRBs), differently from conventional braces, do not exhibit appreciable difference between the tensile and compression capacity and no strength degradation of brace capacity under compressive and cyclic loading. Since lateral and local buckling behaviour modes are restrained, large inelastic capacities are attainable. Hence, BRBs may represent an efficient and reliable solution for reducing the seismic vulnerability of buildings. Results of experimental tests on the response of a real two-story reinforced concrete (RC) building equipped with BRBs are presented and discussed. The considered BRBs are a special `only-steel' version of the more common `unbonded braces'. In particular, two different BRBs have been tested. Both of them are detachable "only-steel" devices, consisting in a rectangular steel plate and a restraining steel sleeve. The latter is composed by two omega shapes which are bolted together. The main characteristic of the braces consists in the possibility to hide them within the space between the facing and the backing of masonry infill walls commonly used for RC buildings.

Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis

PubMed Central

Cuddihy, Laury; Danielsson, Aina J.; Cahill, Patrick J.; Samdani, Amer F.; Grewal, Harsh; Richmond, John M.; Mulcahey, M. J.; Gaughan, John P.; Antonacci, M. Darryl; Betz, Randal R.

2015-01-01

Purpose. We report a comparison study of vertebral body stapling (VBS) versus a matched bracing cohort for immature patients with moderate (25 to 44°) idiopathic scoliosis (IS). Methods. 42 of 49 consecutive patients (86%) with IS were treated with VBS and followed for a minimum of 2 years. They were compared to 121 braced patients meeting identical inclusion criteria. 52 patients (66 curves) were matched according to age at start of treatment (10.6 years versus 11.1 years, resp. [P = 0.07]) and gender. Results. For thoracic curves 25–34°, VBS had a success rate (defined as curve progression <10°) of 81% versus 61% for bracing (P = 0.16). In thoracic curves 35–44°, VBS and bracing both had a poor success rate. For lumbar curves, success rates were similar in both groups for curves measuring 25–34°. Conclusion. In this comparison of two cohorts of patients with high-risk (Risser 0-1) moderate IS (25–44°), in smaller thoracic curves (25–34°) VBS provided better results as a clinical trend as compared to bracing. VBS was found not to be effective for thoracic curves ≥35°. For lumbar curves measuring 25–34°, results appear to be similar for both VBS and bracing, at 80% success. PMID:26618169

Ankle Spatting Compared to Bracing or Taping during Maximal-Effort Sprint Drills

PubMed Central

REUTER, GRANT D; DAHL, ANGELA R; SENCHINA, DAVID S

2011-01-01

The purpose of this study was to compare the influences of 4 ankle conditions (no support, bracing, taping, taping + spatting; all in football cleats) during 2 maximal-effort field drills (40-yd dash and 34-yd cutting drill) on perceptions of comfort and stability and performance outcomes. Fourteen young adult males participated. Subjects’ perceptions of comfort and stability were assessed by visual analogue scales after each drill for each ankle condition. Time-to-completion and post-completion heart rate were recorded. For both drills, significant differences in comfort perception were found such that subjects perceived no support as equivocal to bracing but more comfortable than either taping or spatting + taping. Stability results differed by drill. For the dash, significant differences in stability perception were found such that subjects perceived no support as equivocal to bracing but less stable than either taping or spatting + taping. By contrast, for the cutting drill significant differences in stability perception were found such that subjects perceived their ankles as less stable during the no support condition as compared to all 3 other conditions. Generally, bracing was perceived as equivocal to all 3 other conditions for comfort and stability. There were no significant differences in time-to-completion or heart rate for any comparison. Compared to bracing or taping, spatting + taping (a) did not influence performance time in explosive/sprint-type drills, (b) was perceived as equivalent to taping alone in terms of ankle comfort and stability, and (c) was perceived as equivalent to bracing in terms of stability but not comfort. PMID:27478530

The current status of bracing for patients with adolescent idiopathic scoliosis.

PubMed

Stokes, O M; Luk, K D K

2013-10-01

Adolescent idiopathic scoliosis affects about 3% of children. Non-operative measures are aimed at altering the natural history to maintain the size of the curve below 40° at skeletal maturity. The application of braces to treat spinal deformity pre-dates the era of evidence-based medicine, and there is a paucity of irrefutable prospective evidence in the literature to support their use and their effectiveness has been questioned. This review considers this evidence. The weight of the evidence is in favour of bracing over observation. The most recent literature has moved away from addressing this question, and instead focuses on developments in the design of braces and ways to improve compliance.

Scapular Bracing and Alteration of Posture and Muscle Activity in Overhead Athletes With Poor Posture

PubMed Central

Cole, Ashley K; McGrath, Melanie L; Harrington, Shana E; Padua, Darin A; Rucinski, Terri J; Prentice, William E

2013-01-01

Context Overhead athletes commonly have poor posture. Commercial braces are used to improve posture and function, but few researchers have examined the effects of shoulder or scapular bracing on posture and scapular muscle activity. Objective To examine whether a scapular stabilization brace acutely alters posture and scapular muscle activity in healthy overhead athletes with forward-head, rounded-shoulder posture (FHRSP). Design Randomized controlled clinical trial. Setting Applied biomechanics laboratory. Patients or Other Participants Thirty-eight healthy overhead athletes with FHRSP. Intervention(s) Participants were assigned randomly to 2 groups: compression shirt with no strap tension (S) and compression shirt with the straps fully tensioned (S + T). Posture was measured using lateral-view photography with retroreflective markers. Electromyography (EMG) of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) in the dominant upper extremity was measured during 4 exercises (scapular punches, W's, Y's, T's) and 2 glenohumeral motions (forward flexion, shoulder extension). Posture and exercise EMG measurements were taken with and without the brace applied. Main Outcome Measure(s) Head and shoulder angles were measured from lateral-view digital photographs. Normalized surface EMG was used to assess mean muscle activation of the UT, MT, LT, and SA. Results Application of the brace decreased forward shoulder angle in the S + T condition. Brace application also caused a small increase in LT EMG during forward flexion and Y's and a small decrease in UT and MT EMG during shoulder extension. Brace application in the S + T group decreased UT EMG during W's, whereas UT EMG increased during W's in the S group. Conclusions Application of the scapular brace improved shoulder posture and scapular muscle activity, but EMG changes were highly variable. Use of a scapular brace might improve shoulder posture and muscle activity in

Efficacy, safety, and economics of bracing after spine surgery: a systematic review of the literature.

PubMed

Zhu, Mary P; Tetreault, Lindsay A; Sorefan-Mangou, Fatimah; Garwood, Philip; Wilson, Jefferson R

2018-01-31

Bracing is often used after spinal surgery to immobilize the spine, improve fusion, and relieve pain. However, controversy exists regarding the efficacy, necessity, and safety of various bracing techniques in the postsurgical setting. In this systematic review, we aimed to compare the effectiveness, safety, and cost-effectiveness of postoperative bracing versus no postoperative bracing after spinal surgery in patients with several common operative spinal pathologies. A systematic review was carried out to compare postoperative bracing and no postoperative bracing. A systematic search was conducted of MEDLINE, Embase, and the Cochrane Collaboration Library from 1970 to May 2017, supplemented by manual searching of the reference list of relevant studies and previously published reviews. Studies were included if they compared disability, quality of life, functional impairment, radiographic outcomes, cost-effectiveness, or complications between patients treated with postoperative bracing and patients not receiving any postoperative bracing. Each article was critically appraised independently by two reviewers, and the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Of the 858 retrieved citations, 5 studies met the inclusion criteria and were included in this review, consisting of 4 randomized controlled trials and 1 prospective cohort study. Low to moderate evidence suggests that there are no significant differences in most measures of disability, pain, quality of life, functional impairment, radiographic outcomes, and safety between groups. Isolated studies reported statistically significant and inconsistent differences between groups with respect to Neck Disability Index at 6 weeks postoperatively or Short Form-36 Physical Component Score at 1.5, 3, 6, and 12 months postoperatively. Based on limited evidence, postoperative bracing does not result in improved

An equivalent frequency approach for determining non-linear effects on pre-tensioned-cable cross-braced structures

NASA Astrophysics Data System (ADS)

Giaccu, Gian Felice

2018-05-01

Pre-tensioned cable braces are widely used as bracing systems in various structural typologies. This technology is fundamentally utilized for stiffening purposes in the case of steel and timber structures. The pre-stressing force imparted to the braces provides to the system a remarkable increment of stiffness. On the other hand, the pre-tensioning force in the braces must be properly calibrated in order to satisfactorily meet both serviceability and ultimate limit states. Dynamic properties of these systems are however affected by non-linear behavior due to potential slackening of the pre-tensioned brace. In the recent years the author has been working on a similar problem regarding the non-linear response of cables in cable-stayed bridges and braced structures. In the present paper a displacement-based approach is used to examine the non-linear behavior of a building system. The methodology operates through linearization and allows obtaining an equivalent linearized frequency to approximately characterize, mode by mode, the dynamic behavior of the system. The equivalent frequency depends on both the mechanical characteristics of the system, the pre-tensioning level assigned to the braces and a characteristic vibration amplitude. The proposed approach can be used as a simplified technique, capable of linearizing the response of structural systems, characterized by non-linearity induced by the slackening of pre-tensioned braces.

Evaluation of the efficiency of the Chêneau brace on scoliosis deformity : A systematic review of the literature.

PubMed

Taghi Karimi, Mohammad; Rabczuk, Timon; Kavyani, Mahsa

2018-03-01

Scoliosis is a three-dimensional deformity of the spine and rib cage. Depending on the severity of this disease, various kinds of treatment methods have been used and bracing is among the most common. One of the braces which has been used for subjects with scoliosis is the Chêneau brace. The aim of this review was to evaluate the efficiency of the Chêneau brace on the scoliosis curve progression and control based on the available literature. We conducted a Medline search via PubMed, Google Scholar, ISI Web of Sciences, Ebsco and Scopus. Keywords such as Chêneau brace, Chêneau light and CAD/CAM spinal brace were used in combination with scoliosis. The quality of the studies was evaluated by the Down and Black tool. Based on the aforementioned keywords, 55 papers were found. Finally based on the mentioned criteria 14 papers were selected for final analysis. The quality of the studies varied between scores of 13 and 25 using the Down and Black tool. The results of the selected studies confirmed that a good scoliotic curve correction can be achieved with the Chêneau brace. The Chêneau brace provides a 3-dimensional correction of the spinal deformity which not only influences the progression of scoliotic curve but also influences its natural history. It cannot be concluded that the Chêneau brace is superior to other available braces; however, it has been shown that this brace is effective to control the scoliotic curve progression especially in the lumbar and thoracolumbar regions.

Evaluating the ductility characteristics of self-centering buckling-restrained shape memory alloy braces

NASA Astrophysics Data System (ADS)

Abou-Elfath, Hamdy

2017-05-01

Recently, self-centering earthquake resistant systems have attracted attention because of their promising potential in controlling the residual drifts and reducing repair costs after earthquake events. Considerable portion of self-centering research is based on using short-segment superelastic shape memory alloy (SMA) braces as strengthening technique because of the lower modulus of elasticity of SMA in comparison with that of steel. The goal of this study is to investigate the ductility characteristics of these newly proposed short-segment SMA braces to evaluate their safety levels against fracture failures under earthquake loading. This goal has been achieved by selecting an appropriate seismic performance criterion for steel frames equipped with SMA braces, defining the level of strain capacity of SMA and calculating the strain demands in the SMA braces by conducting a series of pushover and earthquake time history analyzes on typical frame structure. The results obtained in this study indicated the inability of short-segment SMA designs to provide adequate ductility to the lateral resistant systems. An alternative approach is introduced by using hybrid steel-SMA braces that are capable of controlling the residual drifts and providing the structure with adequate lateral stiffness.

State-of-the-Art management of knee osteoarthritis.

PubMed

Fibel, Kenton H; Hillstrom, Howard J; Halpern, Brian C

2015-02-16

Osteoarthritis (OA) is the most common type of arthritis found in the United States' population and is also the most common disease of joints in adults throughout the world with the knee being the most frequently affected of all joints. As the United States' population ages along with the increasing trends in obesity prevalence in other parts of the world, it is expected that the burden of OA on the population, healthcare system, and overall economy will continue to increase in the future without making major improvements in managing knee OA. Numerous therapies aim to reduce symptoms of knee OA and continued research has helped to further understand the complex pathophysiology of its disease mechanism attempting to uncover new potential targets for the treatment of OA. This review article seeks to evaluate the current practices for managing knee OA and discusses emerging therapies on the horizon. These practices include non-pharmacological treatments such as providing patient education and self-management strategies, advising weight loss, strengthening programs, and addressing biomechanical issues with bracing or foot orthoses. Oral analgesics and anti-inflammatories are pharmacologicals that are commonly used and the literature overall supports that some of these medications can be helpful for managing knee OA in the short-term but are less effective for long-term management. Additionally, more prolonged use significantly increases the risk of serious associated side effects that are not too uncommon. Disease-modifying osteoarthritis drugs are being researched as a treatment modality to potentially halt or slow disease progression but data at this time is limited and continued studies are being conducted to further investigate their effectiveness. Intra-articular injectables are also implemented to manage knee OA ranging from corticosteroids to hyaluronans to more recently platelet-rich plasma and even stem cells while several other injection therapies are

Pectus carinatum: the effects of orthotic bracing on pulmonary function and gradual compression on patient compliance.

PubMed

Ateş, Oğuz; Karakuş, Osman Z; Hakgüder, Gülce; Olguner, Mustafa; Akgür, Feza M

2013-09-01

The treatment of pectus carinatum (PC) deformity has been considered to be operative. Some authors have shown that postoperative pulmonary function is worsened. They have suggested that compromised chest wall expansion secondary to surgery leads to compromised pulmonary function. Several authors have advocated an orthotic brace for the treatment of PC. Pulmonary functions after orthotic brace treatment have not been investigated. Between April 2006 and October 2012, 61 patients presented with PC. Orthotic braces allowing gradual compression were prepared according to the anthropometric measurements of individual patients. The brace belt was tightened gradually. The brace was worn 6 h a day during the first week and the bracing time was prolonged for an additional hour per week till 16 h per day has been reached. Pre- and post-treatment echocardiography, pulmonary function tests and thorax computed tomography (CT) were obtained. The pectus severity index (Haller index) and the angle of sternal rotation were measured using CT. Satisfaction from bracing was evaluated by parents or patients at the end of the treatment. While the mean pretreatment Haller index was 1.96 ± 0.24, the mean post-treatment index was 2.26 ± 0.32. The angle of rotation was improved by 47.5%. Forced vital capacity and forced expiratory volume in 1 second were correlated with the predicted values for age. There was no statistically significant difference between pre- and post-treatment values. No skin breakdown or bruising was encountered. The overall average satisfaction score was 3.92 ± 0.27. We conclude that pulmonary function tests are not affected after brace treatment and gradual progression of bracing increases the patient's compliance.

Clinical study on the unloading effect of hip bracing on gait in patients with hip osteoarthritis.

PubMed

Nérot, Agathe; Nicholls, Micah

2017-04-01

Internal hip abduction moment is a major indicator for hip loading. A new hip bracing concept was designed to unload the cartilaginous area in hip osteoarthritis via an abduction and external rotation force intended to alter the weight bearing area and reduce compression through the joint. To assess the effect of a novel brace on hip rotation in the transverse and coronal planes and on the hip abduction moment. Repeated measures. Gait analysis was performed on 14 subjects with unilateral symptomatic hip osteoarthritis. Pain, joint motion, moments and vertical ground reaction force were compared between the braced and the unbraced (control), randomly assigned, conditions. Nine participants felt an immediate reduction in pain while walking with the hip brace. Peak hip abduction moment significantly decreased on the osteoarthritis side ( p = 0.017). Peak hip adduction ( p = 0.004) and internal rotation ( p = 0.0007) angles significantly decreased at stance with the brace. Wearing the brace would appear to reduce the compressive joint reaction force at the femuroacetabular interface as indicated by a reduction in internal hip abduction moment along with immediate pain reduction in nine participants. Further long-term studies are warranted. Clinical relevance The brace rotates the hip in the transverse and coronal planes, possibly resulting in a decrease in load through the diseased area of cartilage. In some patients, an immediate decrease in pain was experienced. The brace offers an alternative solution for hip osteoarthritis patients not ready for a hip replacement.

Inelastic behavior of cold-formed braced walls under monotonic and cyclic loading

NASA Astrophysics Data System (ADS)

Gerami, Mohsen; Lotfi, Mohsen; Nejat, Roya

2015-06-01

The ever-increasing need for housing generated the search for new and innovative building methods to increase speed and efficiency and enhance quality. One method is the use of light thin steel profiles as load-bearing elements having different solutions for interior and exterior cladding. Due to the increase in CFS construction in low-rise residential structures in the modern construction industry, there is an increased demand for performance inelastic analysis of CFS walls. In this study, the nonlinear behavior of cold-formed steel frames with various bracing arrangements including cross, chevron and k-shape straps was evaluated under cyclic and monotonic loading and using nonlinear finite element analysis methods. In total, 68 frames with different bracing arrangements and different ratios of dimensions were studied. Also, seismic parameters including resistance reduction factor, ductility and force reduction factor due to ductility were evaluated for all samples. On the other hand, the seismic response modification factor was calculated for these systems. It was concluded that the highest response modification factor would be obtained for walls with bilateral cross bracing systems with a value of 3.14. In all samples, on increasing the distance of straps from each other, shear strength increased and shear strength of the wall with bilateral bracing system was 60 % greater than that with lateral bracing system.

Seismic Response of Steel Braced Building Frame Considering Soil Structure Interaction (SSI): An Experimental Study

NASA Astrophysics Data System (ADS)

Hirave, Vivek; Kalyanshetti, Mahesh

2018-02-01

Conventional fixed-base analysis ignoring the effect of soil-flexibility may result in unsafe design. Therefore, to evaluate the realistic behavior of structure the soil structure interaction (SSI) effect shall be incorporated in the analysis. In seismic analysis, provision of bracing system is one of the important option for the structure to have sufficient strength with adequate stiffness to resist lateral forces. The different configuration of these bracing systems alters the response of buildings, and therefore, it is important to evaluate the most effective bracing systems in view point of stability against SSI effect. In present study, three RC building frames, G+3, G+5 and G+7 and their respective scaled down steel model with two types of steel bracing system incorporating the effect of soil flexibility is considered for experimental and analytical study. The analytical study is carried out using Elastic continuum approach and the experimental study is carried out using Shake Table. The influence of SSI on various seismic parameters is presented. The study reveals that, steel bracing system is beneficial to control SSI effect and it is observed that V bracing is more effective, in resisting seismic load considering SSI.

An experimental investigation on the ultimate strength of epoxy repaired braced partial infilled RC frames

NASA Astrophysics Data System (ADS)

Dubey, Shailendra Kumar Damodar; Kute, Sunil

2014-09-01

Due to earthquake, buildings are damaged partially or completely. Particularly structures with soft storey are mostly affected. In general, such damaged structures are repaired and reused. In this regard, an experimental investigation was planned and conducted on models of single-bay, single-storey of partial concrete infilled reinforced concrete (RC) frames up to collapse with corner, central and diagonal steel bracings. Such collapsed frames were repaired with epoxy resin and retested. The initiative was to identify the behaviour, extent of restored ultimate strength and deflection of epoxy-retrofitted frames in comparison to the braced RC frames. The performance of such frames has been considered only for lateral loads. In comparison to bare RC frames, epoxy repaired partial infilled frames have significant increase in the lateral load capacity. Central bracing is more effective than corner and diagonal bracing. For the same load, epoxy repaired frames have comparable deflection than similar braced frames.

Correlation between compliance and brace treatment in juvenile and adolescent idiopathic scoliosis: SOSORT 2014 award winner

PubMed Central

2014-01-01

Background Over the last years, evidence has accumulated in support of bracing as an effective treatment option in patients with idiopathic scoliosis. Yet, little information is available on the impact of compliance on the outcome of conservative treatment in scoliotic subjects. The aim of the present study was to prospectively evaluate the association between compliance to brace treatment and the progression of scoliotic curve in patients with idiopathic adolescent (AIS) or juvenile scoliosis (JIS). Methods Among 1.424 patients treated for idiopathic scoliosis, 645 were eligible for inclusion criteria. Three outcomes were distinguished in agreement with the SRS criteria: curve correction, curve stabilization and curve progression. Brace wearing was assessed by one orthopaedic surgeon (LA) and scored on a standardized form. Compliance to treatment was categorized as complete (brace worn as prescribed), incomplete A (brace removed for 1 month), incomplete B (brace removed for 2 months), incomplete C (brace removed during school hours), and incomplete D (brace worn overnight only). Chi square test, T test or ANOVA and ANOVA for repeated measures tests were used as statistical tests. Results The results from our study showed that at follow-up the compliance was: Complete 61.1%; Incomplete A 5.2%; Incomplete B 10.7%; Incomplete C 14.2%; Incomplete D 8.8%. Curve correction was accomplished in 301/319 of Complete, 19/27 Incomplete A, 25/56 Incomplete B, 52/74 Incomplete C, 27/46 Incomplete D. Cobb mean value was 29.8 ± 7.5 SD at beginning and 17.1 ± 10.9 SD at follow-up. Both Cobb and Perdriolle degree amelioration was significantly higher in patients with complete compliance over all other groups, both in juvenile, both in adolescent scoliosis. In the intention-to-treat analysis, the rate of surgical treatment was 2.1% among patients with definite outcome and 12.1% among those with drop-out. Treatment compliance showed significant interactions with time

The Problems Encountered in a CTEV Clinic: Can Better Casting and Bracing Be Accomplished?

PubMed

Agarwal, Anil; Kumar, Anubrat; Shaharyar, Abbas; Mishra, Madhusudan

2016-09-07

The aim of the study is to create awareness in the practicing health care workers toward the problems encountered during casting and bracing of clubfoot following Ponseti method, and in turn avoid them. Retrospective audit of 6 years' clubfoot clinic records to analyze problems associated with Ponseti method. Problems were encountered in 26 cast and in 6 braced patients. Just 4 patients out of 71 syndromic (5.6%) experienced problems during casting compared with 3% overall incidence. The common problems encountered in casted patients were moisture lesions, hematoma, dermatitis due to occlusion, pressure sores, and fractures. There was excessive bleeding in 1 patient at time of tenotomy. In braced patients, pressure sores and tenderness at tenotomy site were major problems. None of the syndromic patients experienced difficulties during bracing. Problems were encountered with Ponseti method during casting, tenotomy, or bracing. Syndromic children had lesser complication rate than idiopathic clubfeet. It is important to be aware of these problems so that appropriate intervention can be done early. Level IV: Retrospective. © 2016 The Author(s).

Compressive orthotic bracing in the treatment of pectus carinatum: the use of radiographic markers to predict success.

PubMed

Stephenson, Jacob T; Du Bois, Jeffrey

2008-10-01

The treatment of pectus carinatum (PC) has classically been operative, though compressive orthotic braces have been used with good success in recent years. The purpose of this article is to evaluate the use of radiologic measurements in a successful bracing protocol. Sixty-three patients with PC have been evaluated for an 8-year span. The average age is 13.3 +/- 2.5. Follow-up is from 4 to 60 months, with a median of 24 months. Seventeen patients with mild defects elected observation alone. The remaining 46 patients began the bracing protocol. Baseline chest computed tomography (CT) was obtained, and custom-fitted orthotic braces were constructed for each patient. Radiographic markers were evaluated to include the Haller index, angle of sternal rotation, and asymmetry index. Patient surveys and chart review were used to identify compliance and success rates. Pretreatment CTs were retrospectively reviewed by bracing outcomes and radiographic measurements were compared. Ten patients received posttreatment CTs after successful bracing. Of 63 patients with PC, 17 patients (27%) with mild defects elected observation alone. The remaining 46 patients began the bracing protocol as described above. Of these, 10 are excluded from analysis, with 6 patients currently in the early treatment phase and 4 who have been lost to follow-up. Of the remaining 36 patients, 8 failed bracing because of noncompliance. Of the 28, 24 patients who completed treatment report either good or excellent results after bracing. Eight patients have required surgical intervention, 4 as a result of noncompliance and 4 who were compliant but failed bracing. In patients who were compliant, significant differences were seen on initial CT between those with successful outcomes and those who required surgical repair. Haller index (2.85 vs 2.05; P < .05), angle of sternal rotation (27.3 vs 14.8; P < .05), and asymmetry index (1.23 vs 1.06; P < .01) were all higher in the group who failed bracing. In those

A displacement-based approach for determining non-linear effects on pre-tensioned-cable cross-braced structures

NASA Astrophysics Data System (ADS)

Giaccu, Gian Felice; Caracoglia, Luca

2017-04-01

Pre-tensioned-cable bracing systems are widely employed in structural engineering to limit lateral deflections and stabilize structures. A suitable configuration of the pre-tensioned-cable bracing systems in a structure is an important issue since the internal force distribution, emerging from the interaction with the existing structure, significantly affects the structural dynamic behavior. The design, however, is often based on the intuition and the previous experience of the engineer. In recent years, the authors have been investigating the non-linear dynamic response of cable systems, installed on cable-stayed bridges, and in particular the so-called "cable-cross-tie systems" forming a cable network. The bracing cables (cross-ties) can exhibit slackening or snapping. Therefore, a non-linear unilateral model, combined with the taut-cable theory, is required to simulate the incipient slackening conditions in the stays. Capitalizing from this work on non-linear cable dynamics, this paper proposes a new approach to analyze, in laterally- braced truss structures, the unilateral effects and dynamic response accounting for the loss in the pre-tensioning force imparted to the bracing cables. This effect leads to non-linear vibration of the structure. In this preliminary study, the free vibrations of the structure are investigated by using the "Equivalent Linearization Method". A performance coefficient, a real positive number between 0.5 and 1.0, is defined and employed to monitor the relative reduction in the apparent stiffness of the braces during structural vibration, "mode by mode". It is shown that the system can exhibit alternate unilateral behavior of the cross-braces. A reduction of the performance coefficient close to fifty percent is observed in the braces when the initial pre-tensioning force is small. On the other hand the performance coefficient tends to one in the case of a high level of pre-stress. It is concluded that the performance coefficient may

A Modern Historical Perspective of Schroth Scoliosis Rehabilitation and Corrective Bracing Techniques for Idiopathic Scoliosis.

PubMed

Moramarco, Kathryn; Borysov, Maksym

2017-01-01

The treatment of scoliosis has a long history dating back to Hippocrates and his luxation table. In recent history, conservative rehabilitation treatment methods have come and gone. Some have had more longevity than others and currently there are only a handful of these "schools" for rehabilitation in existence. What is important to note in this twenty-first century world is that any approach to bracing or scoliosis rehabilitation must strive for a correction effect and be as user-friendly as possible. Patients look to achieve some measure of success, whether it be halted Cobb angle, improved breathing function, decreased rotation, or postural improvement via trunk symmetry. Katharina Schroth created her method in 1921 as a result of self-analysis of her own imperfect scoliotic torso and the effect on it as she altered her breathing patterns. It was from these observations and self-experimentation that she devised her rotational angular breathing method. Subsequently, the Schroth method evolved under the leadership of her daughter, Christa Lehnert-Schroth P.T., and grandson, Dr. Hans-Rudolf Weiss. Collaboration with Dr. Jacques Chêneau led to a new Schroth method compatible scoliosis bracing approach. The most recent advancement of Chêneau bracing is the Gensingen Brace® (GBW). Gensingen braces have an asymmetric design and rely on Schroth principles of correction in a smaller, lighter, more wearer-friendly brace. Each brace is designed to be a complementary supportive orthosis. It may be used independently, or in conjunction with Schroth exercise protocols.

Outcomes of bracing in juvenile idiopathic scoliosis until skeletal maturity or surgery.

PubMed

Khoshbin, Amir; Caspi, Liora; Law, Peggy W; Donaldson, Sandra; Stephens, Derek; da Silva, Trevor; Bradley, Catharine S; Wright, James G

2015-01-01

Retrospective comparative study. To evaluate the outcome of bracing in patients with juvenile idiopathic scoliosis (JIS) at either skeletal maturity or time of scoliosis surgery. JIS is generally thought to have poor outcomes with high rates of surgical fusion. All patients with JIS between the ages of 4 and 10 years treated with a brace at the Hospital for Sick Children (SickKids) between 1989 and 2011 were eligible. Data were collected from patient health records until either 2 years after skeletal maturity or date of surgery. The average age at diagnosis of 88 patients with JIS was 8.4 ± 1.4 years, with a female to male ratio of approximately 8:1. Pretreatment, Risser score was zero for 80 patients (91%); 72 (92%) of the females were premenarche; and primary Cobb angles ranged from 20° to 71°. Of the 88 patients, 60 (68%) had used a thoracolumbosacral orthosis exclusively; 28 (32%) patients used "other braces" (Milwaukee, Charleston, or a combination of braces), with an average treatment duration of 3.6 ± 1.9 years.As per Scoliosis Research Society definitions, a "non-curve-progression" (≤5° change) group consisted of 25 (28%) patients; and a "curve-progression" group consisted of 63 (72%) patients where the curve had progressed 6° or more.Of the 88 patients, 44 (50%) underwent surgery. The operative rate was higher for patients with curves 30° or more than those with curves 20° to 29° prior to brace treatment (37/58 [64%] vs. 7/30 [23%], respectively; P = 0.001); other braces compared with thoracolumbosacral orthosis (19/28 [68%] vs. 25/60 [42%], respectively; P = 0.02); Lenke I and III curves compared with Lenke VI curves (33/54 [61%] vs. 2/14 [14%], respectively; P = 0.007).

Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow

PubMed Central

Struijs, P A A; Bos, I B C Korthals‐de; van Tulder, M W; van Dijk, C N; Bouter, L M

2006-01-01

Background The annual incidence of tennis elbow in the general population is high (1–3%). Tennis elbow often leads to limitation of activities of daily living and work absenteeism. Physiotherapy and braces are the most common treatments. Objectives The hypothesis of the trial was that no difference exists in the cost effectiveness of physiotherapy, braces, and a combination of the two for treatment of tennis elbow. Methods The trial was designed as a randomised controlled trial with intention to treat analysis. A total of 180 patients with tennis elbow were randomised to brace only (n  =  68), physiotherapy (n  =  56), or a combination of the two (n  =  56). Outcome measures were success rate, severity of complaints, pain, functional disability, and quality of life. Follow up was at six, 26, and 52 weeks. Direct healthcare and non‐healthcare costs and indirect costs were measured. Mean cost differences over 12 months were evaluated by applying non‐parametric bootstrap techniques. Results No clinically relevant or statistically significant differences were found between the groups. Success rate at 12 months was 89% in the physiotherapy group, 86% in the brace group, and 87% in the combination group. Mean total costs per patient were €2069 in the brace only group, €978 in the physiotherapy group, and €1256 in the combination group. The mean difference in total costs between the physiotherapy and brace group was substantial (€1005), although not significant. Cost effectiveness ratios and cost utility ratios showed physiotherapy to be the most cost effective, although this also was not statistically significant. Conclusion No clinically relevant or statistically significant differences in costs were identified between the three strategies. PMID:16687482

Rehabilitation device with variable resistance and intelligent control

PubMed Central

Dong, Shufang; Lu, Ke-Qian; Sun, J.Q.; Rudolph, Katherine

2008-01-01

Resistance exercise has been widely reported to have positive rehabilitation effects for patients with neuromuscular and orthopaedic conditions. This paper presents an optimal design of magneto-rheological fluid dampers for variable resistance exercise device in the form of a knee brace. An intelligent supervisory control for regulating the resistive force or torque of the knee brace has also been studied. The device provides both isometric and isokinetic strength training for the knee. PMID:15694609

Determination of brace forces caused by construction loads and wind loads during bridge construction.

DOT National Transportation Integrated Search

2014-04-01

The first objective of this study was to develop procedures for determining bracing forces during bridge construction. : Numerical finite element models and analysis techniques were developed for evaluating brace forces induced by construction loads ...

Acute influence of restricted ankle dorsiflexion angle on knee joint mechanics during gait.

PubMed

Ota, S; Ueda, M; Aimoto, K; Suzuki, Y; Sigward, S M

2014-06-01

Restrictions in range of ankle dorsiflexion (DF) motion can persist following ankle injuries. Ankle DF is necessary during terminal stance of gait, and its restricted range may affect knee joint kinematics and kinetics. The purpose of this study was to investigate the acute influence of varied levels of restricted ankle DF on knee joint sagittal and frontal plane kinematics and kinetics during gait. Thirty healthy volunteers walked with a custom-designed ankle brace that restricted ankle DF. Kinematics and kinetics were collected using a 7-camera motion analysis system and two force plates. Ankle dorsiflexion was restricted in 10-degree increments, allowing for four conditions: Free, light (LR), moderate (MR) and severe restriction (SR). Knee angles and moments were measured during terminal stance. Real peak ankle DF for Free, LR, MR, and SR were 13.7±4.8°, 11.6±5.0°, 7.5±5.3°, and 4.2±7.2°, respectively. Peak knee extension angles under the same conditions were -6.7±6.7°, -5.4±6.4°, -2.5±7.5°, and 0.6±7.8°, respectively, and the peak knee varus moment was 0.48±0.17 Nm/kg, 0.47±0.17 Nm/kg, 0.53±0.20 Nm/kg, and 0.57±0.20 Nm/kg. The knee varus moment was significantly increased from MR condition with an 8-degree restriction in ankle DF. Knee joint kinematics and kinetics in the sagittal and frontal planes were affected by reduced ankle DF during terminal stance of gait. Differences were observed with restriction in ankle DF range of approximately 8°. level III. Copyright © 2014 Elsevier B.V. All rights reserved.

Forces exerted during exercises by patients with adolescent idiopathic scoliosis wearing fiberglass braces

PubMed Central

Romano, Michele; Carabalona, Roberta; Petrilli, Silvia; Sibilla, Paolo; Negrini, Stefano

2006-01-01

Objective To quantify and compare the forces exerted by scoliosis patients in fiberglass braces during exercises usually prescribed in departments where casts are made. The exercises are intended to increase corrective forces, activate muscles, stimulate ventilation and help the patient psychologically. Setting Outpatient care. Patients 17 consecutive adolescent patients wearing fiberglass brace for idiopathic scoliosis. Interventions Exercises (kyphotization, rotation, "escape from the pad") in different positions (sitting, supine, on all fours). Main outcome measure Pressure detected by the F-Socket System between the rib hump and the pad of the brace. Results In static and dynamic conditions, the position adopted did not alter the total pressure exerted by the brace, although the part of the sensor stimulated did vary. Kyphotization and rotation exercises produced a significant increase of pressure (+ 58.9% and +29.8%, respectively); however, the "escape from the pad" exercise, despite its name, did not produce any significant variation of pressure. Conclusion Exercises in the brace allow adjunctive forces to be applied on soft tissues and through them, presumably on the spine. Different exercises can be chosen to obtain different actions. Physical exercises and sporting activities are useful in mechanical terms, although other important actions should not be overlooked. PMID:16859544

Light Steel-Timber Frame with Composite and Plaster Bracing Panels

PubMed Central

Scotta, Roberto; Trutalli, Davide; Fiorin, Laura; Pozza, Luca; Marchi, Luca; De Stefani, Lorenzo

2015-01-01

The proposed light-frame structure comprises steel columns for vertical loads and an innovative bracing system to efficiently resist seismic actions. This seismic force resisting system consists of a light timber frame braced with an Oriented Strand Board (OSB) sheet and an external technoprene plaster-infilled slab. Steel brackets are used as foundation and floor connections. Experimental cyclic-loading tests were conduced to study the seismic response of two shear-wall specimens. A numerical model was calibrated on experimental results and the dynamic non-linear behavior of a case-study building was assessed. Numerical results were then used to estimate the proper behavior factor value, according to European seismic codes. Obtained results demonstrate that this innovative system is suitable for the use in seismic-prone areas thanks to the high ductility and dissipative capacity achieved by the bracing system. This favorable behavior is mainly due to the fasteners and materials used and to the correct application of the capacity design approach. PMID:28793642

Light Steel-Timber Frame with Composite and Plaster Bracing Panels.

PubMed

Scotta, Roberto; Trutalli, Davide; Fiorin, Laura; Pozza, Luca; Marchi, Luca; De Stefani, Lorenzo

2015-11-03

The proposed light-frame structure comprises steel columns for vertical loads and an innovative bracing system to efficiently resist seismic actions. This seismic force resisting system consists of a light timber frame braced with an Oriented Strand Board (OSB) sheet and an external technoprene plaster-infilled slab. Steel brackets are used as foundation and floor connections. Experimental cyclic-loading tests were conduced to study the seismic response of two shear-wall specimens. A numerical model was calibrated on experimental results and the dynamic non-linear behavior of a case-study building was assessed. Numerical results were then used to estimate the proper behavior factor value, according to European seismic codes. Obtained results demonstrate that this innovative system is suitable for the use in seismic-prone areas thanks to the high ductility and dissipative capacity achieved by the bracing system. This favorable behavior is mainly due to the fasteners and materials used and to the correct application of the capacity design approach.

An Experimental Investigation on the Ultimate Strength of Partially Infilled: Braced Steel Frames

NASA Astrophysics Data System (ADS)

Dubey, Shailendra Kumar Damodar; Kute, Sunil Y.

2017-12-01

Infilled walls are usually, considered as non-structural elements. However, these walls are effective in carrying lateral loads. In this regard, an experimental investigation was planned and conducted to study the effect of braced and partially infilled steel frames with cement mortar and concrete in comparison to the bare frames. All these frames were tested up to collapse and subjected only to horizontal loads to obtain an effective and possible solution for soft storey which are generally not infilled. In comparison to bare steel frames, partially infilled frames have an increase of lateral load capacity by 45-60%. Central bracing is more effective than that of the corner bracing. For the same load partially infilled frames have significantly less deflection than that of the bare frames. A reduced load factor is suggested for the design of soft storey columns with the partial infills. A mathematical model has been proposed to calculate the theoretical ultimate load for the braced, cement mortar and concrete partial infilled frames.

Restriction of foot supination by ankle braces in sudden fall situations.

PubMed

Podzielny, S; Hennig, E M

1997-06-01

OBJECTIVE: To investigate the restriction of foot supination in different shoe orthotic combinations for unexpected ankle turns. DESIGN: A supination platform was used to experimentally induce sudden ankle turns. BACKGROUND: This study expanded on previous investigations of the effectiveness of different ankle braces and the influence of shoe material on foot supination. METHODS: For 21 male subjects pressure distribution data, achilles tendon angle, and supination velocity were collected. A comparison between a shoe with cut upper material and an intact shoe was done to show the influence of upper material on supination. The effectiveness of four different orthotics inside of an intact shoe were tested in comparison to the same shoe without ankle brace. Additionally, subjects rated their perceived supination movement of the foot. RESULTS: Between experimental conditions no large differences for the pressure distribution patterns were found. Three of the ankle braces reduced foot supination as well as supination velocities. More than two times lower supination values were measured for a footwear condition in which the upper material was cut away. Already during the free-fall most ankle braces caused a substantial reduction of foot inversion. CONCLUSION: The experiments demonstrated the influence of the upper material of a shoe and different orthotics on foot supination. Biomechanical measurements are necessary because of limited capabilities of subjects in detecting subtalar angular motions. RELEVANCE: This study investigated the effectiveness of different shoe conditions and ankle braces under experimental conditions that simulated unexpected ankle turns, the most frequent causes of sport injuries. The results of the study provide insights into which factors influence the amount of foot supination during unexpected ankle turns.

20. WEB / DECK / LATERAL BRACING DETAIL OF THROUGH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. WEB / DECK / LATERAL BRACING DETAIL OF THROUGH TRUSSES. VIEW TO WEST. - Abraham Lincoln Memorial Bridge, Spanning Missouri River on Highway 30 between Nebraska & Iowa, Blair, Washington County, NE

Treatment of the idiopathic scoliosis with brace and physiotherapy.

PubMed

Hundozi-Hysenaj, Hajrije; Dallku, Iliriana Boshnjaku; Murtezani, Ardiana; Rrecaj, Shkurte

2009-01-01

Scoliosis is a three-dimensional deformation of the spine with a lateral curvature or deviation greater than 10 degrees and associated with vertebral rotation. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their effectiveness is still questioned. The objective of this study was to define the effectiveness of braces and individual physiotherapy for the comprehensive treatment of idiopathic scoliosis in adolescents. A retrospective study of 57 children with idiopathic thoracic dextroscoliosis with the magnitude of the thoracic curve between 20 degrees-35 degrees, treated in Orthopedic and Physiatrist Clinic as well as National Ortho-prosthetic Center within University Clinical Center of Kosova in Prishtina, during the period of 2003-2006. Inclusion of kinesitherapy in the comprehensive management of idiopathic scoliosis varied in the improvement of the muscle strength (satisfied and moderate) in almost 80% of the children while the correction of the curve was small in approximately 42.1% of cases. For children with idiopathic scoliosis, who require braces, an exercise program helps chest mobility, muscle strength, proper breathing flexibility in the spine, correct posture and keeps muscles in tone so that the transition period after brace removal is easier.

[Influence of Ankle Braces on the Prevalence of Ankle Inversion Injuries in the Swiss Volleyball National League A].

PubMed

Jaggi, J; Kneubühler, S; Rogan, S

2016-06-01

Ankle inversion is a common injury among volleyball players. The injury rate during a game is 2.1 times higher than during training. As a result, the preventive use of ankle braces is frequently observed in Swiss volleyball leagues. Studies have shown that ankle braces have a preventive effect on the prevalence of ankle inversion. In Switzerland there has been no investigation into the preventive use of braces and their influence on prevalence. For this reason, the goals of this study are 1) to determine when, why and by whom ankle braces are worn and 2) to evaluate the injury rate of users and non-users of ankle braces. A modified questionnaire was sent to 18 men's and women's teams of the Swiss National League A. The questionnaire included questions about injury rates and the circumstances of ankle inversion injuries. The data were statistically analysed with Microsoft Excel 2012 and SPSS Version 20. The overall response rate was 61 %, allowing data from 181 players to be analysed. 33 % (59 of 181) of the players used an ankle brace. There was a statistically significant difference in the prevalence of ankle inversion between users (12 injured) and non-users (8 injured) (p = 0.006). Wearing an ankle brace during training or during a game made no difference in the prevention of injuries (p = 0.356). More athletes were injured during training (n = 13) than during a game (n = 7). The results of the present study indicate that volleyball players preferably wear ankle braces to prevent injury. More than one third of the players in the study wore an ankle brace, 60 % for primary prevention and 40 % for secondary prevention due to a previous injury. The study shows that significantly more users than non-users of ankle braces were injured. This is contrary to literature. Furthermore it was shown that more injuries occur during training than during a game. This finding results from the fact that ankle braces were rarely worn during training. It is

A Review of Influence of Various Types of Structural Bracing to the Structural Performance of Buildings

NASA Astrophysics Data System (ADS)

Razak, S. M.; Kong, T. C.; Zainol, N. Z.; Adnan, A.; Azimi, M.

2018-03-01

Excessive lateral drift can contribute significantly towards crack formation, leading to structural damage. The structural damage will in turn reduce the capacity of the structure and weaken it from the intended design capacity. Generally, lateral drift is more pronounced in higher and longer structure, such as high rise buildings and bridges. A typical method employed to control lateral drift is structural bracing, which works by increasing stiffness and stability of structure. This paper reviews the influence of various types of structural bracing to structural performance of buildings. The history of structural bracing is visited and the differences between numerous structural bracing in term of suitability to different types of buildings and loading, mechanisms, technical details, advantages and limitations, and the overall effect on the structural behaviour and performance are dissected. Proper and efficient structural bracing is pertinent for each high rise building as this will lead towards safer, sustainable and more economical buildings, which are cheaper to maintain throughout the life of the buildings in the future.

Knee arthrodesis with the Sheffield external ring fixator: fusion in 6 of 10 consecutive patients.

PubMed

Ulstrup, Anton K; Folkmar, Klaus; Broeng, Leif

2007-06-01

Knee arthrodesis with external fixation (XF) is a possible salvage procedure for infected total knee arthroplasties (TKA). We report the outcome in 10 patients who underwent arthrodesis with the Sheffield Ring Fixator. The patients had primary arthrosis in 8 cases; 2 cases were due to rheumatoid arthritis and sclerodermia. The mean time between the primary TKA and arthrodesis was 6 (0.5-14) years. The average age at arthrodesis was 69 years. The average follow-up period was 10 months. Stable fusion was obtained in 6 patients after a mean XF time of 3.6 (2-4) months. 1 patient was referred to another hospital because of nonunion. This patient showed fusion with intramedullary nailing after 7 months. 3 nonunion patients required permanent bracing. 7 patients had pin tract infections. Infections healed in all patients. The Sheffield Ring Fixator gives an acceptable fusion rate for arthrodesis in the infected TKA, with limited complications.

Synthesis, characterization, and fluorescent properties of two Pb(II) complexes: {l_brace}[Pb(hca){sub 2}.DMF].DMF{r_brace} {sub {infinity}} and [Pb(hca){sub 2}(phen).DMF]{sub 2}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu Qingfeng; Zhou Qiuxuan; Lu Jianmei

2007-01-15

Two novel Pb(II) complexes, {l_brace}[Pb(hca){sub 2}.DMF].DMF{r_brace} {sub {infinity}} and [Pb(hca){sub 2}(phen).DMF]{sub 2} (hca=trans-4-hydroxycinnamic group), were obtained by solid-phase reactions of PbAc{sub 2} and Hhca and PbAc{sub 2}, Hhca, and phen, respectively, and characterized by spectroscopy. X-ray crystallography analysis reveals that complex 1, {l_brace}[Pb(hca){sub 2}.DMF].DMF{r_brace} {sub {infinity}} , adopts a 2-dimensional structure through the weak interactions of Pb and O atoms and that complex 2, [Pb(hca){sub 2}(phen).DMF]{sub 2}, shows a discrete dimeric structure, in which hydrogen bonds link the dimers into a 2D network. Both complexes 1 and 2 show visible fluorescence and the intensity is stronger than that of themore » ligand. More interestingly, the intensity of emission was increased at least fivefolds when the pH of the solution was adjusted to alkalinity. This can be attributed to that the deprotonization of phenolic group enhancing the conjugation of the ligand hca. These results indicate that this method may be an effective way to increase the emission intensity of similar complexes. - Graphical abstract: Two novel Pb(II) complexes: {l_brace}[Pb(hca){sub 2}.DMF].DMF{r_brace}{sub {infinity}} and [Pb(hca){sub 2}(phen).DMF]{sub 2}, (hca = trans-4-hydroxycinnamic anion) were obtained and characterized. Their structures are also determined by X-ray crystal analysis. Both of complexes in DMF solution show visible fluorescence and the intensity is stronger than that of ligand. Their emission intensities are increased greatly in an alkaline solution of pH 8, which is due to the enhancement of the planar conjugation of ligand hca with the deprotonate of the phenolic group.« less

The effect of ankle bracing on lower extremity biomechanics during landing: A systematic review.

PubMed

Mason-Mackay, A R; Whatman, C; Reid, D

2016-07-01

To examine the evidence for effect of ankle bracing on lower-extremity landing biomechanics. Literature review. Systematic search of the literature on EBSCO health databases. Articles critiqued by two reviewers. Ten studies were identified which investigated the effect of ankle bracing on landing biomechanics. Overall results suggest that landing biomechanics are altered with some brace types but studies disagree as to the particular variables affected. There is evidence that ankle bracing may alter lower-extremity landing biomechanics in a manner which predisposes athletes to injury. The focus of studies on specific biomechanical variables rather than biomechanical patterns, analysis of pooled data means in the presence of differing landing styles between participants, variation in landing-tasks investigated in different studies, and lack of studies investigating goal-directed sport-specific landing tasks creates difficulty in interpreting results. These areas require further research. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The Effects of a Functional Elbow Brace on Medial Joint Stability: A Case Study

PubMed Central

Pincivero, Danny M.; Rijke, Arie M.; Heinrichs, Kristinn; Perrin, David H.

1994-01-01

Medical elbow ligament sprains in athletics can be traumatic and disabling. In this case report, we outline the effect of a prototype functional elbow brace on joint stability in a female collegiate javelin thrower with an ulnar collateral ligament sprain. A valgus force to both elbows was applied using graded stress radiography (Telos GA-II/E stress device) at 0, 5, 10, and 15 kiloPascals (kPa) of pressure. The increase in gap width between the coronoid process and the medial epicondyle was measured from anteroposterior radiographs to determine medial displacement. The brace resulted in less displacement in both injured and noninjured ulnar collateral ligament; injured ulnar collateral ligament demonstrated greater displacement regardless of condition. The brace restored medial stability to the elbow joint by 49%, 38%, and 35% at 5, 10, and 15 kPa of pressure, respectively. The application of the brace may be useful in athletes with ulnar collateral ligament injuries. ImagesFig 1Fig 2 PMID:16558285

Extended application of WISH type S-form hip brace for patients with bilateral painful hip osteoarthritis: report of two cases.

PubMed

Sato, Takahisa; Yamaji, Takehiko; Inose, Hideyuki; Sato, Ena; Yoshikawa, Ayako; Usuda, Shigeru; Watanabe, Hideomi

2009-06-01

Dynamic lateral instability of the femoral head develops in patients with osteoarthritis (OA) of the hip. Recently we have developed a hip brace, called the WISH-type hip brace, and showed successful response of the patients quantitatively. However, a negligible effect was observed in patients with bilateral involvement. Here, we extended the application of the WISH-type hip brace for two patients with bilateral OA joints. The resultant WISH-type hip brace with two S-form portions for bilateral thighs provided good recovery in hip function. Interestingly Timed Up & Go (TUG) test performed for one patient revealed a positive effect of the brace on the functional mobility. To the best of our knowledge, this is the first report elucidating the therapeutic effect of brace therapy with bilateral hip stabilization from hip functional and functional mobility points of view. Application of the present brace should be taken into account for patients with painful bilateral hip OA before easy application of invasive surgery such as total hip arthroplasty.

Risk factors for renal dysfunction after total knee joint replacement.

PubMed

Hassan, Basim K; Sahlström, Arne; Dessau, Ram B

2015-12-01

Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total knee joint replacement. A retrospective study was conducted among 702 consecutive primary knee joint replacements performed between January 2009 and December 2012 in our department. Increased postoperative serum creatinine was considered indicative of postoperative renal injury according to RIFLE criteria. Sixty three patients (9.7%) had significant moderate or severe postoperative renal dysfunction in which 8 patients (1.2%) ended with severe and permanent renal impairment. Advanced age, low intraoperative blood pressure, hypertension, general anaesthesia, and prophylactic dicloxacillin were identified as significant risk factors. Male gender and BMI were independent risk factors for postoperative increase in serum creatinine. Smoking, female gender, diabetes mellitus and duration of surgery were not identified as significant risk factors.

Reduction of the severity of canine osteoarthritis by prophylactic treatment with oral doxycycline.

PubMed

Yu, L P; Smith, G N; Brandt, K D; Myers, S L; O'Connor, B L; Brandt, D A

1992-10-01

In vitro studies have indicated that levels of neutral metalloproteinases in osteoarthritic (OA) cartilage are elevated and that doxycycline (doxy) inhibits collagenolytic and gelatinolytic activity in extracts of OA cartilage. The purpose of the present study was to test the effect of oral doxy administration on the severity of cartilage degeneration in OA. OA was induced in 12 adult mongrel dogs by transection of the anterior cruciate ligament (ACL) 2 weeks after dorsal root ganglionectomy. Six dogs received doxy orally from the day after ACL transection until they were killed 8 weeks later; the other 6 served as untreated OA controls. The unstable knee of each untreated dog exhibited extensive full-thickness cartilage ulceration of the medial femoral condyle. In sharp contrast, cartilage on the distal aspect of the femoral condyle of the unstable knee was grossly normal in 2 doxy-treated dogs, and exhibited only thinning and/or surface irregularity in the others. Degenerative cartilage lesions on the medial trochlear ridge, superficial fibrillation of the medial tibial plateau, and osteophytosis were, however, unaffected by doxy treatment. Collagenolytic activity and gelatinolytic activity in cartilage extracts from OA knees of untreated dogs were 5-fold and 4-fold greater, respectively, than in extracts from dogs given doxy. Prophylactic administration of doxy markedly reduced the severity of OA in weight-bearing regions of the medial femoral condyle. It remains to be determined whether administration of doxy after OA changes have developed is also effective.

The SPoRT (Symmetric, Patient-oriented, Rigid, Three-dimensional, active) concept for scoliosis bracing: principles and results.

PubMed

Atanasio, Salvatore; Zaina, Fabio; Negrini, Stefano

2008-01-01

The biomechanical action of an orthesis for the conservative treatment of AIS has two goals: correction and stabilization. These goals have been pursued through very well established principles of correction, developed over the years, divided in terms of efficacy (the correct positioning of pushes, as well as through escape ways and proper drivers of the forces and stops) and acceptability (compliance, perfect body design, maximal freedom in the ADL). To achieve all these goals, the Sforzesco brace has been developed through progressive changes and verification. Finally, we discovered we had something new, and summarised it in the SPoRT acronym: Symmetric, Patient-oriented, Rigid, Three-dimensional, active. The SPoRT concept always requires a customised construction of the brace according to the patient's individual requirements. It's possible to apply CAD-CAM technologies, which usually allow us to obtain the best results in this case, but without using pre-built forms stored in databases, as is usually done. Once done, a final test must be made on the patient so as to change the first theoretical project and adapt it in the best possible way, depending on the real interaction between the body and the brace. The results that are today available on the SPoRT concept relate to the Sforzesco brace and necessarily are short-term, because the first treated patients are now reaching the third-year follow-up examination and haven't yet completed their treatments. According to first studies we can state that: tte Sforzesco brace is more effective than the Lyon brace after six months of treatment; the Sforzesco brace is equally effective as Risser Plast brace.

The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players

PubMed Central

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Takei, Keiichi; Yamamoto, Mitsuru

2017-01-01

Background: Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. Hypothesis/Purpose: The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. Study Design: Controlled laboratory study. Methods: Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. Results: In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching (P < .01). In contrast, in the elbow brace condition, ulnohumeral joint space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches (P < .01). Conclusion: An elbow brace has the effect of preventing medial elbow joint space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. Clinical Relevance: An elbow brace worn during baseball pitching practice may help reduce mechanical stress

The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players.

PubMed

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Takei, Keiichi; Yamamoto, Mitsuru

2017-04-01

Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. Controlled laboratory study. Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching ( P < .01). In contrast, in the elbow brace condition, ulnohumeral joint space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches ( P < .01). An elbow brace has the effect of preventing medial elbow joint space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. An elbow brace worn during baseball pitching practice may help reduce mechanical stress on the elbow by reducing medial elbow joint space gapping.

Cognitive strategies and self-esteem as predictors of brace-wear noncompliance in patients with idiopathic scoliosis and kyphosis.

PubMed

Lindeman, M; Behm, K

1999-01-01

Psychological determinants of brace-wear compliance were analyzed among 113 patients who used a brace because of an adolescent idiopathic scoliosis (92%), kyphosis (5%), or both (3%). The results showed that noncompliant girls did not expect to succeed in dealing with scoliosis and that they were anxious about the possibility of failure. They also had low self-esteem and did not seek social support from other people. Noncompliant boys, in contrast, had high self-esteem and high achievement success expectation. Among patients with a short time of brace use, low compliance was best predicted by low amount of reflective thinking and a good body-image. In turn, among patients who had used the brace for >6 months, low compliance was best predicted by high amount of reflective thinking, poor body-image, low social success expectation, and low master orientation in social behavior. Only sleeping problems predicted compliance across gender and the time of brace use: the more the patients experienced sleeping problems, the less they used the brace.

Parachute Ankle Brace Effectiveness Evaluation

DTIC Science & Technology

2010-05-01

increase in the risk of other injuries (2, 7, 11). There were no differences in risk of ankle injury comparing periods when brace use was not...2006. The exclusions based on age and missing data were thought to represent coding errors . (Figure 2.1) 5 Figure 2.1 PAS Extens ion Project...similar to the referent (data not shown). Rate ratios were similar after adjustment for age at start of training, rank, duration of service, ankle

A clinical study of the biomechanics of step descent using different treatment modalities for patellofemoral pain.

PubMed

Selfe, James; Thewlis, Dominic; Hill, Stephen; Whitaker, Jonathan; Sutton, Chris; Richards, Jim

2011-05-01

In the previous study we have demonstrated that in healthy subjects significant changes in coronal and transverse plane mechanics can be produced by the application of a neutral patella taping technique and a patellar brace. Recently it has also been identified that patients with patellofemoral pain syndrome (PFPS) display alterations in gait in the coronal and transverse planes. This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee of patellofemoral pain patients during a step descent task. Thirteen patients diagnosed with patellofemoral pain syndrome performed a slow step descent. This was conducted under three randomized conditions: (a) no intervention, (b) neutral patella taping, (c) patellofemoral bracing. A 20cm step was constructed to accommodate an AMTI force platform. Kinematic data were collected using a ten camera infra-red Oqus motion analysis system. Reflective markers were placed on the foot, shank and thigh using the Calibrated Anatomical System Technique (CAST). The coronal plane knee range of motion was significantly reduced with taping (P=0.031) and bracing (P=0.005). The transverse plane showed a significant reduction in the knee range of motion with the brace compared to taping (P=0.032) and no treatment (P=0.046). Patients suffering from patellofemoral pain syndrome demonstrated improved coronal plane and torsional control of the knee during slow step descent following the application of bracing and taping. This study further reinforces the view that coronal and transverse plane mechanics should not be overlooked when studying patellofemoral pain. Copyright © 2011 Elsevier B.V. All rights reserved.

Which one Enhances Muscular Performance in ACL Reconstructed Subjects

PubMed Central

Harput, Gulcan; Ulusoy, Burak; Atay, Ahmet Ozgur; Baltacı, Gul

2014-01-01

Objectives: The aim of this study was to investigate the effects of functional knee brace and kinesiotaping on muscular performance in anterior cruciate ligament reconstructed subjects who reached return to sport phase of the rehabilitation. Methods: Twenty (17 males, 3 females, Age: 24.7±7.1 years, Body weight: 74.4±12.0 kg, Height: 177.9±6.5 cm, BMI: 23.9±3.6 kg/m2) subjects who underwent anterior cruciate ligament reconstruction by using hamstring tendon auto graft were included in this study. When the subjects reached the return to sports phase of rehabilitation which was 6th months after surgery, knee muscle strength, jump performance and balance tests were performed 3 times: bare, with knee brace and with kinesio taping. The order of the tests were randomized to eliminate the effects of fatigue and motor learning. Quadriceps and hamstring muscle strength was measured on an isokinetic dynamometer at 180 °/s and 60°/s angular velocities. Vertical Jump (VJ) and One Leg Hop Tests (OLHT) were used to assess jump performance. Star Excursion Balance Test (SEBT) with anterior, posteromedial and posterolateral reach distance was used to assess the dynamic balance. When all tests were performed, the subjects were asked under which test condition they felt more confident. Repeated measures of ANOVA was used to analyze the difference among three test conditions (bare, kinesiotaping, knee brace). Bonferroni post hoc test was used for pairwise comparison. Results: SEBT posteromedial (PM)and posterolateral (PL) reach distances were found significantly different among three test conditions(PM: F(2,38)=3.42,p=0.04), PL: F(2,38)=4.37,p=0.02). Kinesiotaping increased posteromedial reach distance (p=0.03). On the other hand, brace decreased posterolateral reach distance (p=0.04). VJ and OLHT performance were also found significantly different between three test conditions (VJ: F (2,38)=3.44,p=0.04, OLHT: (F(2,38)=4.04,p=0.02). Kinesio taping increased one leg hop distance

Associations of Varus Thrust and Alignment with Pain in Knee Osteoarthritis

PubMed Central

Lo, Grace H.; Harvey, William F.; McAlindon, Timothy E.

2012-01-01

Objective To compare associations of varus thrust and varus static alignment with pain in those with knee osteoarthritis (OA). Method This was a cross-sectional study of participants from a randomized controlled trial of vitamin D for knee OA. Participants were video recorded walking and scored for presence of varus thrust. Standard PA knee X-rays were measured for static alignment. Pain questions from the Western Ontario McMasters Osteoarthritis (WOMAC) questionnaire assessed symptoms. We calculated means for total WOMAC pain by varus thrust and varus alignment (i.e. corrected anatomic alignment < 178°). We performed ordinal logistic regressions; outcomes: individual WOMAC pain questions; predictors: varus thrust and varus alignment. Results There were 82 participants, mean age 65.1 (±8.5), mean body mass index 30.2 (±5.4), and 60% female. Total WOMAC pain was 6.3 versus 3.9, p = 0.007 in those with versus without definite varus thrust. For varus alignment, total WOMAC pain was 5.2 versus 4.2, p = 0.30. Odds ratios for pain with walking and standing were 5.5 (95%CI 2.0 – 15.1) and 6.0 (95%CI 2.2 – 16.2) in those with versus without definite varus thrust. There were no significant associations between varus alignment and individual WOMAC pain questions. Sensitivity analyses suggested a more stringent definition of varus might have been associated with walking and standing pain. Conclusion In those with knee OA, varus thrust and possibly varus static alignment, were associated with pain, specifically during weight-bearing activities. Treatment of varus thrust (e.g. via bracing or gait modification) may lead to improvement of symptoms. PMID:22307813

The effects of a semi-rigid ankle brace on a simulated isolated subtalar joint instability.

PubMed

Choisne, Julie; Hoch, Matthew C; Bawab, Sebastian; Alexander, Ian; Ringleb, Stacie I

2013-12-01

Subtalar joint instability is hypothesized to occur after injuries to the calcaneofibular ligament (CFL) in isolation or in combination with the cervical and the talocalcaneal interosseous ligaments. A common treatment for hindfoot instability is the application of an ankle brace. However, the ability of an ankle brace to promote subtalar joint stability is not well established. We assessed the kinematics of the subtalar joint, ankle, and hindfoot in the presence of isolated subtalar instability, investigated the effect of bracing in a CFL deficient foot and with a total rupture of the intrinsic ligaments, and evaluated how maximum inversion range of motion is affected by the position of the ankle in the sagittal plane. Kinematics from nine cadaveric feet were collected with the foot placed in neutral, dorsiflexion, and plantar flexion. Motion was applied with and without a brace on an intact foot and after sequentially sectioning the CFL and the intrinsic ligaments. Isolated CFL sectioning increased ankle joint inversion, while sectioning the CFL and intrinsic ligaments affected subtalar joint stability. The brace limited inversion at the subtalar and ankle joints. Additionally, examining the foot in dorsiflexion reduced ankle and subtalar joint motion. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

[Prophylactic antibiotic treatment of neutropenic patients].

PubMed

Telekes, András; Hegedüs, Márta

2004-07-11

There is no special signs of neutropenia therefore it is usually diagnosed due to an acute infection or laboratory control. Infections acquired during chemotherapy induced myelosuppression may further deteriorate the neutropenia in cancer patients. There are many possible cause of fever in cancer patients but in case of neutropenia infection is the most likely reason. If febrile neutropenia occurs immediately broad spectrum intravenous antibiotic treatment should be initiated. Recently introduced aggressive chemotherapy protocols further increased the number of neutropenic patients. Therefore it would be important to prevent febrile neutropenia. Unfortunately the available data still insufficient to make any conclusions regarding the efficacy of short or long term prophylactic treatment. While there are generally accepted recommendations of empiric antibiotic therapy no such options are available regarding prophylactic treatments. The decision regarding prophylactic treatment (similarly to empiric therapy) should be based on the resistance of the dominant pathogens in a therapeutic unit. Several study had been conducted regarding prophylactic administration of antibiotics the results however contradictory. Considering the advantages and disadvantages, the prophylactic antibiotic treatment of neutropenic patients could be suggested only in certain cases.

Prophylactic antibiotics and anticonvulsants in neurosurgery.

PubMed

Ratilal, B; Sampaio, C

2011-01-01

The prophylactic administration of antibiotics to prevent infection and the prophylactic administration of anticonvulsants to prevent first seizure episodes are common practice in neurosurgery. If prophylactic medication therapy is not indicated, the patient not only incurs the discomfort and the inconvenience resulting from drug treatment but is also unnecessarily exposed to adverse drug reactions, and incurs extra costs. The main situations in which prophylactic anticonvulsants and antibiotics are used are described and those situations we found controversial in the literature and lack further investigation are identified: anticonvulsants for preventing seizures in patients with chronic subdural hematomas, antiepileptic drugs for preventing seizures in those suffering from brain tumors, antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures, and antibiotic prophylaxis for the surgical introduction of intracranial ventricular shunts.In the following we present systematic reviews of the literature in accordance with the standard protocol of The Cochrane Collaboration to evaluate the effectiveness of the use of these prophylactic medications in the situations mentioned. Our goal was to efficiently integrate valid information and provide a basis for rational decision-making.

Rehabilitation of adolescent idiopathic scoliosis: results of exercises and bracing from a series of clinical studies. Europa Medicophysica-SIMFER 2007 Award Winner.

PubMed

Negrini, S; Atanasio, S; Zaina, F; Romano, M

2008-06-01

Rehabilitation of adolescent idiopathic scoliosis (AIS) requires a careful choice from among the possible treatments, such as bracing and exercises, according to the patient's needs. According to the literature, there is little evidence regarding the efficacy of these rehabilitation instruments. During the past few years, a full series of studies has been carried out to investigate their efficacy. The aim of this paper was to summarize all these results. Three systematic reviews (two on exercises and one on manual therapy), and four cohort prospective studies were performed. The prospective studies included two trials with a prospective control group on exercises (one to avoid bracing and one in preparation to bracing) and two trials with retrospective control group on a new brace developed by the Authors (Sforzesco brace and SPoRT concept of correction versus Lyon brace and Risser cast). Results show that in literature there is proof of level 1b on exercises but no studies on manual therapy. High quality exercises like Scientific Exercises Approach to Scoliosis (SEAS) have more efficacy than usual physiotherapy, significantly reducing brace prescription in one year from 25% of cases to 6%. Moreover, such exercises help to obtain the best results in bracing first correction. The Sforzesco brace has proved to have more efficacy than the Lyon brace, whereas it has the same efficacy--but reduced side effects and impact on quality of life--than the Risser brace. With an efficient management of data collection, it is possible to develop a set of studies aimed at verifying the efficacy of clinical daily rehabilitation approaches.

Regional Intraosseous Administration of Prophylactic Antibiotics is More Effective Than Systemic Administration in a Mouse Model of TKA.

PubMed

Young, Simon W; Roberts, Tim; Johnson, Sarah; Dalton, James P; Coleman, Brendan; Wiles, Siouxsie

2015-11-01

In human TKA studies, intraosseous regional administration (IORA) of prophylactic antibiotics achieves local tissue antibiotic concentrations 10 times greater than systemic administration. However, it is unclear if such high concentrations provide more effective prophylaxis. We asked: (1) What prophylaxis dosage and route (intravenous [IV] versus IORA of prophylactic antibiotics) produce less in vivo bacterial burden compared with no-antibiotic controls? (2) Compared with controls, what prophylaxis dosage and route yield fewer colony-forming units (CFUs) in euthanized animals in a model of TKA? (3) Is prophylactic IORA of antibiotics more effective than same-dose IV antibiotic administration in reducing CFUs? Mice (six to nine per group) were block randomized to one of six prophylaxis regimens: control, systemic cefazolin (C100IV), IORA of cefazolin (C100IORA), systemic vancomycin (V110IV), low-dose systemic vancomycin (V25IV), and low-dose IORA of vancomycin (V25IORA). Surgery involved placement of an intraarticular knee prosthesis, followed by an inoculum of bioluminescent Staphylococcus aureus strain Xen36. Biophotonic imaging assessed in vivo bacterial loads, and after 4 days bacterial load was quantified using culture-based techniques. Comparisons were made for each prophylactic regimen to controls and between same-dose IV and IORA of prophylactic antibiotic regimens. Mice treated with systemic high-dose vancomycin, IORA of vancomycin, or IORA of cefazolin had lower in vivo Staphylococcus aureus burdens (median area under curve, Control: 5.0 × 10(6); V110IV: 1.5 × 10(6), difference of medians 3.5 × 10(6), p = 0.003; V25IV: 1.94 × 10(6), difference 3.07 × 10(6), p = 0.49; V25IORA: 1.51 × 10(6), difference 3.5 × 10(6), p = 0.0011; C100IORA: 1.55 × 10(6), difference 3.46 × 10(6), p = 0.0016; C100IV: 2.35 × 10(6), difference 2.66 × 10(6), p = 0.23.) Similar findings were seen with culture-based techniques on recovered implants. IORA of prophylactic

Mechanical stability of the subtalar joint after lateral ligament sectioning and ankle brace application: a biomechanical experimental study.

PubMed

Kamiya, Tomoaki; Kura, Hideji; Suzuki, Daisuke; Uchiyama, Eiichi; Fujimiya, Mineko; Yamashita, Toshihiko

2009-12-01

The roles of each ligament supporting the subtalar joint have not been clarified despite several biomechanical studies. The effects of ankle braces on subtalar instability have not been shown. The ankle brace has a partial effect on restricting excessive motion of the subtalar joint. Controlled laboratory study. Ten normal fresh-frozen cadaveric specimens were used. The angular motions of the talus were measured via a magnetic tracking system. The specimens were tested while inversion and eversion forces, as well as internal and external rotation torques, were applied. The calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament were sectioned sequentially, and the roles of each ligament, as well as the stabilizing effects of the ankle brace, were examined. Complete sectioning of the ligaments increased the angle between the talus and calcaneus in the frontal plane to 51.7 degrees + or - 11.8 degrees compared with 35.7 degrees + or - 6.0 degrees in the intact state when inversion force was applied. There was a statistically significant difference in the angles between complete sectioning of the ligaments and after application of the brace (34.1 degrees + or - 7.3 degrees ) when inversion force was applied. On the other hand, significant differences in subtalar rotation were not found between complete sectioning of the ligaments and application of the brace when internal and external rotational torques were applied. The ankle brace limited inversion of the subtalar joint, but it did not restrict motion after application of internal or external rotational torques. In cases of severe ankle sprains involving the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament injuries, application of an ankle brace might be less effective in limiting internal-external rotational instabilities than in cases of inversion instabilities in the subtalar joint. An improvement in the design of the brace is needed to restore

Spondylolysis: returning the athlete to sports participation with brace treatment.

PubMed

d'Hemecourt, Pierre A; Zurakowski, David; Kriemler, Susi; Micheli, Lyle J

2002-06-01

Between 1988 and 1995, 73 adolescent athletes treated with the Boston Overlap Brace for spondylolysis were reviewed to evaluate improvement in pain score and activity level. A favorable clinical outcome was achieved in 80%. Girls and boys who participated in high-risk sports were five times more likely to have an unfavorable clinical outcome than those who participated in low-risk sports (odds ratio = 5, 95% confidence interval = 2.4-7.5, P = .003). In addition, acute onset of pain and hamstring tightness were associated with a worse outcome. Athletes with symptomatic spondylolysis treated with an antilordotic brace can expect improvement in their clinical course and return to sports participation in 4-6 weeks.

A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.

PubMed

Kemler, Ellen; van de Port, Ingrid; Backx, Frank; van Dijk, C Niek

2011-03-01

Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of taping the ankle. The purpose of this review is to evaluate the effectiveness of ankle braces as a treatment for acute ankle sprains compared with other types of functional treatments such as ankle tape and elastic bandages. A computerized literature search was conducted using PubMed, EMBASE, CINAHL and the Cochrane Clinical Trial Register. This review includes randomized controlled trials in English, German and Dutch, published between 1990 and April 2009 that compared ankle braces as a treatment for lateral ankle sprains with other functional treatments. The inclusion criteria for this systematic review were (i) individuals (sports participants as well as non-sports participants) with an acute injury of the ankle (acute ankle sprains); (ii) use of an ankle brace as primary treatment for acute ankle sprains; (iii) control interventions including any other type of functional treatment (e.g. Tubigrip™, elastic wrap or ankle tape); and (iv) one of the following reported outcome measures: re-injuries, symptoms (pain, swelling, instability), functional outcomes and/or time to resumption of sports, daily activities and/or work. Eight studies met all inclusion criteria. Differences in outcome measures, intervention types and patient characteristics precluded pooling of the results, so best evidence syntheses were conducted. A few individual studies reported positive outcomes after treatment with an ankle brace compared with other functional methods, but our best evidence syntheses only demonstrated a better treatment result in terms of functional outcome. Other studies have suggested that ankle brace treatment is a more cost-effective method, so the use of braces after acute

Thermal Behavior of Cylindrical Buckling Restrained Braces at Elevated Temperatures

PubMed Central

Talebi, Elnaz; Tahir, Mahmood Md.; Yasreen, Airil

2014-01-01

The primary focus of this investigation was to analyze sequentially coupled nonlinear thermal stress, using a three-dimensional model. It was meant to shed light on the behavior of Buckling Restraint Brace (BRB) elements with circular cross section, at elevated temperature. Such bracing systems were comprised of a cylindrical steel core encased in a strong concrete-filled steel hollow casing. A debonding agent was rubbed on the core's surface to avoid shear stress transition to the restraining system. The numerical model was verified by the analytical solutions developed by the other researchers. Performance of BRB system under seismic loading at ambient temperature has been well documented. However, its performance in case of fire has yet to be explored. This study showed that the failure of brace may be attributed to material strength reduction and high compressive forces, both due to temperature rise. Furthermore, limiting temperatures in the linear behavior of steel casing and concrete in BRB element for both numerical and analytical simulations were about 196°C and 225°C, respectively. Finally it is concluded that the performance of BRB at elevated temperatures was the same as that seen at room temperature; that is, the steel core yields prior to the restraining system. PMID:24526915

Thermal behavior of cylindrical buckling restrained braces at elevated temperatures.

PubMed

Talebi, Elnaz; Tahir, Mahmood Md; Zahmatkesh, Farshad; Yasreen, Airil; Mirza, Jahangir

2014-01-01

The primary focus of this investigation was to analyze sequentially coupled nonlinear thermal stress, using a three-dimensional model. It was meant to shed light on the behavior of Buckling Restraint Brace (BRB) elements with circular cross section, at elevated temperature. Such bracing systems were comprised of a cylindrical steel core encased in a strong concrete-filled steel hollow casing. A debonding agent was rubbed on the core's surface to avoid shear stress transition to the restraining system. The numerical model was verified by the analytical solutions developed by the other researchers. Performance of BRB system under seismic loading at ambient temperature has been well documented. However, its performance in case of fire has yet to be explored. This study showed that the failure of brace may be attributed to material strength reduction and high compressive forces, both due to temperature rise. Furthermore, limiting temperatures in the linear behavior of steel casing and concrete in BRB element for both numerical and analytical simulations were about 196°C and 225°C, respectively. Finally it is concluded that the performance of BRB at elevated temperatures was the same as that seen at room temperature; that is, the steel core yields prior to the restraining system.

Informed consent for braces.

PubMed

Jharwal, Vikas; Trehan, Mridula; Rathore, Nidhi; Rathee, Pooja; Agarwal, Deepesh; Mathur, Nikunj

2014-05-01

The influence of law on the orthodontic profession has greatly increased in the last few decades. Dental law has emerged today as a full-fedged specialty dealing with a variety of areas, like professional negligence, doctor-patient contracts, consumer protection laws, ethics, general and special health legislations and practice regulatory mechanisms. This article highlights the concept of informed consent which is based on the premise that each individual has a right to make decisions concerning his health, disease and treatment. How to cite this article: Jharwal V, Trehan M, Rathore N, Rathee P, Agarwal D, Mathur N. Informed Consent for Braces. Int J Clin Pediatr Dent 2014;7(2):105-108.

Lifetime Costs of Prophylactic Mastectomies and Reconstruction versus Surveillance.

PubMed

Mattos, David; Gfrerer, Lisa; Reish, Richard G; Hughes, Kevin S; Cetrulo, Curtis; Colwell, Amy S; Winograd, Jonathan M; Yaremchuk, Michael J; Austen, William G; Liao, Eric C

2015-12-01

The past decade has seen an increasing prevalence of prophylactic mastectomy with decreasing ages of patients treated for breast cancer. Data are limited on the fiscal impacts of contralateral prophylactic mastectomy trends, and no study has compared bilateral prophylactic mastectomy with reconstruction to surveillance in high-risk patients. Lifetime third-party payer costs over 30 years were estimated with 2013 Medicare reimbursement rates. Costs were estimated for patients choosing contralateral or bilateral prophylactic mastectomy versus surveillance, with immediate reconstructions using a single-stage implant, tissue expander, or perforator-based free flap approach. Published cancer incidence rates predicted the percentage of surveillance patients that would require mastectomies. Sensitivity analyses were conducted that varied cost growth, discount rate, cancer incidence rate, and other variables. Lifetime costs and present values (3 percent discount rate) were estimated. Lifetime prophylactic mastectomy costs were lower than surveillance costs, $1292 to $1993 lower for contralateral prophylactic mastectomy and $15,668 to $21,342 lower for bilateral prophylactic mastectomy, depending on the reconstruction. Present value estimates were slightly higher for contralateral prophylactic mastectomy over contralateral surveillance but still cost saving for bilateral prophylactic mastectomy compared with bilateral surveillance. Present value estimates are also cost saving for contralateral prophylactic mastectomy when the modeled contralateral breast cancer incidence rate is increased to at least 0.6 percent per year. These findings are consistent with contralateral and bilateral prophylactic mastectomy being cost saving in many scenarios, regardless of the reconstructive option chosen. They suggest that physicians and patients should continue to receive flexibility in deciding how best to proceed clinically in each case.

Seismic rehabilitation of skewed and curved bridges using a new generation of buckling restrained braces : research brief.

DOT National Transportation Integrated Search

2016-12-01

Damage to skewed and curved bridges during strong earthquakes is documented. This project investigates whether such damage could be mitigated by using buckling restrained braces. Nonlinear models show that using buckling restrained braces to mitigate...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cranial drill handpiece (brace). 882.4325 Section 882.4325 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cranial drill handpiece (brace). 882.4325 Section 882.4325 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill...

Detorsion night-time bracing for the treatment of early onset idiopathic scoliosis.

PubMed

Moreau, S; Lonjon, G; Mazda, K; Ilharreborde, B

2014-12-01

Management for early onset scoliosis has recently changed, with the development of new surgical procedures. However, multiple surgeries are often required and high complication rates are still reported. Conservative management remains an alternative, serial casting achieving excellent results in young children. Better compliance and improvement over natural history have been reported with night-time bracing in adolescent idiopathic scoliosis (AIS), but this treatment has never been reported in early onset idiopathic scoliosis (EIOS). All patients treated for progressive EOIS by detorsion night-time bracing (DNB), and meeting the Scoliosis Research Society (SRS) criteria for brace studies were reviewed. Recommendations were given to wear the DNB 8h/night and no restriction was given regarding sports activities. Radiological parameters were compared between referral and latest follow-up. Based on the SRS criteria defined for AIS, a similar classification was used as follows to analyze the course of the curves: success group: patients with a progression of 5° or less; unsuccess group (progression or failure): patients with a progression>5°, patients with curves exceeding 45° at maturity, or who have had recommendation for/undergone surgery, or patients who changed orthopaedic treatment, or who were lost to follow-up. Thirty-three patients were included (21 girls and 12 boys), with a median Cobb angle of 31° (Q1-Q3: 22-40). Age at brace initiation averaged 50months (Q1-Q3: 25-60). Median follow-up was 102-months (Q1-Q3: 63-125). Fifteen patients (45.5%) had reached skeletal maturity at last follow-up. The success rate was 67% (22 patients), with a median Cobb angle reduction of 15° (P<0.001). Four patients stopped DNB due to an important regression. Eleven patients were in the unsuccessful group (33%). Only one had surgery. All patients remained balanced in the frontal plane and normokyphotic. Initial curve magnitude and age at brace initiation appeared to be

54. VIEW SHOWING THE PLACEMENT OF SPIDER WEB BRACING, SHOOFLY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

54. VIEW SHOWING THE PLACEMENT OF SPIDER WEB BRACING, SHOOFLY BRIDGE, January 1935 - Sacramento River Bridge, Spanning Sacramento River at California State Highway 275, Sacramento, Sacramento County, CA

31. Underside of tracks showing columns, concreteencased Ibeams, lateral bracing, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. Underside of tracks showing columns, concrete-encased I-beams, lateral bracing, and ramps. Looking south. - Stillwell Avenue Station, Intersection of Stillwell & Surf Avenues, Brooklyn, Kings County, NY

New rain shed (Building No. 241) interior showing posts, braces, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

New rain shed (Building No. 241) interior showing posts, braces, and roof structure. - Hawaii Volcanoes National Park Water Collection System, Hawaii Volcanoes National Park, Volcano, Hawaii County, HI

Effectiveness of Treatment of Idiopathic Scoliosis by SpineCor Dynamic Bracing with Special Physiotherapy Programme in SpineCor System.

PubMed

Rożek, Karina; Potaczek, Tomasz; Zarzycka, Maja; Lipik, Ewa; Jasiewicz, Barbara

2016-10-28

The SpineCor dynamic brace for the treatment of idiopathic scoliosis is designed to maintain the correct position of the spine and a new movement strategy for 20 hours per day. The SpineCor exercise system intensifies and complements the brace treatment. This study evaluated the effectiveness of a comprehensive treatment of idiopathic scoliosis involving the SpineCor system. The study assessed a group of 40 patients (38 girls and 2 boys) with idiopathic scoliosis treated with the SpineCor brace. The average age at beginning of treatment was 13.1 yrs (10-15). Minimum treatment time was 18 months. 28 participants met the SRS criteria. Angles of the curve before and after bracing based on imaging studies were measured at the beginning and end of the treatment, analyzed and compared. Rehabilitation focused on teaching active corrective movement throughout the brace treatment. A control group was formed of 33 patients, including 21 meeting the SRS criteria, who used the SpineCor dynamic brace but did not participate in the associated exercise programme. Among patients from the exercise group who met the SRS criteria, 25% demonstrated reduced curve angles, 35.7% demonstrated curve progression and 39.3% showed stabilization (no change). Among patients meeting the SRS criteria from the control group, a decrease in curve angle was observed in 14.3% of the patients, curve progression in 57.1% and stabilization in 28.6%. 1. The addition of a dedicated physiotherapy programme to SpineCor dynamic bracing improves the chances of obtaining a positive outcome. 2. It is necessary to further analyse the course of the comprehensive treatment, also with regard to other types of braces and kinesiotherapy programmes.

Engineering Design of Safe Automobile Front Strut Tower Brace with Predetermined Destruction

NASA Astrophysics Data System (ADS)

Mironenko, R. Ye; Balaev, E. Yu; Blednova, Zh M.

2018-03-01

This paper shows the developed design of an automobile front strut tower brace instantly breakable on reaching a predetermined value impact load, which allows the impact load not to be transferred to the opposite strut. An automobile front strut tower brace with the directed destruction V-shaped element using the SolidWorks and SolidWorks Simulations software complex was developed, designed and analyzed. The obtained data were confirmed experimentally. By changing geometric features of the V-shaped element, it is possible to change the impact load value required for its destruction.

A Genetic Test Predicts Providence Brace Success for Adolescent Idiopathic Scoliosis When Failure Is Defined as Progression to >45 Degrees.

PubMed

Bohl, Daniel D; Telles, Connor J; Ruiz, Ferrin K; Badrinath, Raghav; DeLuca, Peter A; Grauer, Jonathan N

2016-04-01

Retrospective cohort. To determine whether a genetic test is associated with successful Providence bracing for adolescent idiopathic scoliosis (AIS). Genetic factors have been defined that predict the risk of progression of AIS in a polygenic fashion. From these data, a commercially available genetic test, ScoliScore, was developed. It is now used in clinical practice for counseling and to guide clinical management. Bracing is a mainstay of treatment for AIS. Large efforts have been made recently to reduce potential confounding across studies of different braces; however, none of these have considered genetics as a potential confounder. In particular, ScoliScore has not been evaluated in a population undergoing bracing. We conducted a retrospective cohort study in which we identified a population of AIS patients who were initiated with Providence bracing and followed over time. Although these patients did not necessarily fit the commercial indications for ScoliScore, we contacted the patients and obtained a saliva sample from each for genetic analysis. We then tested whether ScoliScore correlated with the outcome of their bracing therapy. We were able to contact and invite 25 eligible subjects, of whom 16 (64.0%) returned samples for laboratory analysis. Patients were followed for an average of 2.3 years (range, 1.1-4 y) after initiation of the Providence brace. Eight patients (50.0%) progressed to >45 degrees, whereas the other 8 patients (50.0%) did not. The mean ScoliScore among those who progressed to >45 degrees was higher than that among those who did not (176 vs. 112, P=0.030). We demonstrate that a genetic test correlates with bracing outcome. It may be appropriate for future bracing studies to include analysis of genetic predisposition to limit potential confounding.

Aeroelasticity of Axially Loaded Aerodynamic Structures for Truss-Braced Wing Aircraft

NASA Technical Reports Server (NTRS)

Nguyen, Nhan; Ting, Eric; Lebofsky, Sonia

2015-01-01

This paper presents an aeroelastic finite-element formulation for axially loaded aerodynamic structures. The presence of axial loading causes the bending and torsional sitffnesses to change. For aircraft with axially loaded structures such as the truss-braced wing aircraft, the aeroelastic behaviors of such structures are nonlinear and depend on the aerodynamic loading exerted on these structures. Under axial strain, a tensile force is created which can influence the stiffness of the overall aircraft structure. This tension stiffening is a geometric nonlinear effect that needs to be captured in aeroelastic analyses to better understand the behaviors of these types of aircraft structures. A frequency analysis of a rotating blade structure is performed to demonstrate the analytical method. A flutter analysis of a truss-braced wing aircraft is performed to analyze the effect of geometric nonlinear effect of tension stiffening on the flutter speed. The results show that the geometric nonlinear tension stiffening effect can have a significant impact on the flutter speed prediction. In general, increased wing loading results in an increase in the flutter speed. The study illustrates the importance of accounting for the geometric nonlinear tension stiffening effect in analyzing the truss-braced wing aircraft.

Preliminary design characteristics of a subsonic business jet concept employing an aspect ratio 25 strut braced wing

NASA Technical Reports Server (NTRS)

Turriziani, R. V.; Lovell, W. A.; Martin, G. L.; Price, J. E.; Swanson, E. E.; Washburn, G. F.

1980-01-01

The advantages of replacing the conventional wing on a transatlantic business jet with a larger, strut braced wing of aspect ratio 25 were evaluated. The lifting struts reduce both the induced drag and structural weight of the heavier, high aspect ratio wing. Compared to the conventional airplane, the strut braced wing design offers significantly higher lift to drag ratios achieved at higher lift coefficients and, consequently, a combination of lower speeds and higher altitudes. The strut braced wing airplane provides fuel savings with an attendant increase in construction costs.

RESEARCH PROGRAM FOR BRACE - PROVIDING NO AND SPECIFIC NO2 MEASUREMENTS FOR THE BRACE DATABASE DURING THE MAY '02 FIELD STUDY

EPA Science Inventory

Three scientists from the EPA, RTP facility in Research Triangle Park, N.C. worked with the State of Florida and BRACE scientists to provide accurate and precise NO and specific NO2 measurements at two monitoring sites, the rural Sydney site and the near-bay, suburban Gandy sit...

The immediate effect of patellar tendon strap on weight-bearing asymmetry during squatting in patients with unilateral knee osteoarthritis: A pilot study.

PubMed

Demirbüken, İlkşan; Özyürek, Seher; Angın, Salih

2016-12-01

Knee osteoarthritis has commonly been associated with a symptom of pain resulting in an inter-limb weight-bearing asymmetry during functional tasks. Patellar tendon strap is one of the non-pharmacologic interventions to alleviate knee pain. To investigate the immediate effect of a patellar tendon strap on weight-bearing asymmetry during squatting in people with unilateral knee osteoarthritis. Cross-sectional study. Ten patients with unilateral knee osteoarthritis and 10 healthy subjects were included in the study. Weight-bearing asymmetry of patients was assessed using a weight-bearing squat test during squatting at 30° and 60° both with and without patellar tendon strap. Pain intensity was assessed during squatting in unstrapped and strapped conditions with Visual Analog Scale. The decrease in weight-bearing asymmetry values immediately after wearing patellar tendon strap during 30° (p = 0.006) and 60° (p = 0.011) of squatting tests was significantly higher in knee osteoarthritis patients than in healthy subjects. Reported pain intensity was similar in unstrapped and strapped conditions (p = 0.066). The results of this study showed improved inter-limb weight-bearing symmetry during squatting. Further research with larger sample sizes investigating the effect of patellar tendon strap on weight-bearing asymmetry during functional activities in people with knee osteoarthritis is warranted. Patellar tendon straps (easily fit and cheap unlike knee braces) had more improvements in inter-limb weight-bearing symmetry during squatting in people with knee osteoarthritis compared to healthy subjects. This study is a new insight for future studies to investigate clinical benefits of wearing patellar tendon straps in this population. © The International Society for Prosthetics and Orthotics 2015.

The cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.

PubMed

Fatoye, Francis; Haigh, Carol

2016-05-01

To examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains. Economic evaluation based on cost-utility analysis. Ankle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains. A decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists. The cost and quality adjusted life years gained using semi-rigid ankle brace was £184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was £155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was £263 per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option. Taping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay £263 for an additional gain in quality adjusted life year. The findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle

Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy.

PubMed

Suh, Jee-Won; Joo, Seok; Lee, Geun Dong; Haam, Seok Jin; Lee, Sungsoo

2016-04-01

We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. The mean age of the patients was 24.35±13.20 years (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60-2.31), and 2.22±0.19 (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5-15 days). Only one patient experienced postoperative complications. Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.

Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy

PubMed Central

Suh, Jee-Won; Joo, Seok; Lee, Geun Dong; Haam, Seok Jin; Lee, Sungsoo

2016-01-01

Background We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results The mean age of the patients was 24.35±13.20 years (range, 14–57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60–2.31), and 2.22±0.19 (range, 1.87–2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5–15 days). Only one patient experienced postoperative complications. Conclusion Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients. PMID:27066432

Knee Bracing: What Works?

MedlinePlus

... what it’s treating. Some are worn all the time. Some are only worn during sports, exercise, or physical activity. You should check the ... and Injury Prevention, Injury Rehabilitation, Prevention and Wellness, Sports ... Management September 1, 2005 Copyright © American Academy of Family ...

47. Viaduct detail showing riveted plate bracing and lattice members, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. Viaduct detail showing riveted plate bracing and lattice members, same double post as MA-46. - Broadway Bridge, Spanning Foundry Street, MBTA Yard, Fort Point Channel, & Lehigh Street, Boston, Suffolk County, MA

A correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis

PubMed Central

2014-01-01

Background It has been proposed that in-brace correction is the best guideline for prediction of the results of brace treatment for patients with Adolescent Idiopathic Scoliosis (AIS). However, bracing may be a stressful experience for patients and bracing non-compliance could be psychologically related. The purpose of this study was to assess the correlation between brace compliance, in-brace correction and QoL of patients with AIS. Methods Fifty-five patients with a diagnosis of AIS were recruited. All were female and aged 10 years or above when a brace was prescribed, none had undergone prior treatment, and all had a Risser sign of 0–2 and a Cobb angle of 25-40°. The patients were examined in three consecutive visits with 4 to 6 months between each visit. The Chinese translated Trunk Appearance Perception Scale (TAPS), the Chinese translated Brace Questionnaires (BrQ) and the Chinese translated SRS-22 Questionnaires were used in the study. The in-brace Cobb angle, vertebral rotation and trunk listing were also measured. Patients’ compliance, in-brace correction and patients’ QoL were assessed. To identify the relationship among these three areas, logistic regression model and generalized linear model were used. Result For the compliance measure, a significant difference (p = 0.008) was detected on TAPS mean score difference between Visit 1 and Visit 2 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). In addition, a significant difference (p = 0.000) was detected on BrQ mean score difference between Visit 2 and Visit 3 in the least compliant group (0–8 hours) and the most compliant group (17–23 hours). For the orthosis effectiveness measure, no significant difference was detected between the three groups of bracing hours (0–8 hours, 9–16 hours, 17–23 hours) on in-brace correction (below 40% and 40% or above). For the QoL measure, no significant difference was detected between the two

Sensitivity analysis for axis rotation diagrid structural systems according to brace angle changes

NASA Astrophysics Data System (ADS)

Yang, Jae-Kwang; Li, Long-Yang; Park, Sung-Soo

2017-10-01

General regular shaped diagrid structures can express diverse shapes because braces are installed along the exterior faces of the structures and the structures have no columns. However, since irregular shaped structures have diverse variables, studies to assess behaviors resulting from various variables are continuously required to supplement the imperfections related to such variables. In the present study, materials elastic modulus and yield strength were selected as variables for strength that would be applied to diagrid structural systems in the form of Twisters among the irregular shaped buildings classified by Vollers and that affect the structural design of these structural systems. The purpose of this study is to conduct sensitivity analysis for axial rotation diagrid structural systems according to changes in brace angles in order to identify the design variables that have relatively larger effects and the tendencies of the sensitivity of the structures according to changes in brace angles and axial rotation angles.

8. DETAIL VIEW, LOOKING NORTHEAST, SHOWING OUTRIGGERS FOR LATERAL BRACING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. DETAIL VIEW, LOOKING NORTHEAST, SHOWING OUTRIGGERS FOR LATERAL BRACING FOR TRUSSES AND BOTTOM CHORD CONNECTIONS. - White Bowstring Arch Truss Bridge, Spanning Yellow Creek at Cemetery Drive (Riverside Drive), Poland, Mahoning County, OH

The importance of trunk perception during brace treatment in moderate juvenile idiopathic scoliosis: What is the impact on self-image?

PubMed

Paolucci, Teresa; Piccinini, Giulia; Iosa, Marco; Piermattei, Cristina; De Angelis, Simona; Zangrando, Federico; Saraceni, Vincenzo Maria

2017-01-01

The perception of body image and the deformity of the trunk in patients with adolescent idiopathic scoliosis (AIS) are a silver lining that has yet to be discussed in the relevant literature during brace rehabilitation treatment. To determine whether and how the use of the brace changes perception of the trunk in patients with AIS by the drawing test. We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects). Trunk perception and quality of life were evaluated using the Trunk Appearance Perception Scale and Scoliosis Research Society-22 questionnaire, and the perception of one's back was measured by the drawing test. Pain was lower in BG versus CG (p= 0.095). Satisfaction with the treatment was higher in BG than in CG (p= 0.002). Self-image did not differ significantly between the groups in terms of TAPS. Drawings of the most severe cases of scoliosis were made by the group without the brace. The use of the brace corrects the function of the trunk and has a positive influence on its perception.

[Conservative treatment of idiopathic scoliosis with effective braces: early response to trunk asymmetry may avoid curvature progress].

PubMed

Matussek, J; Dingeldey, E; Wagner, F; Rezai, G; Nahr, K

2014-07-01

Vertical posture of the growing child requires minute central nervous control mechanisms in order to maintain symmetry of the torso in its various activities. Scoliosis describes a constant deviation in the frontal, transverse and sagittal planes from the dynamic symmetry of the trunk. Early intervention with effective bracing, physiotherapy and sports can reverse curve progression during growth spurts, once these are identified in screening. Modern braces have a derotating and reducing effect (mirror effect) on asymmetric body volumes, thus influencing the growing torso and restoring lasting symmetry. Recent data support the use of braces to reverse progressing scoliosis.

Characterising the effect of global and local geometric imperfections on the numerical performance of a brace member

NASA Astrophysics Data System (ADS)

Hassan, M. S.; Goggins, J.; Salawdeh, S.

2015-07-01

A numerical imperfection study is carried out on a hot rolled tubular brace member under displacement controlled amplitudes. An appropriate range of global and local imperfections is used in the finite element analyses to evaluate the initial-post buckling compressive strength, lateral storey drift, energy dissipation and mid-length lateral deformation of the brace member. The purpose of this study is to assess the impact of the geometrical imperfection on the numerical performance, and to determine an amplitude range that can be used unequivocally for numerical modelling of brace members. It is shown that the amplitude of global imperfections has an effect on the initial response, whereas the amplitude of local imperfections has influence on the resistance capacity of the brace member at higher ductility level. Based on the results, a refined range of amplitude of global and local imperfections is proposed. This range is found to have a good agreement with design standards. In addition, an already established equation to find lateral deformation is compared to results from the analyses and found that the equation with some modification can be used accurately in design. In this paper, a modification factor is proposed in the equation to find the lateral deformation to account for the imperfection amplitude in the numerical analyses of brace members.

BRACING WITHOUT SCALE FIGURE. AveryBartholomew Patent Railroad Iron Bridge, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

BRACING WITHOUT SCALE FIGURE. - Avery-Bartholomew Patent Railroad Iron Bridge, Town park south of Route 222, west of Owasco Inlet (moved from Elm Street Extension spanning Fall Creek, Nubia, NY), Groton, Tompkins County, NY

External supports improve knee performance in anterior cruciate ligament reconstructed individuals with higher kinesiophobia levels.

PubMed

Harput, Gulcan; Ulusoy, Burak; Ozer, Hamza; Baltaci, Gul; Richards, Jim

2016-10-01

The objectives of this study were to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals six months post-ACLR who desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores >37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P=0.04) and improved balance (P=0.01, P=0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P<0.05). Individuals reported having better knee function with KB when compared to no intervention (P<0.001) and KT (P=0.03). Both KB and KT have positive effects in individuals post-ACLR which may assist in reducing kinesiophobia when returning to their pre-injury activity levels, with the KB appearing to offer the participants better knee function compared to KT. Copyright © 2016 Elsevier B.V. All rights reserved.

Efficacy of nighttime brace in preventing progression of idiopathic scoliosis of less than 25°.

PubMed

Lateur, G; Grobost, P; Gerbelot, J; Eid, A; Griffet, J; Courvoisier, A

2017-04-01

The objective of the present study was to assess, at skeletal maturity, the efficacy of non-operative treatment by isolated nighttime brace in the prevention of progression of progressive idiopathic scoliosis of less than 25°. Isolated nighttime brace treatment is effective in the prevention of progression of mild progressive idiopathic scoliosis (Cobb<25°). A single-center retrospective study included 142 patients managed by nighttime brace for progressive idiopathic scoliosis with Cobb angle<25°, with assessment at skeletal maturity. Mean Cobb angle at start of treatment was 15.5° (range, 10-25°). Mean values for Cobb angle and sagittal parameters before treatment and at skeletal maturity were compared on Student t-test. Change in Cobb angle over time was also analyzed. Mean Cobb angle at skeletal maturity was 16.3°, showing significant increase over baseline (15.5°; P=0.04), although the difference was less than the uncertainty of measurement (±6°). In baseline Risser 0 or 1, mean change in Cobb angle at skeletal maturity (16.2°) was not significant (P=0.1). Cobb angle diminished in 26 cases (18%), increased in 24 (17%) and was unchanged in 92 (65%). The present study confirmed the efficacy of non-operative treatment by nighttime brace in mild progressive idiopathic scoliosis (<25°) in a large majority of cases. A nighttime brace thus seems to be an effective option for the treatment of adolescent scoliosis, ensuring a safe curve of around 20°. Level IV, retrospective study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Spring tube braces for seismic isolation of buildings

NASA Astrophysics Data System (ADS)

Karayel, V.; Yuksel, Ercan; Gokce, T.; Sahin, F.

2017-01-01

A new low-cost seismic isolation system based on spring tube bracings has been proposed and studied at the Structural and Earthquake Engineering Laboratory of Istanbul Technical University. Multiple compression-type springs are positioned in a special cylindrical tube to obtain a symmetrical response in tension and compression-type axial loading. An isolation floor, which consists of pin-ended steel columns and spring tube bracings, is constructed at the foundation level or any intermediate level of the building. An experimental campaign with three stages was completed to evaluate the capability of the system. First, the behavior of the spring tubes subjected to axial displacement reversals with varying frequencies was determined. In the second phase, the isolation floor was assessed in the quasi-static tests. Finally, a ¼ scaled 3D steel frame was tested on the shake table using actual acceleration records. The transmitted acceleration to the floor levels is greatly diminished because of the isolation story, which effects longer period and higher damping. There are no stability and self-centering problems in the isolation floor.

TOP CHORD, CENTRAL BRACING DETAIL. AveryBartholomew Patent Railroad Iron ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

TOP CHORD, CENTRAL BRACING DETAIL. - Avery-Bartholomew Patent Railroad Iron Bridge, Town park south of Route 222, west of Owasco Inlet (moved from Elm Street Extension spanning Fall Creek, Nubia, NY), Groton, Tompkins County, NY

DETAIL OF BRACING WITH SCALE FIGURE. AveryBartholomew Patent Railroad ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL OF BRACING WITH SCALE FIGURE. - Avery-Bartholomew Patent Railroad Iron Bridge, Town park south of Route 222, west of Owasco Inlet (moved from Elm Street Extension spanning Fall Creek, Nubia, NY), Groton, Tompkins County, NY

View northwest, wharf B, timber framing, detail of cross bracing, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View northwest, wharf B, timber framing, detail of cross bracing, charred piers, recent galvanized fastenings - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Performance enhancement of bridge bracing under service and extreme loads.

DOT National Transportation Integrated Search

2010-12-01

The purpose of this study was to develop and demonstrate the concept of retrofitting bridge brace elements with fiber reinforced composites in order to provide restraint against buckling. The advanced materials consisted of a combination of fiber rei...

View south, wharf B, timber framing, detail of cross bracing, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View south, wharf B, timber framing, detail of cross bracing, recent galvanized straps, bolts and washers - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

The B-Lynch uterine brace suture, and a bit of this and a bit of that...

PubMed

Karoshi, Mahantesh

2010-03-01

The widespread application of the B-Lynch brace suture to control postpartum hemorrhage has sparked interest in a variety of adjunctive methods, used alone or in combination, to control uterine bleeding. Although the B-Lynch brace suture has been used with good results throughout the world, failures can and do occur in rare instances, especially when the suture is incorrectly placed for use for an inappropriate indication. Four reports of additional methods to control postpartum hemorrhage are published in this issue of IJGO. Three use the B-Lynch brace suture combined with other techniques. The need for additional techniques reminds the reader of the importance of proper suture application for proper indication. Potential reasons for failure of the B-Lynch suture are provided.

26. Typical top chord, vertical lattice, diagonal bracing and bottom ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. Typical top chord, vertical lattice, diagonal bracing and bottom chord assembly. View is of south side of center panels of 4th span. - Cleves Bridge, Spanning Great Miami River on U.S. Highway 50, Cleves, Hamilton County, OH

Lateral Bracing of Bridge Girders by Permanent Metal Deck Forms

DOT National Transportation Integrated Search

2005-01-10

Lateral torsional buckling is a failure mode that often controls the design of steel bridge girders during construction. Bracing in the form of cross-frames and diaphragms are often provided at locations along the bridge length to reduce the unbraced...

Female patients' and parents' assessment of deformity- and brace-related stress in the conservative treatment of adolescent idiopathic scoliosis.

PubMed

Misterska, Ewa; Glowacki, Maciej; Latuszewska, Joanna

2012-06-15

A cross-sectional analysis of parents' and patients' perceptions of deformity- and brace-related stress regarding conservative treatment of adolescent idiopathic scoliosis. The purpose of this study was to determine the agreement between patients' and parents' assessments of emotional stress and to compare these assessments with radiographical measurements of spinal deformity. Conservative treatment in patients with scoliosis may cause emotional stress. To our knowledge, no group has ever reported patient and parental estimation of stress related to wearing a brace and spinal deformity in girls with adolescent idiopathic scoliosis. Sixty-three pairs of parents and girls with adolescent idiopathic scoliosis treated with a Cheneau brace were separately asked to complete the Bad Sobberheim Stress Questionnaire-Deformity and the Bad Sobberheim Stress Questionnaire-Brace. The age range of the patients was from 10 to 17 years. Patients were assessed at a mean of 14.12 (SD, 10.99) months after the start of the conservative treatment. Patients thought that a moderate level of stress was connected with conservative treatment; however, the stress level, related to perceived trunk deformation, was low. From the parents' perspective, patients experienced a moderate level of stress during conservative treatment and related to spinal deformity. The study groups differ in their perception of stress levels due to body disfigurement but not during the conservative treatment. Parent-patient stress-level disparities were not related to body mass index, age of the patient, brace application, and radiographical measurements of spinal deformity. Patients and parents perceive the emotional stress related to brace treatment in the same way; however, parents overestimate the assessment of stress levels related to body deformity. From the perspective of patients and parents, brace wearing increased the level of stress induced by the deformity alone. Complete assessment of conservative

Single (sub)species then and now: An examination of the nonracial perspective of C. Loring Brace.

PubMed

Smith, Shelley L

2018-01-01

C. Loring Brace's writings on the concept of race have been among the most influential within anthropology. A review of the development of Brace's perspective on race shows that his philosophical approaches to fossil and modern human variation are consistent and integrated. Brace's views on race are compared with those of Ashley Montagu and Frank Livingstone, who also proposed eliminating "race" from anthropology, and with those of Stanley Garn and Alice Brues, who accepted "racial" subdivisions of humans. Carleton Coon's writings are more divergent; the aftermath of the publication of his Origin of Races highlights significant political tensions of the 1960s that intersected with scientific changes in anthropology emanating from the Evolutionary Synthesis. Recent forensic and "no race" positions are compared to explore their differences and the possibility of reconciliation, and the role of Brace and others in combating proposals of intellectual differences among human groups is discussed. While a spectrum of anthropological opinion regarding race exists, the commonalities are sufficient to allow valuable, united commentary emphasizing the complexity of modern human cultural and biological variation. © 2018 American Association of Physical Anthropologists.

'SOSORT consensus paper on brace action: TLSO biomechanics of correction (investigating the rationale for force vector selection)'

PubMed Central

Rigo, M; Negrini, S; Weiss, HR; Grivas, TB; Maruyama, T; Kotwicki, T

2006-01-01

Background The effectiveness of orthotic treatment continues to be controversial in international medical literature due to differences in the reported results and conclusions of various studies. Heterogeneity of the samples has been suggested as a reason for conflicting results. Besides the obvious theoretical differences between the brace concepts, the variability in the technical factors can also explain the contradictory results between same brace types. This paper will investigate the degree of variability among responses of scoliosis specialists from the Brace Study Ground of the International Society on Scoliosis Orthopedic and Rehabilitation Treatment SOSORT. Ultimately, this information could be a foundation for establishing a consensus and framework for future prospective controlled studies. Methods A preliminary questionnaire on the topic of 'brace action' relative to the theory of three-dimensional scoliosis correction and brace treatment was developed and circulated to specialists interested in the conservative treatment of adolescent idiopathic scoliosis. A particular case was presented (main thoracic curve with minor lumbar). Several key points emerged and were used to develop a second questionnaire which was discussed and full filed after the SOSORT consensus meeting (Milano, Italy, January 2005). Results Twenty-one questionnaires were completed. The Chêneau brace was the most frequently recommended. The importance of the three point system mechanism was stressed. Options about proper pad placement on the thoracic convexity were divided 50% for the pad reaching or involving the apical vertebra and 50% for the pad acting caudal to the apical vertebra. There was agreement about the direction of the vector force, 85% selecting a 'dorso lateral to ventro medial' direction but about the shape of the pad to produce such a force. Principles related to three-dimensional correction achieved high consensus (80%–85%), but suggested methods of correction

[Prophylactic drug treatment of migraine].

PubMed

Massiou, H; Bousser, M-G

2005-07-01

Prophylactic treatment is mainly intended to reduce the frequency of migraine attacks. Based on the results of published controlled trials, the main prophylactic drugs are some beta-blockers, methysergide, pizotifene, oxetorone, flunarizine, amitriptyline, NSAIDs, sodium valproate and topiramate. With these drugs, the frequency of attacks can be reduced by half in 50 percent of patients. Some less evaluated substances such as aspirin, DHE, indoramine, and angiotensin II inhibitors may be useful. The decision to treat with drugs and the choice of a prophylactic drug are made together with the patient. The superiority of one major drug over another has never been demonstrated in a comparative trial, thus the choice of the drug to start with depends on the possible side effects and contraindications, the characteristics of the migraine attacks, and the associated morbidities and possible interactions with abortive medications. Doses should be increased gradually, in order to reach the recommended daily dose, only if tolerance permits. Treatment efficacy has to be assessed after 2 or 3 months, and in case of failure or poor tolerance, another treatment should be started. If the treatment is successful, it should be continued for 6 to 12 months, and then tapered off. The moderate efficacy and the frequency of the side effects observed with prophylactic drugs explain the high rate of withdrawals. Some patients nevertheless dramatically improve, warranting trying several drugs successively in order to find the most appropriate one.

Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study.

PubMed

Holm, Bente; Husted, Henrik; Kehlet, Henrik; Bandholm, Thomas

2012-08-01

To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty. A prospective, single-blinded, randomized, cross-over study. A fast-track orthopaedic arthroplasty unit at a university hospital. Twenty patients (mean age 66 years; 10 women) scheduled for primary unilateral total knee arthroplasty. The patients were treated on two days (day 7 and day 10) postoperatively. On one day they received 30 minutes of knee icing (active treatment) and on the other day they received 30 minutes of elbow icing (control treatment). The order of treatments was randomized. Maximal knee extension strength (primary outcome), knee pain at rest and knee pain during the maximal knee extensions were measured 2-5 minutes before and 2-5 minutes after both treatments by an assessor blinded for active or control treatment. The change in knee extension strength associated with knee icing was not significantly different from that of elbow icing (knee icing change (mean (1 SD)) -0.01 (0.07) Nm/kg, elbow icing change -0.02 (0.07) Nm/kg, P = 0.493). Likewise, the changes in knee pain at rest (P = 0.475), or knee pain during the knee extension strength measurements (P = 0.422) were not different between treatments. In contrast to observations in experimental knee effusion models and inflamed knee joints, knee joint icing for 30 minutes shortly after total knee arthroplasty had no acute effect on knee extension strength or knee pain.

Positioning and spinal bracing for pain relief in metastatic spinal cord compression in adults.

PubMed

Lee, Siew Hwa; Grant, Robin; Kennedy, Catriona; Kilbride, Lynn

2015-09-24

This is an updated version of the original Cochrane review published in Issue 3 (Lee 2012) on patient positioning (mobilisation) and bracing for pain relief and spinal stability in adults with metastatic spinal cord compression.Many patients with metastatic spinal cord compression (MSCC) have spinal instability, but their clinician has determined that due to their advanced disease they are unsuitable for surgical internal fixation. Mobilising may be hazardous in the presence of spinal instability as further vertebral collapse can occur. Current guidance on positioning (whether a patient should be managed with bed rest or allowed to mobilise) and whether spinal bracing is helpful, is contradictory. To investigate the correct positioning and examine the effects of spinal bracing to relieve pain or to prevent further vertebral collapse in patients with MSCC. For this update, we searched for relevant studies from February 2012 to 31 March 2015. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE In Process, EMBASE, AMED, CINAHL, TRIP, SIGN, NICE, UK Clinical Research Network, National Guideline Clearinghouse and PEDro database. We also searched the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov, UK Clinical Trials Gateway (UKCTG), WHO International Clinical Trials Registry Platform (ICTRP) and Australia New Zealand Clinical Trials Registry (ANZCTR).For the original version, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, CANCERLIT, NICE, SIGN, AMED, TRIP, National Guideline Clearinghouse, and PEDro database, in February 2012. We selected randomised controlled trials (RCTs) of adults with MSCC of interventions on positioning (mobilisation) and bracing. Two review authors independently assessed each possible study for inclusion and quality. For the original version of the review, we screened 1611 potentially relevant studies. No studies met the inclusion criteria

Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.

PubMed

Gustafson, Jonathan A; Gorman, Shannon; Fitzgerald, G Kelley; Farrokhi, Shawn

2016-01-01

Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (p<0.01) and greater knee flexion excursions (p<0.01) compared to their knee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. Copyright © 2015 Elsevier B.V. All rights reserved.

Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability

PubMed Central

Gustafson, Jonathan A.; Gorman, Shannon; Fitzgerald, G. Kelley; Farrokhi, Shawn

2017-01-01

Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (p<0.01) and greater knee flexion excursions (p<0.01) compared to their knee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. PMID:26481256

A decision-making tool to prescribe knee orthoses in daily practice for patients with osteoarthritis.

PubMed

Coudeyre, Emmanuel; Nguyen, Christelle; Chabaud, Aurore; Pereira, Bruno; Beaudreuil, Johann; Coudreuse, Jean-Marie; Deat, Philippe; Sailhan, Frédéric; Lorenzo, Alain; Rannou, François

2018-03-01

To develop a decision-making tool (DMT) to facilitate the prescription of knee orthoses for patients with osteoarthritis (OA) in daily practice. A steering committee gathered a multidisciplinary task force experienced in OA management/clinical research. Two members performed a literature review with qualitative analysis of the highest-quality randomized controlled trials and practice guidelines to confirm evidence concerning knee orthosis for OA. A first DMT draft was presented to the task force in a 1-day meeting in January 2016. The first version of the DMT was criticized and discussed regarding everyday practice issues. Every step was discussed and amended until consensus agreement was achieved within the task force. Then 4 successive consultation rounds occurred by electronic communication, first with primary- and secondary-care physicians, then with international experts. All corrections and suggestions by each member were shared with the rest of the task force and included to reach final consensus. The final version was validated by the steering committee. The definition and indication of several types of knee orthoses (sleeve, patello-femoral, hinged or unicompartmental offloading braces) were detailed. Orthoses may be proposed in addition to first-line non-pharmacological treatment if patient acceptance is considered good. At every step, a specific clinical assessment is needed. Based on the latest high-level evidence, practice guidelines, and an expert panel, a DMT to facilitate daily practice prescription of knee orthoses for OA patients was designed. An evaluation of DMT implementation in a wide range of health professionals is still needed. Copyright © 2018 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Feasibility study of a wearable exoskeleton for children: is the gait altered by adding masses on lower limbs?

PubMed

Rossi, Stefano; Colazza, Alessandra; Petrarca, Maurizio; Castelli, Enrico; Cappa, Paolo; Krebs, Hermano Igo

2013-01-01

We are designing a pediatric exoskeletal ankle robot (pediatric Anklebot) to promote gait habilitation in children with Cerebral Palsy (CP). Few studies have evaluated how much or whether the unilateral loading of a wearable exoskeleton may have the unwanted effect of altering significantly the gait. The purpose of this study was to evaluate whether adding masses up to 2.5 kg, the estimated overall added mass of the mentioned device, at the knee level alters the gait kinematics. Ten healthy children and eight children with CP, with light or mild gait impairment, walked wearing a knee brace with several masses. Gait parameters and lower-limb joint kinematics were analyzed with an optoelectronic system under six conditions: without brace (natural gait) and with masses placed at the knee level (0.5, 1.0, 1.5, 2.0, 2.5 kg). T-tests and repeated measures ANOVA tests were conducted in order to find noteworthy differences among the trial conditions and between loaded and unloaded legs. No statistically significant differences in gait parameters for both healthy children and children with CP were observed in the five "with added mass" conditions. We found significant differences among "natural gait" and "with added masses" conditions in knee flexion and hip extension angles for healthy children and in knee flexion angle for children with CP. This result can be interpreted as an effect of the mechanical constraint induced by the knee brace rather than the effect associated with load increase. The study demonstrates that the mechanical constraint induced by the brace has a measurable effect on the gait of healthy children and children with CP and that the added mass up to 2.5 kg does not alter the lower limb kinematics. This suggests that wearable devices weighing 25 N or less will not noticeably modify the gait patterns of the population examined here.

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

PubMed Central

2011-01-01

Background Progressive 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. Methods A 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. Results At 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. Conclusion Conservative 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. PMID:21266084

The risk of venous thromboembolism with aspirin compared to anticoagulants after hip and knee arthroplasty.

PubMed

Chu, Janet N; Maselli, Judith; Auerbach, Andrew D; Fang, Margaret C

2017-07-01

Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in more contemporary patient populations. We compared rates of post-operative VTE between patients who received aspirin-only versus anticoagulants after hip or knee arthroplasty, using data from a large US-based administrative database. We conducted a retrospective cohort study of 231,780 adults who underwent total knee arthroplasty and 110,621 who underwent total hip arthroplasty in 2009-2012 and who received pharmacologic VTE prophylaxis (aspirin or anticoagulant) within the first 7days after surgery. We compared the risk of post-operative VTE between patients receiving aspirin-only vs. anticoagulants, controlling for clinical and hospital characteristics using multivariable logistic regression with propensity score adjustment. Aspirin-only prophylaxis was administered to 7.5% of patients after knee arthroplasty and 8.0% after hip arthroplasty. Post-operative VTE was diagnosed in 2217 (0.96%) patients after knee arthroplasty and 454 (0.41%) after hip arthroplasty. Compared to anticoagulants, aspirin was not associated with a higher risk for post-operative VTE either after knee arthroplasty (adjusted odds ratio and 95% confidence interval [OR] 0.34 [0.24-0.48]) or hip arthroplasty (OR 0.82 [0.45-1.51]). Aspirin was uncommonly administered as the sole prophylactic agent after hip or knee arthroplasty in this study. However, patients who received aspirin-only had similar rates of post-operative VTE compared to patients who received anticoagulants. Further research should focus on distinguishing which patients benefit more from anticoagulants versus aspirin after arthroplasty. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bracing Regular Polygons as We Race into the Future

ERIC Educational Resources Information Center

Frederickson, Greg N.

2012-01-01

How many rods does it take to brace a square in the plane? Once Martin Gardner's network of readers got their hands on it, it turned out to be fewer than Raphael Robinson, who originally posed the problem, thought. And who could have predicted the stunning solutions found subsequently for various generalizations of the problem?

Design method of redundancy of brace-anchor sharing supporting based on cooperative deformation

NASA Astrophysics Data System (ADS)

Liu, Jun-yan; Li, Bing; Liu, Yan; Cai, Shan-bing

2017-11-01

Because of the complicated environment requirement, the support form of foundation pit is diversified, and the brace-anchor sharing support is widely used. However, the research on the force deformation characteristics and the related aspects of the cooperative response of the brace-anchor sharing support is insufficient. The application of redundancy theory in structural engineering has been more mature, but there is little theoretical research on redundancy theory in underground engineering. Based on the idea of collaborative deformation, the paper calculates the ratio of the redundancy degree of the cooperative deformation by using the local reinforcement design method and the structural component redundancy parameter calculation formula based on Frangopol. Combined with the engineering case, through the calculation of the ratio of cooperative deformation redundancy in the joint of brace-anchor sharing support. This paper explores the optimal anchor distribution form under the condition of cooperative deformation, and through the analysis and research of displacement field and stress field, the results of the collaborative deformation are validated by comparing the field monitoring data. It provides theoretical basis for the design of this kind of foundation pit in the future.

Associations of varus thrust and alignment with pain in knee osteoarthritis.

PubMed

Lo, Grace H; Harvey, William F; McAlindon, Timothy E

2012-07-01

To investigate associations of varus thrust and varus static alignment with pain in patients with knee osteoarthritis (OA). This was a cross-sectional study of participants from a randomized controlled trial of vitamin D treatment for knee OA. Participants were video recorded while walking and scored for presence of varus thrust. Static alignment was measured on standard posteroanterior knee radiographs. Pain questions from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire were used to assess symptoms. We calculated means for total WOMAC pain in relation to varus thrust and static varus alignment (i.e., corrected anatomic alignment<178 degrees). Ordinal logistic regressions were performed, with responses on individual WOMAC pain questions as the outcomes and varus thrust and varus alignment as the predictors. There were 82 participants, 60% of whom were female. The mean±SD age was 65.1±8.5 years, and the mean±SD body mass index was 30.2±5.4 kg/m2. The mean total WOMAC pain score was 6.3 versus 3.9, respectively, in those with versus without definite varus thrust (P=0.007) and 5.0 versus 4.2 in those with versus without varus alignment (P=0.36). Odds ratios for pain with walking and standing were 4.7 (95% confidence interval 1.8-11.9) and 5.5 (95% confidence interval 2.2-14.2), respectively, in those with and those without definite varus thrust. There were no significant associations between varus alignment and responses to individual WOMAC pain questions. Sensitivity analyses suggested that varus classified using a more stringent definition might have been associated with pain on walking and standing. In patients with knee OA, varus thrust, and possibly varus static alignment, were associated with pain, specifically during weight-bearing activities. Treatment of varus thrust (e.g., via bracing or gait modification) may lead to improvement of symptoms. Copyright © 2012 by the American College of Rheumatology.

13. VIEW OF TOP LATERAL STRUT AND BRACING, U10 IN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. VIEW OF TOP LATERAL STRUT AND BRACING, U10 IN TOP FOREGROUND, U9 IN LOWER CENTER, SPAN 2, LOOKING NORTH - Emlenton Bridge, Spanning Allegheny River, Travel Route 38 (Legislative Route 75), Emlenton, Venango County, PA

[Periinterventional prophylactic antibiotics in radiological port catheter implantation].

PubMed

Gebauer, B; Teichgräber, U; Werk, M; Wagner, H-J

2007-08-01

To evaluate whether catheter-related infections after radiologically placed port catheters can be reduced by single-shot periinterventional antibiosis. Between January and September 2002, 164 consecutive patients with indication for central venous port catheter implantation were included in the present study. During implantation the interventional radiologist was responsible for deciding whether to administer a prophylactic single-shot antibiosis. The prophylactic antibiosis entailed intravenous administration of ampicillin and sulbactam (3 g Unacid, Pfizer) or 100 mg ciprofloxacine (Ciprobay, Bayer) in the case of an allergy history to penicillins. Catheter-related infection was defined as a local or systemic infection necessitating port catheter extraction. Indication for port catheter implantation was a malignant disease requiring chemotherapy in 158 cases. The port catheter (Chemosite [Tyco Healthcare] [n = 123], low-profile [Arrow International] [n = 35], other port system [n = 6]) was implanted via sonographically guided puncture of the right jugular vein in 139 patients, via the left jugular vein in 24 cases and via the right subclavian vein in one patient. 75 patients received periinterventional prophylactic antibiosis (Unacid [n = 63] Ciprobay [n = 12]) and 89 patients did not receive antibiosis. The prophylactic antibiosis caused a minor allergic reaction in one patient that improved with antihistamic and corticoid medication. A total of 7 ports, 6 without prophylactic antibiosis versus one with periinterventional prophylaxis, were extracted due to infectious complications. Single-shot periinterventional prophylactic antibiosis can reduce early and late infectious complications after radiological-interventional placement of central venous port catheters.

The aerodynamic properties of thick aerofoils suitable for internal bracing

NASA Technical Reports Server (NTRS)

Norton, F H

1920-01-01

The object of this investigation was to determine the characteristics of various types of wings having sufficient depth to entirely inclose the wing bracing, and also to provide data for the further design of such sections. This type of wing is of interest because it eliminates the resistance of the interplane bracing, a portion of the airplane that sometimes absorbs one-quarter of the total power required to fly, and because these wings may be made to give a very high maximum lift. Results of the investigation of the following subjects are given: (1) effect of changing the upper and lower camber of thick aerofoils of uniform section; (2) effect of thickening the center and thinning the tips of a thin aerofoil; (3) effect of adding a convex lower surface to a tapered section; (4) effect of changing the mean thickness with constant center and tip sections; and (5) effect of varying the chord along the span.

Guidelines on "Standards of management of idiopathic scoliosis with corrective braces in everyday clinics and in clinical research": SOSORT Consensus 2008

PubMed Central

Negrini, Stefano; Grivas, Theodoros B; Kotwicki, Tomasz; Rigo, Manuel; Zaina, Fabio

2009-01-01

Background Reported failure rates,(defined based on percentage of cases progressing to surgery) of corrective bracing for idiopathic scoliosis are highly variable. This may be due to the quality of the brace itself, but also of the patient care during treatment. The latter is sometimes neglected, even though it is considered a main determinant of good results among conservative experts of SOSORT. The aim of this paper was to develop and verify the Consensus on management of scoliosis patients treated with braces Methods We followed a Delphi process in four steps, distributing and gradually changing according to the results a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ), and during a Consensus Session at the SOSORT Athens Meeting with a Meeting Questionnaire (MQ). We set a 90% agreement as the minimum to be reached. Results We had a 71% response rate to PMQ, and 66.7% to MQ. Since the PMQ we had a good agreement (no answers below 72% – 70.2% over 90%). With the MQ the agreement consistently increased for all the answers previously below 90% (no answers below 83%, 75% over 90%). With increasing experience in bracing all numerical criteria tended to become more strict. We finally produced a set of 14 recommendations, grouped in 6 Domains (Experience/competence, Behaviours, Prescription, Construction, Brace Check, Follow-up). Conclusion The Consensus permits establishment of recommendations concerning the standards of management of idiopathic scoliosis with bracing, with the aim to increase efficacy and compliance to treatment. The SOSORT recommends to professionals engaged in patient care to follow the guidelines of this Consensus in their clinical practice. The SOSORT criteria should also be followed in clinical research studies to achieve a minimum quality of care. If the aim is to verify the efficacy of bracing these criteria should be companions of the methodological research

The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players.

PubMed

Zebis, Mette K; Bencke, Jesper; Andersen, Lars L; Døssing, Simon; Alkjaer, Tine; Magnusson, S Peter; Kjaer, Michael; Aagaard, Per

2008-07-01

The project aimed to implement neuromuscular training during a full soccer and handball league season and to experimentally analyze the neuromuscular adaptation mechanisms elicited by this training during a standardized sidecutting maneuver known to be associated with non-contact anterior cruciate ligament (ACL) injury. The players were tested before and after 1 season without implementation of the prophylactic training and subsequently before and after a full season with the implementation of prophylactic training. A total of 12 female elite soccer players and 8 female elite team handball players aged 26 +/- 3 years at the start of the study. The subjects participated in a specific neuromuscular training program previously shown to reduce non-contact ACL injury. Neuromuscular activity at the knee joint, joint angles at the hip and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. Neuromuscular training markedly increased before activity and landing activity electromyography (EMG) of the semitendinosus (P < 0.05), while quadriceps EMG activity remained unchanged. Neuromuscular training increased EMG activity for the medial hamstring muscles, thereby decreasing the risk of dynamic valgus. This observed neuromuscular adaptation during sidecutting could potentially reduce the risk for non-contact ACL injury.

Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics.

PubMed

Dixon, Anthony J; Dixon, Mary P; Askew, Deborah A; Wilkinson, David

2006-06-01

The study aimed to identify wound sites/procedures where infection incidence was over 5%, such that these circumstances may warrant wound infection antibiotic prophylaxis. We undertook a 3-year prospective study of 5,091 lesions (predominantly nonmelanoma skin cancer) treated on 2,424 patients from July 2002 to June 2005. No patient was given prophylactic antibiotics, and no patient ceased warfarin or aspirin. Overall infection incidence was 1.47%. Individual procedures had the following infection incidence: curettage 0.73% (3/412); skin flap repairs 2.94% (47/1601); simple excision and closure 0.54% (16/2974); skin grafts 8.70% (6/69); and wedge excision 8.57% (3/35). Analysis of regions of the body demonstrated that surgery below the knee (n = 448) had an infection incidence of 6.92% (31/448) (p < .0001). Subanalysis demonstrated that all regions below the knee were at high infection risk. Elsewhere, groin excisional surgery had an infection incidence of 10% (1/10) (p = .027). No other body site demonstrated an infection incidence beyond 5% of statistical significance. Procedures on the face demonstrated an infection incidence of 0.81% (18/2,209). Diabetic patients, those on warfarin and/or aspirin, and smokers showed no difference in infection incidence. Based on a prediction of infection incidence over 5%, the following cutaneous oncologic procedures warrant consideration of oral antibiotic wound infection prophylaxis: all procedures below the knee, wedge excisions of lip and ear, all skin grafts, and lesions in the groin. Other than under these circumstances, surgery to the nose, ear, fingers, lips, skin flap surgery, and surgery on diabetics, smokers, and those on anticoagulants have previously been considered for wound infection prophylaxis but do not warrant such intervention based on our data. The authors have indicated no significant interest with commercial supporters.

17. Photocopy of drawing, Erection Plan of Top Lateral Bracing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photocopy of drawing, Erection Plan of Top Lateral Bracing of Bridge at South Norwalk for the N.Y., N.H. and H.R.R., dated June 12, 1895. Original on file with Metro North Commuter Railroad. - South Norwalk Railroad Bridge, South Main & Washington Streets, Norwalk, Fairfield County, CT

Knee mechanics during planned and unplanned sidestepping: a systematic review and meta-analysis.

PubMed

Brown, Scott R; Brughelli, Matt; Hume, Patria A

2014-11-01

manoeuvre. For kinetic variables, unplanned sidestepping produced mostly small (small to large) increases in knee flexor moments, small to moderate increases in knee abductor moments and mostly moderate (small to large) increases in internal rotator moments relative to planned sidestepping. Approach velocity constraints during the sidestepping manoeuvre were lifted due to the low number of eligible studies. The varying approach velocities included (ranging from 3.0 to 5.5 m s(−1)) may impact the kinematic and kinetic variables examined in this review. Differences in knee mechanics between planned and unplanned sidestepping exist. The most substantial effects occurred during the weight acceptance phase of sidestepping. It seems that biomechanical factors commonly associated with anterior cruciate ligament injury risk are affected the most during the loading phase compared with peak push-off; made evident in the coronal (abductor) and transverse (internal rotator) knee kinetic data presented in this review. The authors of this review propose a rationale for the incorporation of unplanned sport tasks in the development of anterior cruciate ligament injury screening and in prophylactic training programmes.

Chronic Achilles tendinopathy: a prospective randomized study comparing the therapeutic effect of eccentric training, the AirHeel brace, and a combination of both.

PubMed

Petersen, Wolf; Welp, Robert; Rosenbaum, Dieter

2007-10-01

Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace. AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect. Randomized controlled clinical trial; Level of evidence, 1. One hundred patients were randomly assigned to 1 of 3 treatment groups: (1) eccentric training, (2) AirHeel brace, and (3) combination of eccentric training and AirHeel brace. Patients were evaluated at 6, 12, and 54 weeks after the beginning of the treatment protocol with ultrasonography, visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and Short Form-36 (SF-36). The VAS score for pain, AOFAS score, and SF-36 improved significantly in all 3 groups at all 3 follow-up examinations. At the 3 time points (6 weeks, 12 weeks, and 54 weeks) of follow-up, there was no significant difference between all 3 treatment groups. In all 3 groups, there was no significant difference in tendon thickness after treatment. The AirHeel brace is as effective as eccentric training in the treatment of chronic Achilles tendinopathy. There is no synergistic effect when both treatment strategies are combined. The AirHeel brace is an alternative treatment option for chronic Achilles tendinopathy.

Swollen Knee (Water on the Knee)

MedlinePlus

... your knee joint. Some people call this condition "water on the knee." A swollen knee may be ... Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don't place continuous weight- ...

17. Detail, looking north of the diagonal brace joint, typical ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Detail, looking north of the diagonal brace joint, typical of all trestle construction, at the east end of Trestle 18. Also visible is the walkway attaching rod and cross support. - Lake Hodges Flume, Along San Dieguito River between Lake Hodges & San Dieguito Reservoir, Rancho Santa Fe, San Diego County, CA

Effectiveness of braces designed using computer-aided design and manufacturing (CAD/CAM) and finite element simulation compared to CAD/CAM only for the conservative treatment of adolescent idiopathic scoliosis: a prospective randomized controlled trial.

PubMed

Cobetto, N; Aubin, C E; Parent, S; Clin, J; Barchi, S; Turgeon, I; Labelle, Hubert

2016-10-01

Clinical assessment of immediate in-brace effect of braces designed using CAD/CAM and FEM vs. only CAD/CAM for conservative treatment of AIS, using a randomized blinded and controlled study design. Forty AIS patients were prospectively recruited and randomized into two groups. For 19 patients (control group), the brace was designed using a scan of patient's torso and a conventional CAD/CAM approach (CtrlBrace). For the 21 other patients (test group), the brace was additionally designed using finite element modeling (FEM) and 3D reconstructions of spine, rib cage and pelvis (NewBrace). The NewBrace design was simulated and iteratively optimized to maximize the correction and minimize the contact surface and material. Both groups had comparable age, sex, weight, height, curve type and severity. Scoliosis Research Society standardized criteria for bracing were followed. Average Cobb angle prior to bracing was 27° and 28° for main thoracic (MT) and lumbar (L) curves, respectively, for the control group, while it was 33° and 28° for the test group. CtrlBraces reduced MT and L curves by 8° (29 %) and 10° (40 %), respectively, compared to 14° (43 %) and 13° (46 %) for NewBraces, which were simulated with a difference inferior to 5°. NewBraces were 50 % thinner and had 20 % less covering surface than CtrlBraces. Braces designed with CAD/CAM and 3D FEM simulation were more efficient and lighter than standard CAD/CAM TLSO's at first immediate in-brace evaluation. These results suggest that long-term effect of bracing in AIS may be improved using this new platform for brace fabrication. NCT02285621.

Developing an Accurate CFD Based Gust Model for the Truss Braced Wing Aircraft

NASA Technical Reports Server (NTRS)

Bartels, Robert E.

2013-01-01

The increased flexibility of long endurance aircraft having high aspect ratio wings necessitates attention to gust response and perhaps the incorporation of gust load alleviation. The design of civil transport aircraft with a strut or truss-braced high aspect ratio wing furthermore requires gust response analysis in the transonic cruise range. This requirement motivates the use of high fidelity nonlinear computational fluid dynamics (CFD) for gust response analysis. This paper presents the development of a CFD based gust model for the truss braced wing aircraft. A sharp-edged gust provides the gust system identification. The result of the system identification is several thousand time steps of instantaneous pressure coefficients over the entire vehicle. This data is filtered and downsampled to provide the snapshot data set from which a reduced order model is developed. A stochastic singular value decomposition algorithm is used to obtain a proper orthogonal decomposition (POD). The POD model is combined with a convolution integral to predict the time varying pressure coefficient distribution due to a novel gust profile. Finally the unsteady surface pressure response of the truss braced wing vehicle to a one-minus-cosine gust, simulated using the reduced order model, is compared with the full CFD.

Polish adaptation of Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity

PubMed Central

Głowacki, Maciej; Harasymczuk, Jerzy

2009-01-01

Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity are relatively new tools aimed at facilitating the evaluation of long-term results of therapy in persons with idiopathic scoliosis undergoing conservative treatment. To use these tools properly in Poland, they must be translated into Polish and adapted to the Polish cultural settings. The process of cultural adaptation of the questionnaires was compliant with the guidelines of International Quality of Life Assessment (IQOLA) Project. In the first stage, two independent translators converted the originals into Polish. Stage two, consisted of a comparison of the originals and two translated versions. During that stage, the team of two translators and authors of the project identified differences in those translations and created a combination of the two. In the third stage, two independent translators, who were native speakers of German, translated the adjusted version of the Polish translation into the language of the original document. At the last stage, a commission composed of: specialists in orthopedics, translators, a statistician and a psychologist reviewed all translations and drafted a pre-final version of the questionnaires. Thirty-five adolescent girls with idiopathic scoliosis who were treated with Cheneau brace were subjected to the questionnaire assessment. All patients were treated in an out-patient setting by a specialist in orthopedics at the Chair and Clinic of Orthopedics and Traumatology. Median age of patients was 14.8 SD 1.5, median value of the Cobb’s angle was 27.8° SD 7.4. 48.6% of patients had thoracic scoliosis, 31.4% had thoracolumbar scoliosis, and 20% patients had lumbar scoliosis. Median results obtained by means of the Polish version of BSSQ-Brace and BSSQ-Deformity questionnaires were 17.9 SD 5.0 and 11.3 SD 4.7, respectively. Internal consistency of BSSQ-Brace and BSSQ-Deformity was at the level of 0.80 and 0.87, whereas the value of the

Polish adaptation of Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity.

PubMed

Misterska, Ewa; Głowacki, Maciej; Harasymczuk, Jerzy

2009-12-01

Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity are relatively new tools aimed at facilitating the evaluation of long-term results of therapy in persons with idiopathic scoliosis undergoing conservative treatment. To use these tools properly in Poland, they must be translated into Polish and adapted to the Polish cultural settings. The process of cultural adaptation of the questionnaires was compliant with the guidelines of International Quality of Life Assessment (IQOLA) Project. In the first stage, two independent translators converted the originals into Polish. Stage two, consisted of a comparison of the originals and two translated versions. During that stage, the team of two translators and authors of the project identified differences in those translations and created a combination of the two. In the third stage, two independent translators, who were native speakers of German, translated the adjusted version of the Polish translation into the language of the original document. At the last stage, a commission composed of: specialists in orthopedics, translators, a statistician and a psychologist reviewed all translations and drafted a pre-final version of the questionnaires. Thirty-five adolescent girls with idiopathic scoliosis who were treated with Cheneau brace were subjected to the questionnaire assessment. All patients were treated in an out-patient setting by a specialist in orthopedics at the Chair and Clinic of Orthopedics and Traumatology. Median age of patients was 14.8 SD 1.5, median value of the Cobb's angle was 27.8 degrees SD 7.4. 48.6% of patients had thoracic scoliosis, 31.4% had thoracolumbar scoliosis, and 20% patients had lumbar scoliosis. Median results obtained by means of the Polish version of BSSQ-Brace and BSSQ-Deformity questionnaires were 17.9 SD 5.0 and 11.3 SD 4.7, respectively. Internal consistency of BSSQ-Brace and BSSQ-Deformity was at the level of 0.80 and 0.87, whereas the value of

Behavior of braced excavation in sand under a seismic condition: experimental and numerical studies

NASA Astrophysics Data System (ADS)

Konai, Sanku; Sengupta, Aniruddha; Deb, Kousik

2018-04-01

The behavior of braced excavation in dry sand under a seismic condition is investigated in this paper. A series of shake table tests on a reduced scale model of a retaining wall with one level of bracing were conducted to study the effect of different design parameters such as excavation depth, acceleration amplitude and wall stiffness. Numerical analyses using FLAC 2D were also performed considering one level of bracing. The strut forces, lateral displacements and bending moments in the wall at the end of earthquake motion were compared with experimental results. The study showed that in a post-seismic condition, when other factors were constant, lateral displacement, bending moment, strut forces and maximum ground surface displacement increased with excavation depth and the amplitude of base acceleration. The study also showed that as wall stiffness decreased, the lateral displacement of the wall and ground surface displacement increased, but the bending moment of the wall and strut forces decreased. The net earth pressure behind the walls was influenced by excavation depth and the peak acceleration amplitude, but did not change significantly with wall stiffness. Strut force was the least affected parameter when compared with others under a seismic condition.

Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance): a case-control retrospective study. 2011 SOSORT Award winner.

PubMed

Tavernaro, Marta; Pellegrini, Anna; Tessadri, Fabrizio; Zaina, Fabio; Zonta, Andrea; Negrini, Stefano

2012-09-20

Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace TREATMENT Management Guidelines (SBTMG) have highlighted the perceived importance of the professional teams surrounding braced patients. To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Design. Initial cross-sectional study, followed by a retrospective case-control study. Thirty-eight patients (15.8 ± 1.6 years; 26 females; 10 hyperkyphosis, 28 scoliosis of 29.2 ± 7.9° Cobb) extracted from a single orthotist database (between January 1, 2008 and September 1, 2009) and treated by the same physician; brace wearing at least 15 hours/day for a minimum of 6 months; age 10 or more. Braces: Sforzesco, Sibilla, Lapadula or Maguelone. Exercises: SEAS. Two questionnaires filled in blindly by patients: SRS-22 and one especially developed and validated with 25 questions on adherence to treatment. Groups (main risk factor): TEAM (private institute: satisfied 44/44 SOSORT criteria; grade of teamwork, "excellent") included 13 patients and NOT 25 (National Health Service Rehabilitation Department: 35/44 SOSORT criteria respected; grade, "insufficient"). TEAM was more compliant to bracing than NOT (97 ± 6% vs. 80 ± 24%) and performed nearly double the exercises (38 ± 12 vs. 20 ± 13 minutes/session). The self-reduction of bracing was significant in NOT (from 16.8 ± 3.7 to 14.8 ± 4.9 hours/day, , P<0.05); TEAM showed a significant reduction in the difficulties due to bracing (from 8.9 ± 1.4 to 3.5 ± 2.0 in 12 months on a 10-point scale, P<0.05). Pain was perceived by 55% of NOT versus 7% of TEAM (P < 0.05). The populations did not differ at the baseline studied outcomes. The absence of a good team surrounding the patient increases by five times the risk of reduced compliance to bracing (odds ratio OR 5.5 - 95% confidence interval 95CI 3.6-7.4), along with more than 15 times

Brace and deformity-related stress level in females with adolescent idiopathic scoliosis based on the Bad Sobernheim Stress Questionnaires

PubMed Central

Misterska, Ewa; Glowacki, Maciej; Harasymczuk, Jerzy

2011-01-01

Summary Background Psychopathological symptoms occur more often in chronically ill patients than in healthy populations. The aim of this study was to analyze the associations between different types of treatment and stress levels. Material/Methods The study group consisted of 69 females, of whom 35 were treated conservatively with a Cheneau brace; the other 34 subjects were treated operatively and, after correction of scoliosis with thoracoplasty, wore a brace for 12 weeks during the postoperative period. Patients completed the Polish versions of the Bad Sobernheim Stress Questionnaire-Deformity and the Bad Sobernheim Stress Questionnaire-Brace. Results Patients who were treated surgically felt a moderate level of stress connected with wearing the brace and with body deformation. The group treated conservatively felt moderate stress connected with wearing the brace, but a low level of stress in relation to body deformation. The groups differed significantly statistically in the level of stress felt regarding body deformation (p=0.004). In the group treated conservatively, the correlation between the level of stress, the age at which treatment was initiated, and degree of apical translation proved to be significant. Conclusions Patients treated surgically in comparison with patients treated conservatively report higher stress levels connected with body deformation. A higher level of stress depends on the degree of trunk deformation on the frontal plane; stress is also higher in patients who begin conservative treatment at a later age. PMID:21278693

The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis.

PubMed

O'Connell, Megan; Farrokhi, Shawn; Fitzgerald, G Kelley

2016-01-01

The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. The moderate/severe pain group demonstrated worse global pain (P<0.01) and physical function scores (P<0.01) compared to the no pain and the mild pain groups. The moderate/severe pain group also walked with greater knee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

Automated Airdrop Information Retrieval System-Human Fact ors Database (AAIRS-HFD) (Users Manual)

DTIC Science & Technology

1994-09-01

creeps, or chokes) Pressure Change Disorders Loss of Sensorimotor Abilities Loss of Cognitive/Perceptual Abilities Treatment drug therapy ...physical therapy cognitive therapy biofeedback therapy 73 9. Psychological Factors Situational Awareness altitude awareness Visual/Spatial...on/off valve prebreather Floatation Devices life preserver Scuba Gear Ankle Braces Knee Braces/Pads 82 7. Cargo/Resupply Parachute Assembly

[Arthroscopic knee arthrodesis: 4 cases].

PubMed

Acquitter, Y; Hulet, C; Souquet, D; Pierre, A; Locker, B; Vielpeau, C

2004-02-01

Arthroscopic arthrodesis of the knee joint is an alternative to classical surgery, which retains a few exceptional indications. We report the first four cases of our experience, describing the technical modalities and indications. The four patients had undergone multiple operations for severe trauma. All four had persistent severe pain with a very limited walking distance. Before the procedure, the IKS score ranged from 11 to 44 and the mean function score was 20 to 45 points. Arthroscopic arthrodesis was proposed after several consultations and took into account the young age of the patient and a positive brace test. The successive arthroscopic times were: exploration and adherence release, complete extramural meniscectomy, joint surface avivement. Traction was not necessary. Careful avivement spared the anatomic curvatures of the condyles and slightly scraped out the plateaus. Finally, the arthrodesis was fixed in correct position under fluoroscopy using a single tube external fixator. The fixation was maintained until fusion (satisfactory x-ray and no pain). A drain was inserted only for the first patient. There were no cutaneous complications. Patients were discharged after 3 days on the average with immediate simulated weight bearing using two crutches. The external fixator was dynamized at two months (mean) and removed at five months. The functional gain was considerable in four patients, assessed at two years, with a mean IKS score of 75 and a mean function score of 80. The four patients walked without crutches and without pain. Single leg stance was stable. Final leg shortening was 1 to 2 cm. The arthroscopic approach provides several benefits: uneventful postoperative period, little bleeding, no cutaneous complications, shorter hospital stay. The time to fusion appears to be shorter than with classical techniques, but cannot be demonstrated clearly because of the diversity of the series reported in the literature. Arthroscopic arthrodesis does not require

The effect of a modified Boston brace with anti-rotatory blades on the progression of curves in idiopathic scoliosis: aetiologic implications.

PubMed

Grivas, Theodoros B; Vasiliadis, Elias; Chatziargiropoulos, Theodoros; Polyzois, Vassilios D; Gatos, Konstandinos

2003-01-01

The effect of a modified Boston brace with anti-rotatory blades on idiopathic scoliotic curves, mainly right thoracic with a compensatory left lumbar, was studied. Twenty-eight scoliotic children divided into three sub-groups according to the curve type were included in the study. Cobb angle and rotation was measured on posteroanterior spinal radiographs taken during the first examination and also during the follow-up with the children in and out of the brace. Ten curves improved, 13 remained stable and 5 increased (Cobb angle change >5 degrees compared with the initial measurement). The brace treatment had more affect on the double curves, while single curves remained unaffected. Rotation remained unchanged in all curve types except in the lumbar component of double (right thoracic-left lumbar) curves. These findings indicate that in curves with a compensatory component (e.g. main thoracic with compensatory lumbar curve), a deforming rotatory force, which is blocked by the de-rotatory action of the blades of the above-modified Boston brace, is present and seems to be more active in the lumbar spine. It is hypothesized that this deforming rotatory force seems to be a major aetiological factor for double curves. In conclusion the conservative treatment using this brace is beneficially affecting the natural history of IS in children.

Surgical site infection and timing of prophylactic antibiotics for appendectomy.

PubMed

Wu, Wan-Ting; Tai, Feng-Chuan; Wang, Pa-Chun; Tsai, Ming-Lin

2014-12-01

Pre-operative prophylactic antibiotics may decrease the frequency of surgical site infection after appendectomy. However, the optimal timing for administration of pre-operative prophylactic antibiotics is unknown. The purpose of this study was to evaluate the effect of timing of prophylactic antibiotics on the frequency of surgical site infection after appendectomy. Medical records were reviewed retrospectively for 577 consecutive patients who had appendectomy for acute appendicitis from 2006 to 2009. Quality assurance guidelines for timing of prophylactic antibiotics before the skin incision were changed from 0 to 30 min before the skin incision (before June 2008) to 30 to 60 min before the skin incision (after June 2008). Surgical site infection occurred in 28 patients (4.9%). There was no difference in frequency of surgical site infection with different timing of pre-operative prophylactic antibiotic (pre-operative time 0 to 30 min: 9 infections [3.6%]; 31 to 60 min: 13 infections [5.4%]; 61 to 120 min: 5 infections [7.0%]; >120 min: 1 infection [6.6%]). Multivariable analysis showed that surgical site infection was associated significantly with medical comorbidity but not perforated appendicitis. The frequency of surgical site infection was independent of timing of preoperative prophylactic antibiotics but was associated with the presence of medical comorbidity.

Radiographic assessment of knee-ankle alignment after total knee arthroplasty for varus and valgus knee osteoarthritis.

PubMed

Gao, Fuqiang; Ma, Jinhui; Sun, Wei; Guo, Wanshou; Li, Zirong; Wang, Weiguo

2017-01-01

There are unanswered questions about knee-ankle alignment after total knee arthroplasty (TKA) for varus and valgus osteoarthritis (OA) of the knee. The aim of this retrospective study was to assess knee-ankle alignment after TKA. The study consisted of 149 patients who had undergone TKA due to varus and valgus knee OA. The alignment and angles in the selected knees and ankles were measured on full-length standing anteroposterior radiographs, both pre-operatively and post-operatively. The paired t-test and Pearson's correlation tests were used for statistical analysis. The results showed that ankle alignment correlated with knee alignment both pre-operatively and postoperatively (P<0.05). The pre-operative malalignment of the knee was corrected (P<0.05), and the ankle tilt angle was accordingly improved in the operative side after TKA (P<0.05). In addition, TKA had little effect on knee-ankle alignment on the non-operative side (P>0.05). These findings indicated that routine TKA could correct the varus or valgus deformity of a knee, and improve the tilt of the ankle. Ankle alignment correlated with knee alignment both pre-operatively and postoperatively. Both pre-operative knee and ankle malalignment can be simultaneously corrected following TKA. Level III. Copyright © 2016 Elsevier B.V. All rights reserved.

Feasibility Study of a Wearable Exoskeleton for Children: Is the Gait Altered by Adding Masses on Lower Limbs?

PubMed Central

Rossi, Stefano; Colazza, Alessandra; Petrarca, Maurizio; Castelli, Enrico; Cappa, Paolo; Krebs, Hermano Igo

2013-01-01

We are designing a pediatric exoskeletal ankle robot (pediatric Anklebot) to promote gait habilitation in children with Cerebral Palsy (CP). Few studies have evaluated how much or whether the unilateral loading of a wearable exoskeleton may have the unwanted effect of altering significantly the gait. The purpose of this study was to evaluate whether adding masses up to 2.5 kg, the estimated overall added mass of the mentioned device, at the knee level alters the gait kinematics. Ten healthy children and eight children with CP, with light or mild gait impairment, walked wearing a knee brace with several masses. Gait parameters and lower-limb joint kinematics were analyzed with an optoelectronic system under six conditions: without brace (natural gait) and with masses placed at the knee level (0.5, 1.0, 1.5, 2.0, 2.5 kg). T-tests and repeated measures ANOVA tests were conducted in order to find noteworthy differences among the trial conditions and between loaded and unloaded legs. No statistically significant differences in gait parameters for both healthy children and children with CP were observed in the five “with added mass” conditions. We found significant differences among “natural gait” and “with added masses” conditions in knee flexion and hip extension angles for healthy children and in knee flexion angle for children with CP. This result can be interpreted as an effect of the mechanical constraint induced by the knee brace rather than the effect associated with load increase. The study demonstrates that the mechanical constraint induced by the brace has a measurable effect on the gait of healthy children and children with CP and that the added mass up to 2.5 kg does not alter the lower limb kinematics. This suggests that wearable devices weighing 25 N or less will not noticeably modify the gait patterns of the population examined here. PMID:24023822

Do Prophylactic Foam Dressings Reduce Heel Pressure Injuries?

PubMed

Ramundo, Janet; Pike, Catlin; Pittman, Joyce

The purpose of this evidence-based report card is to examine the evidence and provide recommendations related to the effectiveness of prophylactic foam dressings in reducing heel pressure injuries. Do prophylactic foam dressings applied to the heel reduce heel pressure injuries for patients in the acute care setting? A search of the literature was performed by a trained university librarian that resulted in 56 articles that examined pressure injury, prevention, and prophylactic dressings. A systematic approach was used to review titles, abstracts, and text, yielding 13 studies that met inclusion criteria. Strength of the evidence was rated based on the methodology from Essential Evidence Plus: Levels of Evidence and Oxford Center for Evidence-Based Medicine. Thirteen studies were identified that met inclusion criteria; 1 was a randomized controlled trial, 2 were systematic reviews, 3 quasi-experimental cohort studies, 1 quality improvement study, 1 case series, 1 scoping review, 1 consensus panel, and 3 bench studies. All of the studies identified suggest that the use of prophylactic foam dressings reduces the development of pressure injuries on the heel when used in conjunction with a pressure injury prevention program. The strength of the evidence for the identified studies was level 1 (4 level A, 4 level B, and 5 level C). The use of prophylactic multilayer foam dressings applied to the heels, in conjunction with an evidence-based pressure injury prevention program, is recommended for prevention of pressure injuries on the heel (SORT level 1).

Orthopedic Management of Scoliosis by Garches Brace and Spinal Fusion in SMA Type 2 Children.

PubMed

Catteruccia, Michela; Vuillerot, Carole; Vaugier, Isabelle; Leclair, Danielle; Azzi, Viviane; Viollet, Louis; Estournet, Brigitte; Bertini, Enrico; Quijano-Roy, Susana

2015-11-21

Scoliosis is the most debilitating issue in SMA type 2 patients. No evidence confirms the efficacy of Garches braces (GB) to delay definitive spinal fusion. Compare orthopedic and pulmonary outcomes in children with SMA type 2 function to management. We carried out a monocentric retrospective study on 29 SMA type 2 children who had spinal fusion between 1999 and 2009. Patients were divided in 3 groups: group 1-French patients (12 children) with a preventive use of GB; group 2-French patients (10 children) with use of GB after the beginning of the scoliosis curve; and group 3-Italian patients (7 children) with use of GB after the beginning of the scoliosis curve referred to our centre to perform orthopedic preoperative management. Mean preoperative and postoperative Cobb angle were significantly lower in the group 1 of proactively braced than in group 2 or 3 (Anova p = 0.03; Kruskal Wallis test p = 0.05). Better surgical results were observed in patients with a minor preoperative Cobb angle (r = 0.92 p <  0.0001). Fewer patients in the group 1 proactively braced required trunk casts and/or halo traction and an additional anterior fusion in comparison with patients in the group 2 and 3. Moreover, major complications tend to be less in the group 1 proactively braced. No significant differences were found between groups in pulmonary outcome measures. A proactive orthotic management may improve orthopedic outcome in SMA type 2. Further prospective studies comparing SMA management are needed to confirm these results. Therapeutic Level III. See Instructions to Authors on jbjs.org for a complete description of levels of evidence (Retrospective comparative study).

MyPectus: First-in-human pilot study of remote compliance monitoring of teens using dynamic compression bracing to correct pectus carinatum.

PubMed

Harrison, Brittany; Stern, Lily; Chung, Philip; Etemadi, Mozziyar; Kwiat, Dillon; Roy, Shuvo; Harrison, Michael R; Martinez-Ferro, Marcelo

2016-04-01

Patient compliance is a crucial determinant of outcomes in treatments involving medical braces, such as dynamic compression therapy for pectus carinatum (PC). We performed a pilot study to assess a novel, wireless, real-time monitoring system (MyPectus) to address noncompliance. Eight patients (10-16years old) with moderately severe PC deformities underwent bracing. Each patient received a data logger device inserted in the compression brace to sense temperature and pressure. The data were transmitted via Bluetooth 4.0 to an iOS smartphone app, then synced to cloud-based storage, and presented to the clinician on a web-based dashboard. Patients received points for brace usage on the app throughout the 4-week study, and completed a survey to capture patient-reported usage patterns. In all 8 patients, the data logger sensed and recorded data, which connected through all MyPectus system components. There were occasional lapses in data collection because of technical difficulties, such as limited storage capacity. Patients reported positive feedback regarding points. The components of the MyPectus system recorded, stored, and provided data to patients and clinicians. The MyPectus system will inform clinicians about issues related to noncompliance: discrepancy between patient-reported and sensor-reported data regarding brace usage; real-time, actionable information; and patient motivation. Copyright © 2015 Elsevier Inc. All rights reserved.

Total knee arthroplasty for severe valgus knee deformity.

PubMed

Zhou, Xinhua; Wang, Min; Liu, Chao; Zhang, Liang; Zhou, Yixin

2014-01-01

Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging, and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release. The purpose of this study was to review 8 to 11 years (mean, 10 years) follow-up results of primary TKA for varient-III valgus knee deformity with use of different type implants. Between January 2002 and January 2005, 20 women and 12 men, aged 47 to 63 (mean, 57.19 ± 6.08) years old, with varient-III valgus knees underwent primary TKA. Of the 32 patients, 37 knees had varient-III deformities. Pie crusting was carefully performed with small, multiple inside-out incisions, bone resection balanced the knee in lieu of soft tissue releases that were not used in the series. Cruciate-retaining knees (Gemini MKII, Link Company, Germany) were used in 13 knees, Genesis II (Simth & Nephew Company, USA) in 14 knees, and hinged knee (Endo-Model Company, Germany) in 10 knees. In five patients with bilateral variant-III TKAs, three patients underwent 1-stage bilateral procedures, and two underwent 2-stage procedures. All implants were cemented and the patella was not resurfaced. The Hospital for Special Surgery (HSS) knee score was assessed. Patients were followed up from 8 to 11 years. The mean HSS knee score were improved from 50.33 ± 11.60 to 90.06 ± 3.07 (P < 0.001). The mean tibiofemoral alignment were improved from valgus 32.72° ± 9.68° pre-operation to 4.89° ± 0.90° post-operation (P < 0.001). The mean range of motion were improved from 93.72° ± 23.69° pre-operation to 116.61 ± 16.29° post-operation (P < 0.001). No patients underwent revision. One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years. Three patients developed transient peroneal nerve palsies, which resolved within nine months. Two patients developed symptomatic deep vein thrombosis that was managed with

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

PubMed

Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

2016-08-01

Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

PubMed

Novikova, Natalia; Hofmeyr, G Justus; Essilfie-Appiah, George

2012-09-12

Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. The objective of this review was to assess the effects of prophylactic amnioinfusion for women in labour with oligohydramnios, but not fetal heart deceleration, compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012). Randomised trials comparing prophylactic amnioinfusion in women in labour with oligohydramnios but not fetal heart rate deceleration in labour with therapeutic amnioinfusion. The authors assessed trial quality and extracted data. One randomized trial of 116 women was included. No differences were found in the rate of caesarean section (risk ratio 1.29, 95% confidence interval 0.60 to 2.74). There were no differences in cord arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05). There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

PubMed

Hofmeyr, G J

2000-01-01

Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. The Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register were searched. Date of last search: October 1997. Randomised trials comparing prophylactic with therapeutic amnioinfusion in women with oligohydramnios but not fetal heart rate deceleration in labour. The reviewer assessed trial quality and extracted data. Two studies of 285 women were included. No differences were found in the rate of caesarean section (relative risk 0.98, 95% confidence interval 0.58 to 1.66), or forceps delivery. There were no difference in Apgar scores, cord arterial pH, oxytocin augmentation, meconium aspiration, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (relative risk 3.48, 95% confidence interval 1.21 to 10.05). There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

Evidence-based Value of Prophylactic Drainage in Gastrointestinal Surgery

PubMed Central

Petrowsky, Henrik; Demartines, Nicolas; Rousson, Valentin; Clavien, Pierre-Alain

2004-01-01

Objective: To determine the evidence-based value of prophylactic drainage in gastrointestinal (GI) surgery. Methods: An electronic search of the Medline database from 1966 to 2004 was performed to identify articles comparing prophylactic drainage with no drainage in GI surgery. The studies were reviewed and classified according to their quality of evidence using the grading system proposed by the Oxford Centre for Evidence-based Medicine. Seventeen randomized controlled trials (RCTs) were found for hepato-pancreatico-biliary surgery, none for upper GI tract, and 13 for lower GI tract surgery. If sufficient RCTs were identified, we performed a meta-analysis to characterize the drain effect using the random-effects model. Results: There is evidence of level 1a that drains do not reduce complications after hepatic, colonic, or rectal resection with primary anastomosis and appendectomy for any stage of appendicitis. Drains were even harmful after hepatic resection in chronic liver disease and appendectomy. In the absence of RCTs, there is a consensus (evidence level 5) about the necessity of prophylactic drainage after esophageal resection and total gastrectomy due to the potential fatal outcome in case of anastomotic and gastric leakage. Conclusion: Many GI operations can be performed safely without prophylactic drainage. Drains should be omitted after hepatic, colonic, or rectal resection with primary anastomosis and appendectomy for any stage of appendicitis (recommendation grade A), whereas prophylactic drainage remains indicated after esophageal resection and total gastrectomy (recommendation grade D). For many other GI procedures, especially involving the upper GI tract, there is a further demand for well-designed RCTs to clarify the value of prophylactic drainage. PMID:15570212

Knee arthrodesis.

PubMed

MacDonald, James H; Agarwal, Sanjeev; Lorei, Matthew P; Johanson, Norman A; Freiberg, Andrew A

2006-03-01

Arthrodesis is one of the last options available to obtain a stable, painless knee in a patient with a damaged knee joint that is not amenable to reconstructive measures. Common indications for knee arthrodesis include failed total knee arthroplasty, periarticular tumor, posttraumatic arthritis, and chronic sepsis. The primary contraindications to knee fusion are bilateral involvement or an ipsilateral hip arthrodesis. A variety of techniques has been described, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Allograft or autograft may be necessary to restore lost bone stock or to augment fusion. For the carefully selected patient with realistic expectations, knee arthrodesis may relieve pain and obviate the need for additional surgery or extensive postoperative rehabilitation.

Prophylactic antibiotics in dermatological surgery.

PubMed

Lee, Michael R; Paver, Robert

2016-05-01

This is a review of the common pathogens of surgical site infections, antibiotic coverage for particular anatomical sites, mechanisms by which surgical site infections occur and the latest data and recommendations for prophylactic antibiotics in the prevention of surgical site infections, infective endocarditis and haematogenous joint infections. Recent evidence-based guidelines on surgical prophylaxis is for restricted indications and a shorter duration of antibiotic prophylaxis in situations where no clinical benefit of prolonged therapy has been proven, in order to minimise the potential adverse ecological and clinical effects associated with antibiotic therapy. This review recommends the cautious use of prophylactic antibiotics in dermatological surgery to help prevent the growing problem of bacterial resistance as well as other morbidity and health-care costs. © 2015 The Australasian College of Dermatologists.

Prophylactic use of octreotide for asparaginase-induced acute pancreatitis.

PubMed

Sakaguchi, Sachi; Higa, Takeshi; Suzuki, Mitsuyoshi; Fujimura, Junya; Shimizu, Toshiaki

2017-08-01

In the present study, we sought to evaluate the prophylactic use of octreotide for asparaginase-induced acute pancreatitis. We reviewed the medical records of seven patients in two institutions who received prophylactic octreotide for re-administration of asparaginase after asparaginase-induced acute pancreatitis. Three patients completed asparaginase treatment without developing pancreatitis, and four experienced recurrence of pancreatitis. A literature search using PubMed identified four additional patients in whom asparaginase was successfully re-administered with octreotide. Prophylactic use of octreotide may, thus, be warranted for patients who would benefit from re-administration of asparaginase for cancer treatment; however, careful observation is needed to monitor for breakthrough recurrence of pancreatitis.

Self-Reported Knee Instability Before and After Total Knee Replacement Surgery.

PubMed

Fleeton, Genevieve; Harmer, Alison R; Nairn, Lillias; Crosbie, Jack; March, Lyn; Crawford, Ross; van der Esch, Martin; Fransen, Marlene

2016-04-01

To determine the prevalence and burden of pain and activity limitations associated with retaining presurgery self-reported knee instability 6 months after total knee replacement (TKR) surgery and to identify early potentially modifiable risk factors for retaining knee instability in the operated knee after TKR surgery. A secondary analysis was performed using measures obtained from 390 participants undergoing primary unilateral TKR and participating in a randomized clinical trial. Self-reported knee instability was measured using 2 items from the Activities of Daily Living Scale of the Knee Outcome Survey. Outcome measures were knee pain (range 0-20) and physical function (range 0-68) on the Western Ontario and McMaster Universities Arthritis Index (WOMAC), stair-climb power, 50-foot walk time, knee range of motion, and isometric knee flexion and extension strength. In this study, 72% of participants reported knee instability just prior to surgery, with 32% retaining instability in the operated knee 6 months after surgery. Participants retaining operated knee instability had significantly more knee pain and activity limitations 6 months after surgery, with mean ± SD WOMAC scores of 4.8 ± 3.7 and 17.5 ± 11.1, respectively, compared to participants without knee instability, with 2.9 ± 3.1 and 9.8 ± 9.2. The multivariable predictor model for retained knee instability included a high comorbidity score (>6), low stair-climb power (<150 watts), more pain in the operated knee (>7 of 20), and younger age (<60 years). Self-reported knee instability is highly prevalent before and after TKR surgery and is associated with a considerable burden of pain and activity limitation in the operated knee. Increasing lower extremity muscle power may reduce the risk of retaining knee instability after TKR surgery. © 2016, American College of Rheumatology.

Soft-plastic brace for lower limb fractures in patients with spinal cord injury.

PubMed

Uehara, K; Akai, M; Kubo, T; Yamasaki, N; Okuma, Y; Tobimatsu, Y; Iwaya, T

2013-04-01

Retrospective study at a rehabilitation center. Patients with spinal cord injury, even if they are wheelchair users, sometimes suffer from fractures of the lower limb bones. As their bones are too weak to have surgery, and because a precise reduction is not required for restoration, such patients are often indicated for conservative treatment. This case series study investigated the use of a hinged, soft-plastic brace as a conservative approach to treating fractures of the lower extremities of patients with spinal cord injury. National Rehabilitation Center, Japan. Fifteen patients (male, n=10; female, n=5; average age, 52.7 years) with 19 fractures of the femur or the tibia who were treated with a newly-developed hinged, soft-plastic brace were studied. All of them used wheelchairs. We analyzed the time taken for fracture union and for wearing orthotics, degree of malalignment, femorotibial angle and side effects. The fractures in this series were caused by relatively low-energy impact. The average time taken for fracture union was 80.1 (37-189) days, and the average amount of time spent wearing orthotics was 77.9 (42-197) days. On final X-ray imaging, the average femorotibial angle was 176.9° (s.d. ±8.90), and 15° of misalignment in the sagittal plane occurred in one patient. A hinged, soft-plastic brace is a useful option as a conservative approach for treating fractures of the lower extremities in patients with spinal cord injury.

49 CFR 572.166 - Knees and knee impact test procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Knees and knee impact test procedure. 572.166... Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.166 Knees and knee impact test procedure. The knee assembly is assembled and tested as specified in 49 CFR 572.126 (Subpart N). ...

Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis.

PubMed

Negrini, Stefano; Zaina, Fabio; Romano, Michele; Negrini, Alessandra; Parzini, Silvana

2008-06-01

To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis. Prospective controlled cohort observational study. Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously. Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation. There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened. These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.

50 CFR Figure 15 to Part 223 - Weedless TED Brace Bar Description

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Weedless TED Brace Bar Description 15 Figure 15 to Part 223 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS THREATENED MARINE AND ANADROMOUS SPECIES Pt...

50 CFR Figure 15 to Part 223 - Weedless TED Brace Bar Description

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 10 2012-10-01 2012-10-01 false Weedless TED Brace Bar Description 15 Figure 15 to Part 223 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS THREATENED MARINE AND ANADROMOUS SPECIES Pt...

Trends in vena cava filter insertions and "prophylactic" use.

PubMed

Power, John R; Nakazawa, Kenneth R; Vouyouka, Ageliki G; Faries, Peter L; Egorova, Natalia N

2018-04-17

Prophylactic vena cava filter (VCF) use in patients without venous thromboembolism is common practice despite ongoing controversy. Thorough analysis of the evolution of this practice is lacking. We describe trends in VCF use and identify events associated with changes in practice. Using the National Inpatient Sample, we conducted a retrospective observational study of U.S. adult hospitalizations from 2000 to 2014. Trends in prophylactic VCF insertion were analyzed both across the entire study population and within subgroups according to trauma status and type of concurrent surgery. Annual percentage change (APC) was calculated, and trends were analyzed using Poisson regression. Among 461,904,314 adult inpatients (median [interquartile range] age, 58.1 [38.5-74.3] years; 39.6% male), the incidence of VCF insertion increased rapidly at first (from 0.19% to 0.35%; APC, 11.2%; 95% confidence interval [CI], 10.3%-12.2%; P < .001), then at a slower rate after the publication of the Prévention du Risque d'Embolie Pulmonaire par Interruption Cave 2 (PREPIC2) trial in 2005 (from 0.35% to 0.42%; APC, 4.4%; 95% CI, 2.8%-6.0%; P < .001), and it began decreasing after the 2010 Food and Drug Administration (FDA) safety alert (from 0.42% to 0.32%; APC, -5.5%; 95% CI, -6.5% to -4.6%; P < .001). The percentage of total VCFs that had a prophylactic indication increased quickly before publication of the PREPIC2 trial (APC, 19.5%; 95% CI, 17.9%-21.0%; P < .001), increased at a slower rate after publication in 2005 (APC, 4.4%; 95% CI, 2.6%-6.2%; P < .001), and dropped after the FDA safety alert, stabilizing at 18.5% for the last 3 years (APC, -0.3%; 95% CI, -2.2% to 1.7%; P = .8). Subgroups most associated with prophylactic VCF insertion were operative trauma (odds ratio [OR], 10.9; 95% CI, 10.2-11.7), orthopedic surgery (OR, 4.7; 95% CI, 4.3-5.2), and neurosurgical procedures (OR, 3.9; 95% CI, 3.6-4.2). All groups except orthopedic surgery experienced a deceleration in

Cost analysis of prophylactic intraoperative cystoscopic ureteral stents in gynecologic surgery.

PubMed

Fanning, James; Fenton, Bradford; Jean, Geraldine Marie; Chae, Clara

2011-12-01

Prophylactic intraoperative ureteral stent placement is performed to decrease operative ureteric injury, though few data are available on the effectiveness of this procedure, and no data are available on its cost. To analyze the cost of prophylactic intraoperative cystoscopic ureteral stents in gynecologic surgery. All cases of prophylactic ureteral stent placement performed in gynecologic surgery during a 1-year period were identified and retrospectively reviewed through the electronic medical records database of Summa Health System. Costs were obtained through the Healthcare Cost Accounting System. The principles of cost-effective analysis were used (ie, explicit and detailed descriptions of costs and cost-effectiveness statistics). Importantly, we evaluated cost and not charges or financial model estimates. In addition, we obtained the contribution margins (ie, the hospital's net profit or loss) for prophylactic ureteral stent placement. Other gynecologic procedures were also analyzed. Among 792 major inpatient gynecologic procedures, 18 cases of prophylactic intraoperative ureteral stents were identified. Median costs were as follows: additional cost of prophylactic intraoperative ureteral stenting, $1580; additional cost of surgical resources, $770; cost of ureteral catheters, $427; cost of surgeons, $383. The contribution margins per case for various gynecologic surgical procedures were as follows: oophorectomy, $2804 profit; abdominal hysterectomy, $2649 profit; laparoscopically assisted vaginal hysterectomy (LAVH), $1760 profit. When intraoperative ureteral stenting was added, the contribution margins changed to the following: oophorectomy, $782 profit; abdominal hysterectomy, $627 profit; LAVH, $262 loss. Overall, the contribution margin profit was decreased by about 85%, from $2400 to $380. Prophylactic intraoperative ureteral stenting in gynecologic surgery decreases a hospital's contribution margin. Because of the expense of this procedure, as well as

A tool for teaching the B-Lynch brace suture method: an inexpensive new simulator allows obstetricians to polish an essential technique.

PubMed

Pereira, Nigel; Delvadia, Dipak

2013-12-01

The B-Lynch brace suture is invaluable in the surgical management of postpartum hemorrhage, particularly as a fertility-sparing alternative to hysterectomy. In this video, we show how to create a low-cost simulator to teach the B-Lynch brace suture technique, followed by the intraoperative application of the same technique. Copyright © 2013 Mosby, Inc. All rights reserved.

Human occupants in low-speed frontal sled tests: effects of pre-impact bracing on chest compression, reaction forces, and subject acceleration.

PubMed

Kemper, Andrew R; Beeman, Stephanie M; Madigan, Michael L; Duma, Stefan M

2014-01-01

The purpose of this study was to investigate the effects of pre-impact bracing on the chest compression, reaction forces, and accelerations experienced by human occupants during low-speed frontal sled tests. A total of twenty low-speed frontal sled tests, ten low severity (∼2.5g, Δv=5 kph) and ten medium severity (∼5g, Δv=10 kph), were performed on five 50th-percentile male human volunteers. Each volunteer was exposed to two impulses at each severity, one relaxed and the other braced prior to the impulse. A 59-channel chestband, aligned at the nipple line, was used to quantify the chest contour and anterior-posterior sternum deflection. Three-axis accelerometer cubes were attached to the sternum, 7th cervical vertebra, and sacrum of each subject. In addition, three linear accelerometers and a three-axis angular rate sensor were mounted to a metal mouthpiece worn by each subject. Seatbelt tension load cells were attached to the retractor, shoulder, and lap portions of the standard three-point driver-side seatbelt. In addition, multi-axis load cells were mounted to each interface between the subject and the test buck to quantify reaction forces. For relaxed tests, the higher test severity resulted in significantly larger peak values for all resultant accelerations, all belt forces, and three resultant reaction forces (right foot, seatpan, and seatback). For braced tests, the higher test severity resulted in significantly larger peak values for all resultant accelerations, and two resultant reaction forces (right foot and seatpan). Bracing did not have a significant effect on the occupant accelerations during the low severity tests, but did result in a significant decrease in peak resultant sacrum linear acceleration during the medium severity tests. Bracing was also found to significantly reduce peak shoulder and retractor belt forces for both test severities, and peak lap belt force for the medium test severity. In contrast, bracing resulted in a significant

Planning horizon affects prophylactic decision-making and epidemic dynamics

DOE PAGES

Nardin, Luis G.; Miller, Craig R.; Ridenhour, Benjamin J.; ...

2016-11-08

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon?the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals? payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adoptmore » prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. Lastly, these effects can be made stronger by increasing the behavioral decision frequency or distorting an individual's perceived risk of infection.« less

Planning horizon affects prophylactic decision-making and epidemic dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nardin, Luis G.; Miller, Craig R.; Ridenhour, Benjamin J.

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon?the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals? payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adoptmore » prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. Lastly, these effects can be made stronger by increasing the behavioral decision frequency or distorting an individual's perceived risk of infection.« less

Planning horizon affects prophylactic decision-making and epidemic dynamics.

PubMed

Nardin, Luis G; Miller, Craig R; Ridenhour, Benjamin J; Krone, Stephen M; Joyce, Paul; Baumgaertner, Bert O

2016-01-01

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon-the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals' payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adopt prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. These effects can be made stronger by increasing the behavioral decision frequency or distorting an individual's perceived risk of infection.

Planning horizon affects prophylactic decision-making and epidemic dynamics

PubMed Central

Ridenhour, Benjamin J.; Krone, Stephen M.

2016-01-01

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon—the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals’ payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adopt prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. These effects can be made stronger by increasing the behavioral decision frequency or distorting an individual’s perceived risk of infection. PMID:27843714

Knee extension range of motion and self-report physical function in total knee arthroplasty: mediating effects of knee extensor strength

PubMed Central

2013-01-01

Background Knee extensor strength and knee extension range of motion (ROM) are important predictors of physical function in patients with a total knee arthroplasty (TKA). However, the relationship between the two knee measures remains unclear. The purpose of this study was to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function. Methods Data from 441 patients with a TKA were collected preoperatively and 6 months postoperatively. Self-report measure of physical function was assessed by the Short Form 36 (SF-36) questionnaire. Knee extensor strength was measured by handheld dynamometry and knee extension ROM by goniometry. A bootstrapped cross product of coefficients approach was used to evaluate mediation effects. Results Mediation analyses, adjusted for clinicodemographic measures, revealed that the association between changes in knee extension ROM and SF-36 physical function was mediated by changes in knee extensor strength. Conclusions In patients with TKA, knee extensor strength mediated the influence of knee extension ROM on physical function. These results suggest that interventions to improve the range of knee extension may be useful in improving knee extensor performance. PMID:23332039

Mechanical and Clinical Evaluation of a Shape Memory Alloy and Conventional Struts in a Flexible Scoliotic Brace.

PubMed

Chan, Wing-Yu; Yip, Joanne; Yick, Kit-Lun; Ng, Sun-Pui; Lu, Lu; Cheung, Kenneth Man-Chee; Kwan, Kenny Yat-Hong; Cheung, Jason Pui-Yin; Yeung, Kelvin Wai-Kwok; Tse, Chi-Yung

2018-04-24

Smart materials have attracted considerable attention in the medical field. In particular, shape memory alloys (SMAs) are most commonly utilized for their superelasticity (SE) in orthopaedic treatment. In this study, the resin struts of a flexible brace for adolescent idiopathic scoliosis (AIS) are replaced with different conventional materials and an SMA. The corrective mechanism mainly depends on the compressive force applied by the brace at the desired location. Therefore, the mechanical properties of the materials used and the interface pressure are both critical factors that influence the treatment effectiveness. The results indicate that titanium is the most rigid among the five types of materials, whereas the brace with SMA struts presents the best recovery properties and the most stable interface pressure. A radiographic examination of two patients with AIS is then conducted to validate the results, which shows that the SMA struts can provide better correction of thoracic curvature. These findings suggest that SMAs can be applied in orthoses because their SE allows for continuous and controllable corrective forces.

Cruise Speed Sensitivity Study for Transonic Truss Braced Wing

NASA Technical Reports Server (NTRS)

Wells, Douglas P.

2017-01-01

NASA's investment and research in aviation has led to new technologies and concepts that make aircraft more efficient and environmentally friendly. One aircraft design operational concept is the reduction of cruise speed to reduce fuel burned during a mission. Although this is not a new idea, it was used by all of the contractors involved in a 2008 NASA sponsored study that solicited concept and technology ideas to reduce environmental impacts for future subsonic passenger transports. NASA is currently improving and building new analysis capabilities to analyze advanced concepts. To test some of these new capabilities, a transonic truss braced wing configuration was used as a test case. This paper examines the effects due to changes in the design cruise speed and other tradeoffs in the design space. The analysis was baselined to the Boeing SUGAR High truss braced wing concept. An optimization was run at five different design cruise Mach numbers. These designs are compared to provide an initial assessment space and the parameters that should be considered when selecting a design cruise speed. A discussion of the design drivers is also included. The results show that the wing weight in the current analysis has more influence on the takeoff gross weight than expected. This effect caused lower than expected wing sweep angle values for higher cruise speed designs.

[Knee disarticulation and through-knee amputation].

PubMed

Baumgartner, R

2011-10-01

A knee disarticulation or a through-knee stump is superior compared to a transfemoral stump. The thigh muscles are all preserved, and the muscle balance remains undisturbed. The range of motion of the hip joint is not limited. The bulbous shape of the stump allows full weight bearing at the stump end and can easily be fitted with a prosthesis. An amputee with a bilateral knee disarticulation is able to walk "barefoot". A more distal amputation level, e.g., an ultra-short transtibial amputation, is not possible. Important alternative to transfemoral amputations. Possible for any etiology except for Buerger-Winiwarter's disease. New indications are infected and loosened total knee replacements. Preservation of the knee joint is possible. Knee disarticulation is a very atraumatic procedure, compared to transfemoral amputations. Neither bones nor muscles have to be severed, just skin, ligaments, vessels, and nerves. Even the meniscal cartilages may be left in place to act as axial shock absorbers. The cartilage of the femur is not resected, but only bevelled in case of osteoarthritis. There are no tendon attachments or myoplastic procedures necessary. The patella remains in place and is held in position only by the retinacula. Skin closure must be performed without the slightest tension, and if possible not in the weight-bearing area. Transcondylar amputations across the femoral condyles only are indicated when there are not sufficient soft tissues for wound closure of a knee disarticulation. Alternatives as the techniques of Gritti, Klaes, and Eigler, the shortening of the femur and the Sauerbruch's rotation plasty [14] are presented and discussed. The risk of decubital ulcers is rather high. Correct bandaging of the stump is, therefore, particularly important. Prosthetic fitting is possible 3-6 weeks after surgery. The type of prosthesis depends on the amputee's activity level. The superior performance of amputees with knee disarticulations in sports prove the

Total Knee Replacement

PubMed Central

2005-01-01

the knee prosthesis. The most common risks and complications associated with TKR are deep venous thrombosis, infection, stiffness, loosening, and osteolysis. To prevent deep venous thrombosis, patients are treated with heparin prophylactically and/or given support stockings to wear. Patients are also given antibiotics for 24 hours after surgery to minimize the risk of infection. Stiffness is another associated complication. In most patients, it can be avoided by keeping the knee moving in the days and weeks following surgery. The National Institutes of Health in the United States concluded that the indications for TKR should include the following: radiological evidence of joint damage, moderate to severe persistent pain that is not adequately relieved by nonsurgical management, and clinically significant functional limitation resulting in diminished quality of life. Review Strategy In March 2005, the following databases were searched: Cochrane Library International Agency for Health Technology Assessment (first quarter 2005), Cochrane Database of Systematic Reviews (first quarter 2005), Cochrane Central Register of Controlled Trials (first quarter 2005), MEDLINE (1966 to March 2005), MEDLINE In-Process and Other Non-indexed Citations (1966 to March 14, 2005), and EMBASE (1980 to 2005 week 9). The Medical Advisory Secretariat also searched Medscape on the Internet for recent reports on trials that were unpublished but that were presented at international conferences. In addition, the Web site Current Controlled Trials (www.controlled-trials.com) was searched for ongoing trials investigating TKR or unicompartmental knee replacement. No studies were identified that compared TKR to an alternative treatment. Several studies have been reported that compare preoperative measurement scores on targeted measures of functioning and pain to postoperative measurement scores in patients undergoing various TKR procedures. In order for the Medical Advisory Secretariat to measure the

Radiographic evaluation of acute distal radius fracture stability: A comparative cadaveric study between a thermo-formable bracing system and traditional fiberglass casting.

PubMed

Santoni, Brandon G; Aira, Jazmine R; Diaz, Miguel A; Kyle Stoops, T; Simon, Peter

2017-08-01

Distal radius fractures are common musculoskeletal injuries and many can be treated non-operatively with cast immobilization. A thermo-formable brace has been developed for management of such fractures, but no data exist regarding its comparative stabilizing efficacy to fiberglass casting. A worst-case distal radius fracture was created in 6 cadaveric forearms. A radiolucent loading fixture was created to apply cantilever bending/compression loads ranging from 4.5N to 66.7N across the simulated fracture in the: (1) non-stabilized, (2) braced; and (3) casted forearms, each forearm serving as its own control. Fracture fragment translations and rotations were measured radiographically using orthogonal radiographs and a 2D-3D, CT-based transformation methodology. Under 4.5N of load in the non-stabilized condition, average sagittal plane rotation and 3D center of mass translation of the fracture fragment were 12.3° and 5.3mm, respectively. At the 4.5N load step, fragment rotation with the brace (avg. 0.0°) and cast (0.1°) reduced sagittal plane rotation compared to the non-stabilized forearm (P<0.001). There were no significant differences in measured sagittal plane fracture fragment rotations or 3D fragment translations between the brace or cast at any of the four load steps (4.5N, 22.2N, 44.5N, and 66.7N, P≥0.138). In this in vitro radiographic study utilizing 6 cadaveric forearms with simulated severe-case, unstable and comminuted distal radius fractures, the thermo-formable brace stabilized the fracture in a manner that was not radiographically or biomechanically different from traditional fiberglass casting. Study results support the use of the thermo-formable brace clinically. Copyright © 2017 Elsevier Ltd. All rights reserved.

21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral (hemi-knee...

Static knee alignment and its association with radiographic knee osteoarthritis.

PubMed

Teichtahl, A J; Cicuttini, F M; Janakiramanan, N; Davis, S R; Wluka, A E

2006-09-01

Although knee alignment is associated with the progression of knee osteoarthritis (OA), it is unclear which features that characterize radiographic OA are related to alignment. The aim of this study was to examine the relationship between static knee joint alignment (measured as a continuous variable) and the radiographic features of knee OA (joint space narrowing and osteophytes). One hundred and twenty one adults with symptomatic knee OA were recruited using a combined strategy including referral from specialist centres, arthritis support groups and media advertising. X-rays were performed to classify the severity of disease and to determine static knee alignment. Increasing varus knee alignment was associated with increasing risk of medial compartment joint space narrowing (P < 0.001) and osteophytes (P = 0.005). Increasing valgus knee alignment was associated with an increased risk for lateral compartment joint space narrowing (P < 0.001) and osteophytes (P = 0.002). This study has demonstrated that the static knee angle, measured as a continuous variable, is an important determinant of the compartment-specific features of radiographic knee OA. Further work is required to determine whether interventions aimed at correcting these relatively minor levels of varus and valgus angulation will have an effect on the risk of tibiofemoral OA.

Systematic review and meta-analysis of prophylactic abdominal drainage after pancreatic resection

PubMed Central

Dou, Chang-Wei; Liu, Zhi-Kui; Jia, Yu-Li; Zheng, Xin; Tu, Kang-Sheng; Yao, Ying-Min; Liu, Qing-Guang

2015-01-01

AIM: To investigate whether prophylactic abdominal drainage is necessary after pancreatic resection. METHODS: PubMed, Web of Science, and the Cochrane Library were systematically searched to obtain relevant articles published before January 2014. Publications were retrieved if they met the selection criteria. The outcomes of interest included: mortality, morbidity, postoperative pancreatic fistula (POPF), clinically relevant pancreatic fistula (CR-PF), abdominal abscess, reoperation rate, the rate of interventional radiology drainage, and the length of hospital stay. Subgroup analyses were also performed for pancreaticoduodenectomy (PD) and for distal pancreatectomy. Begg’s funnel plot and the Egger regression test were employed to assess potential publication bias. RESULTS: Nine eligible studies involving a total of 2794 patients were identified and included in this meta-analysis. Of the included patients, 1373 received prophylactic abdominal drainage. A fixed-effects model meta-analysis showed that placement of prophylactic drainage did not have beneficial effects on clinical outcomes, including morbidity, POPF, CR-PF, reoperation, interventional radiology drainage, and length of hospital stay (Ps > 0.05). In addition, prophylactic drainage did not significantly increase the risk of abdominal abscess. Overall analysis showed that omitting prophylactic abdominal drainage resulted in higher mortality after pancreatectomy (OR = 1.56; 95%CI: 0.93-2.92). Subgroup analysis of PD showed similar results to those in the overall analysis. Elimination of prophylactic abdominal drainage after PD led to a significant increase in mortality (OR = 2.39; 95%CI: 1.22-4.69; P = 0.01). CONCLUSION: Prophylactic abdominal drainage after pancreatic resection is still necessary, though more evidence from randomized controlled trials assessing prophylactic drainage after PD and distal pancreatectomy are needed. PMID:25987799

Knee MRI scan

MedlinePlus

... CT scan of the knee Knee x-ray Alternative Names MRI - knee; Magnetic resonance imaging - knee Patient ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

Association of knee confidence with pain, knee instability, muscle strength, and dynamic varus-valgus joint motion in knee osteoarthritis.

PubMed

Skou, Søren T; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Bennell, Kim L

2014-05-01

To investigate associations between self-reported knee confidence and pain, self-reported knee instability, muscle strength, and dynamic varus-valgus joint motion during walking. We performed a cross-sectional analysis of baseline data from 100 participants with symptomatic and radiographic medial tibiofemoral compartment osteoarthritis (OA) and varus malalignment recruited for a randomized controlled trial. The extent of knee confidence, assessed using a 5-point Likert scale item from the Knee Injury and Osteoarthritis Outcome Score, was set as the dependent variable in univariable and multivariable ordinal regression, with pain during walking, self-reported knee instability, quadriceps strength, and dynamic varus-valgus joint motion during walking as independent variables. One percent of the participants were not troubled with lack of knee confidence, 17% were mildly troubled, 50% were moderately troubled, 26% were severely troubled, and 6% were extremely troubled. Significant associations were found between worse knee confidence and higher pain intensity, worse self-reported knee instability, lower quadriceps strength, and greater dynamic varus-valgus joint motion. The multivariable model consisting of the same variables significantly accounted for 24% of the variance in knee confidence (P < 0.001). Worse knee confidence is associated with higher pain, worse self-reported knee instability, lower quadriceps muscle strength, and greater dynamic varus-valgus joint motion during walking. Since previous research has shown that worse knee confidence is predictive of functional decline in knee OA, addressing lack of knee confidence by treating these modifiable impairments could represent a new therapeutic target. Copyright © 2014 by the American College of Rheumatology.

Clinical assessment of the efficacy of SpineCor brace in the correction of postural deformities in the course of idiopathic scoliosis.

PubMed

Plewka, Barbara; Sibiński, Marcin; Synder, Marek; Witoński, Dariusz; Kołodziejczyk-Klimek, Katarzyna; Plewka, Michał

2013-03-26

The objective of the study was to perform a clinical, comparative assessment of the degree of postural deformities before and after the treatment of idiopathic scoliosis in patients treated with SpineCor brace compared to the control group. A group of 90 children with idiopathic scoliosis (including 74 girls) at the average age of 12.2 was subject to prospective observation. Average pre-treatment Cobb angle was 24.9° in the thoracic spine and 25.8° in the lumbar spine. The group actively treated with the SpineCor brace consisted of 45 children, while the control group consisted of the remaining 45 children with the natural course of the disease. Both groups did not differ significantly in terms of age, gender, height, body weight, Risser sign of skeletal maturity and baseline clinical and radiological parameters of scoliosis. Significant reduction of rib hump was observed upon 2-year SpineCor brace treatment (P=0.04) compared to the group treated by physiotherapy only (P=0.91). Similarly, improvement in lumbar prominence was observed in the actively treated group (P=0.009), with a trend towards worse results in the control group (P=0.07) In the group treated with the SpineCor brace, significant reduction in pectoral and hamstring muscle contractures as well as reduction in shoulder asymmetry and reduction in anterior and posterior vertical deviation were observed. Treatment using the SpineCor dynamic brace leads to a clinical improvement in posture, particularly to reduction in rib hump, lumbar prominence and muscular contractures.

Benefit-Risk Assessment, Communication, and Evaluation (BRACE) throughout the life cycle of therapeutic products: overall perspective and role of the pharmacoepidemiologist.

PubMed

Radawski, Christine; Morrato, Elaine; Hornbuckle, Kenneth; Bahri, Priya; Smith, Meredith; Juhaeri, Juhaeri; Mol, Peter; Levitan, Bennett; Huang, Han-Yao; Coplan, Paul; Li, Hu

2015-12-01

Optimizing a therapeutic product's benefit-risk profile is an on-going process throughout the product's life cycle. Different, yet related, benefit-risk assessment strategies and frameworks are being developed by various regulatory agencies, industry groups, and stakeholders. This paper summarizes current best practices and discusses the role of the pharmacoepidemiologist in these activities, taking a life-cycle approach to integrated Benefit-Risk Assessment, Communication, and Evaluation (BRACE). A review of the medical and regulatory literature was performed for the following steps involved in therapeutic benefit-risk optimization: benefit-risk evidence generation; data integration and analysis; decision making; regulatory and policy decision making; benefit-risk communication and risk minimization; and evaluation. Feedback from International Society for Pharmacoepidemiology members was solicited on the role of the pharmacoepidemiologist. The case example of natalizumab is provided to illustrate the cyclic nature of the benefit-risk optimization process. No single, globally adopted benefit-risk assessment process exists. The BRACE heuristic offers a way to clarify research needs and to promote best practices in a cyclic and integrated manner and highlight the critical importance of cross-disciplinary input. Its approach focuses on the integration of BRACE activities for risk minimization and optimization of the benefit-risk profile. The activities defined in the BRACE heuristic contribute to the optimization of the benefit-risk profile of therapeutic products in the clinical world at both the patient and population health level. With interdisciplinary collaboration, pharmacoepidemiologists are well suited for bringing in methodology expertise, relevant research, and public health perspectives into the BRACE process. Copyright © 2015 John Wiley & Sons, Ltd.

Second generation cephalosporin antibiotic prophylaxis and Clostridium difficile infection in hip and knee arthroplasty.

PubMed

Al-Tawil, K; Babu, A; Loeffler, M; Williams, T

2017-05-01

Introduction The use of broad spectrum cephalosporin antibiotics has been discouraged by the Department of Health in England because of the link to increased Clostridium difficile infection rates. The aim of this study was to evaluate whether a local protocol that included the use of second generation cephalosporin (cefuroxime) antibiotics as a prophylactic agent was associated with increased risk of C difficile in elective hip and knee arthroplasty patients. Methods A retrospective intention-to-treat study was conducted. An infection control database of all cases of C difficile infection both in hospital and in the community was reviewed and cross-referenced against surgical records. A positive correlation was identified when a C difficile positive sample was documented within eight weeks of arthroplasty surgery. Results Only 1 case (0.02%) of C difficile positive diarrhoea was identified that correlated to the 8-week postoperative period following 4,488 arthroplasty procedures. Conclusions The use of cephalosporin antibiotic prophylaxis in the elective hip and knee arthroplasty setting does not appear to be associated with increased C difficile infection rates, achieving surgical site infection rates that are comparable with the national average.

50 CFR Figure 15 to Part 223 - Weedless TED Brace Bar Description

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Weedless TED Brace Bar Description 15 Figure 15 to Part 223 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS THREATENED MARINE AND ANADROMOUS SPECIES Pt. 223, Fig. 15 Figure 15 to Part 223...

The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteria: a prospective study.

PubMed

Negrini, Stefano; Donzelli, Sabrina; Lusini, Monia; Minnella, Salvatore; Zaina, Fabio

2014-08-06

Recently an RCT confirmed brace efficacy in adolescent idiopathic scoliosis (AIS) patients. Previously, a Cochrane review suggested also producing studies according to the Scoliosis Research Society (SRS) criteria on the effectiveness of bracing for AIS. Even if the SRS criteria propose a prospective design, until now only one out of 6 published studies was prospective. Our purpose was to evaluate the effects of bracing plus exercises following the SRS and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria for AIS conservative treatment. prospective cohort study nested in a clinical database of all outpatients of a clinic specialized in scoliosis conservative treatment. seventy-three patients (60 females), age 12 years 10 months ±17 months, 34.4±4.4 Cobb degrees, who satisfied SRS criteria were included out of 3,883 patients at first evaluation. Cobb angle at the end of treatment according to SRS criteria : (unchanged; worsened 6° or more, over 45° and surgically treated, and rate of improvement of 6° or more).Braces were prescribed for 18-23 hours/day according to curves magnitude and actual international guidelines. Weaning was gradual after Risser 3. All patients performed exercises and were managed according to SOSORT criteria. Results in all patients were analyzed according to intent-to-treat at the end of the treatment. Funding and Conflict of Interest: no. Overall 34 patients (52.3%) improved. Seven patients (9.6%) worsened, of which 1 patient progressed beyond 45° and was fused. Referred compliance was assessed during a mean period of 3 years 4 months ±20 months; the median adherence was 99.1% (range 22.2-109.2%). Employing intent-to-treat analysis, there were failures in 11 patients (15.1%). At start, these patients had statistically significant low BMI and kyphosis, high thoracic rotation and higher Cobb angles. Drop-outs showed reduced compliance and years of treatment; their average scoliosis at

13. 'Portal and Transverse Bracing, 1 180'01/4' c. to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. 'Portal and Transverse Bracing, 1 - 180'-0-1/4' c. to c. end pins S. Tr. Thro. Truss Span, 16th Crossing Sacramento River, Sacramento Division, So. Pac. Co., The Phoenix Bridge Co., C.O. #842, Draw #6, Engineer C. Scheidl, Draftsman Hermanns, Scale 1' = 1', Apr. 26, 1901.' - Southern Pacific Railroad Shasta Route, Bridge No. 324.99, Milepost 324.99, Shasta Springs, Siskiyou County, CA

[Total knee arthroplasty by lateral parapatellar approach for valgus knee].

PubMed

Zhou, Dian-ge; Zhang, Bin; Kou, Bo-long; Lü, Hou-shan

2007-07-17

To investigate the effect of lateral parapatellar approach in total knee arthroplasty (TKA) of valgus knee. Lateral parapatellar approach of total knee arthroplasty was applied in 8 patients (10 knees) with severe valgus osteoarthritis knee (bilateral in 2 cases and unilateral in 6 cases), with the valgus angle > 15 degrees , 1 male (1 knee) and 7 females (9 knee), aged 68.2 (58 - 79), 7 cases (9 knees) being of the Krackow type I and 1 case (1 knee) of the Krackow type I, I. After incision of the skin through lateral knee, ilio-tibial band was prolonged by apple pie arthroplasty. The joint capsule was cut open laterally 2 - 4 cm from the para-patellar edge. Soft tissue balance was performed by releasing I - T band in Gerdy tubercle, lateral collateral ligament and poster-lateral capsule from the femur and tibial side. Valgus angle of distal femur cutting were five degree. Whiteside line and trans-epicondylar line were used as AP rotational cutting reference. All patellar of the group were resurfaced. Capsule closure is completed with the knee flexed. The expanded deep lateral soft tissue sleeve (coronal Z-plasty) is sutured with the medial retinaculum sleeve (superficial layer). Follow-up was conducted for 19.6 months (1 - 51 months). Seven cases (9 knees) were replaced by posterior stabilized cemented prostheses (TC-Dynamic, PLUS), one case (1 knee) was replaced by RT prosthesis (RT-PLUS(TM) Solution, PLUS). After operation, the valgus deformity of all patients was corrected and all patients could walk 100 m with or without the help of walking holders. The average range of motion (ROM) was improved from the pre-operative. 95.6 degrees (85 degrees - 110 degrees ) to the post-operative 117.1 degrees (100 degrees - 125 degrees ). The average femorotibial angle (FTA) was corrected from the pre-operative. 27.6 degrees (20 degrees - 40 degrees ) to the post-operative 6.8 degrees (5 degrees - 9 degrees ). The Knee Score System (KSS) score and functional score were

21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be implanted...

21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made of...

Mathematical model to predict drivers' reaction speeds.

PubMed

Long, Benjamin L; Gillespie, A Isabella; Tanaka, Martin L

2012-02-01

Mental distractions and physical impairments can increase the risk of accidents by affecting a driver's ability to control the vehicle. In this article, we developed a linear mathematical model that can be used to quantitatively predict drivers' performance over a variety of possible driving conditions. Predictions were not limited only to conditions tested, but also included linear combinations of these tests conditions. Two groups of 12 participants were evaluated using a custom drivers' reaction speed testing device to evaluate the effect of cell phone talking, texting, and a fixed knee brace on the components of drivers' reaction speed. Cognitive reaction time was found to increase by 24% for cell phone talking and 74% for texting. The fixed knee brace increased musculoskeletal reaction time by 24%. These experimental data were used to develop a mathematical model to predict reaction speed for an untested condition, talking on a cell phone with a fixed knee brace. The model was verified by comparing the predicted reaction speed to measured experimental values from an independent test. The model predicted full braking time within 3% of the measured value. Although only a few influential conditions were evaluated, we present a general approach that can be expanded to include other types of distractions, impairments, and environmental conditions.

Outcome in adolescent idiopathic scoliosis after brace treatment and surgery assessed by means of the Scoliosis Research Society Instrument 24.

PubMed

Weigert, Karen Petra; Nygaard, Linda Marie; Christensen, Finn Bjarke; Hansen, Ebbe Stender; Bünger, Cody

2006-07-01

A retrospectively designed long-term follow-up study of adolescent idiopathic scoliosis (AIS) patients who had completed treatment, of at least 2 years, by means of brace, surgery, or both brace and surgery. This study is to assess the outcome after treatment for AIS by means of the Scoliosis Research Society Outcome Instrument 24 (SRS 24). One hundred and eighteen AIS patients (99 females and 19 males), treated at the Aarhus University Hospital from January 1, 1987 to December 31, 1997, were investigated with at least 2 years follow-up at the time of receiving a posted self-administered questionnaire. Forty-four patients were treated with Boston brace (B) only, 41 patients had surgery (S), and 33 patients were treated both with brace and surgery (BS). The Cobb angles of the three treatment groups did not differ significantly after completed treatment. The outcome in terms of the total SRS 24 score was not significantly different among the three groups. B patients had a significantly better general (not treatment related) self-image and higher general activity level than the total group of surgically treated patients, while surgically treated patients scored significantly better in post-treatment self-image and satisfaction. Comparing B with BS we found a significantly higher general activity level in B patients, while the BS group had significantly higher satisfaction. There were no significant differences between BS and S patients in any of the domain scores. All treatment groups scored "fair or better" in all domain scores of the SRS 24 questionnaire, except in post-treatment function, where all groups scored worse than "fair". Improvement of appearance by means of surgical correction increases mean scores for post-treatment self-image and post-treatment satisfaction. Double-treatment by brace and surgery does not appear to jeopardize a good final outcome.

[Clinical effect of total knee arthroplasty on patients with knee osteoarthritis combined with mild to moderate valgus knee deformity].

PubMed

Chen, Peng; Zeng, Min; Xie, Jie; Wang, Long; Su, Weiping; Hu, Yihe

2016-09-28

To investigate the clinical effect of total knee arthroplasty on patients with knee osteoarthritis combined with mild to moderate valgus knee deformity.
 A total of 15 patients received total knee arthroplasty for correcting mild (10°-15°) to moderate (15°-30°) valgus knee between January 2011 and February 2014 in Xiangya Hospital of Central South University. We adopted a stable prosthesis surgery through patellar medial approach, osteophytes cleaning, conventional osteotomy, a selective soft tissue release and balance technical correcting of knee valgus deformity. Then conventional anticoagulation and symptomatic rehabilitation was utilized. Preoperative and postoperative X-ray was conducted in patients with measuring femor-tibial angle (FTA) and inspecting the prosthesis position. FTA, visual analog scale (VAS) standard, and parallel knee scoring system (KSS) were used to evaluate the clinical effect.
 Fifteen patients were followed up for 14 to 36 (22.40±11.88) months. The hospitalization time was 7-13 (7.73±1.58) d; operative time was 58-110 (81.8±16.85) min, the dominant blood loss was 140-600 (337.30±143.65) mL. Two cases had knee extension hysteresis, and the knee activity recovered after exercise. Leg power lines were normal. Three postoperative cases suffered anterior knee pain. They were subjected to celecoxib analgesic treatment and the pain gradually eased after 3 months. One postoperative case showed incision discharge and swelling, which was healed after change of dressing. During follow-up, review of X-ray film does not show prosthesis loose, subsidence and other complications. The knee valgus angle (8.1±1.8)°, knee motion range (107.33±9.61)°, KSS knee score (74.7±14.5, 75.3±2.7) and pain score (2.5±0.9) were significantly better than the preoperative (P<0.05). The clinical and function KSS scores showed that the improvement rate was 80%. 
 Total knee arthroplasty is an effective way to treat patients with knee osteoarthritis

[Correlation analysis between interleukin 6 polymorphism and adolescent idiopathic scoliosis susceptibility and bracing effectiveness].

PubMed

Gao, Junsheng; Zhang, Lu; Liu, Zhiang; Yao, Shuaihui; Gao, Songming

2018-06-01

To analyze the correlation between the polymorphism on interleukin 6 (IL-6) gene promoter region-174 locus and adolescent idiopathic scoliosis (AIS), including the susceptibility, the bracing effectiveness, and the possible mechanism. The 182 AIS patients and 210 healthy controls who met the inclusion criteria between January 2013 and January 2016 were collected as research objects. The genotype of IL-6 gene promoter region-174 locus, the serum IL-6, the bone mineral density (BMD) of femoral neck and vertebrae (L 1-4 ), and the bone metabolism parameters, including bone alkaline phosphatase (BALP), bone gla protein (BGP), tartrate resistant acid phosphatase 5b (TRACP-5b), urine Ca, and urine Ca/Cr, were detected. All research objects were divided into the AIS group and the control group according to whether they had AIS, the GG, CG, CC groups according to their genotype, and progression-free group and progression group according to the therapeutic effectiveness of 1-year bracing treatment. Statistical analysis for the indexes were conducted respectively. There were significant differences in AIS history, BMD of femoral neck and lumbar vertebrae between the AIS group and control group ( P <0.05). According to the therapeutic effecitveness of 1-year bracing treatment, 182 AIS patients were divided into progression-free group in 110 cases and progression group in 72 cases. The results of single factor analysis showed that there were significant differences in the genotype and allele distribution of IL-6 gene promoter region-174 locus, BMD of femoral neck and lumbar vertebrae, IL-6, TRACP-5b, urine Ca, and urine Ca/Cr between the progression-free group and progression group ( P <0.05). The results of multivariable analysis showed that the BMD of lumbar vertebrae, TRACP-5b, and urine Ca were the influencing factors of bracing efficacy ( P< 0.05). According to the results of genotype detection, all research objects were divided into GG group in 264 cases, CG group in 104

Effect of kinesiotaping, non-elastic taping and bracing on segmental foot kinematics during drop landing in healthy subjects and subjects with chronic ankle instability.

PubMed

Kuni, B; Mussler, J; Kalkum, E; Schmitt, H; Wolf, S I

2016-09-01

To evaluate the effects of kinesiotape, non-elastic tape, and soft brace on segmental foot kinematics during drop landing in subjects with chronic ankle instability and healthy subjects. Controlled study with repeated measurements. Three-dimensional motion analysis laboratory. Twenty participants with chronic ankle instability and 20 healthy subjects. The subjects performed drop landings with 17 retroreflective markers on the foot and lower leg in four conditions: barefoot, with kinesiotape, with non-elastic tape and with a soft brace. Ranges of motion of foot segments using a foot measurement method. In participants with chronic ankle instability, midfoot movement in the frontal plane (inclination of the medial arch) was reduced significantly by non-elastic taping, but kinesiotaping and bracing had no effect. In healthy subjects, both non-elastic taping and bracing reduced that movement. In both groups, non-elastic taping and bracing reduced rearfoot excursion in inversion/eversion significantly, which indicates a stabilisation effect. No such effect was found with kinesiotaping. All three methods reduced maximum plantar flexion significantly. Non-elastic taping stabilised the midfoot best in patients with chronic ankle instability, while kinesiotaping did not influence foot kinematics other than to stabilise the rearfoot in the sagittal plane. ClinicalTrials.gov NCT01810471. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

[CORRECTION OF VARUS KNEE WITH REDUCTION OSTEOTOMY DURING TOTAL KNEE ARTHROPLASTY].

PubMed

Su, Weiping; Xie, Jie; Li, Mingqing; Zeng, Min; Lei, Pengfei; Wang, Long; Hu, Yihe

2015-12-01

To evaluate the effectiveness of reduction osteotomy for correction of varus knee during total knee arthroplasty. A retrospective analysis was made on the clinical data of 16 patients (24 knees) who received reduction osteotomy for correcting varus knee during total knee arthroplasty between May 2010 and July 2012. There were 2 males (3 knees) and 14 females (21 knees), with an average age of 67 years (range, 57-79 years). The disease duration ranged from 3 to 15 years (mean, 9.1 years). The Knee Society Score (KSS) was 38.71 ± 10.04 for clinical score and 50.31 ± 14.31 for functional score. The range of motion (ROM) of the knee was (91.88 ± 13.01). The tibiofemoral angle was (9.04 ± 4.53)° of varus deformity. Reduction osteotomy was applied to correct varus knee. The operation time was 85-245 minutes (mean, 165.5 minutes); the obvious blood loss was 10-800 mL (mean, 183.1 mL); the hospitalization time was 8-22 days (mean, 13.6 days). All incisions healed by first intention. No neurovascular injury or patellar fracture occurred. The follow-up duration ranged from 37 to 62 months (mean, 48 months). The tibiofemoral angle was corrected to (3.92 ± 1.89)° of valgus at 48 hours after operation. The lower limb alignment recovered to normal. The X-ray films showed no evidence of obvious radiolucent line, osteolysis, or prosthesis subsidence. The results of KSS were significantly improved to 84.21 ± 6.49 for clinical score and 85.31 ± 6.95 for functional score (t = 20.665, P = 0.000; t = 9.585, P = 0.000); and ROM of the knee was significantly increased to (105.83 ± 11.29)° (t = 8.333, P = 0.000) at last follow-up. The effectiveness of reduction osteotomy for varus knee deformity during total knee arthroplasty is satisfactory. Proper alignment, ROM, and function of knee can be achieved.

Brace treatment is effective in idiopathic scoliosis over 45°: an observational prospective cohort controlled study.

PubMed

Lusini, Monia; Donzelli, Sabrina; Minnella, Salvatore; Zaina, Fabio; Negrini, Stefano

2014-09-01

Recently, positive results in bracing patients with idiopathic scoliosis (IS) above 45° who refused surgery have been presented in a retrospective study. Obviously, this can give only an efficacy (EA) analysis, as there is neither a control group, nor it is possible to know failures because of dropouts. To present the prospective results of bracing patients affected by IS above 45° and still growing. Prospective study including all IS patients with 45° or more, Risser stage 0 to 4, who had their first evaluation in our institute, an outpatient clinic specialized in scoliosis evaluation and conservative treatment, from March 1, 2003 to December 21, 2010 and utterly denied any surgical intervention. Of 59 patients, we excluded 2 patients still in treatment and 57 (11 males) patients were included. At the beginning of the study, they were 15 years 3±22 months of age, had 52.5° Cobb (range, 45°-93°), and Risser 2 (0-4). Thirty-nine accepted a full-time brace treatment (BG) to try avoiding surgery, 18 refused any treatment and served as controls (CG). Physiological measures: radiographic and clinical data. Treatment: A year of full-time Sforzesco brace (23 hours/day) or Risser cast (8-12 months) and gradual weaning after Risser 3; all patients performed exercises; and International Society on Scoliosis Orthopaedic and Rehabilitation TREATMENT management criteria were respected. Analyses: EA in patients who completed treatment/observation (34 in BG and 10 in CG) and intent-to-treat (ITT) with worst case analysis in the whole population. Relative risk (RR) and 95% confidence interval (CI) have been computed. Efficacy: failures were 23.5% in BG and 100% in CG. Intent-to-treat: failures were 20.5% in BG and 55.6% in CG. Relative risks of failure in CG were 4.3 (95% CI, 3.6-4.9) in EA and 2.7 (95% CI, 2.0-3.5) in ITT (p<.05). Percentage of patients (53.8%) improved: RRs of improvement in BG were 1.6 (95% CI, 1.46-1.9) in EA and 1.9 (95% CI, 1.6-2.2) in ITT (p<.05

Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.

PubMed

Messier, Stephen P; Beavers, Daniel P; Loeser, Richard F; Carr, J Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J; Hunter, David J; Devita, Paul

2014-09-01

Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Fat depots were quantified using computed tomography, and total lean and fat mass were determined with dual energy x-ray absorptiometry in 176 adults (age, 66.3 yr; body mass index, 33.5 kg·m) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Higher total body mass was significantly associated (P ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (P < 0.0001), patellofemoral forces (P < 0.006), and knee extensor moments (P = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (P = 0.0001), shear (P < 0.001), and patellofemoral forces (P = 0.01) and knee extension moment (P = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (P = 0.002). A regression model that included total thigh and total abdominal fat found that both were significantly associated with knee compressive and shear forces (P ≤ 0.04). Thigh fat was associated with knee abduction (P = 0.03) and knee extension moment (P = 0.02). Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA.

Association of magnetic resonance imaging-based knee cartilage T2 measurements and focal knee lesions with knee pain: data from the Osteoarthritis Initiative.

PubMed

Baum, Thomas; Joseph, Gabby B; Arulanandan, Ahilan; Nardo, Lorenzo; Virayavanich, Warapat; Carballido-Gamio, Julio; Nevitt, Michael C; Lynch, John; McCulloch, Charles E; Link, Thomas M

2012-02-01

To evaluate the association of magnetic resonance imaging (MRI)-based knee cartilage T2 measurements and focal knee lesions with knee pain in knees without radiographic osteoarthritis (OA) among subjects with OA risk factors. We studied the right knees of 126 subjects from the Osteoarthritis Initiative database. We randomly selected 42 subjects ages 45-55 years with OA risk factors, right knee pain (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain score ≥5), no left knee pain (WOMAC pain score 0), and no radiographic OA (Kellgren/Lawrence [K/L] score ≤1) in the right knee. We also selected 2 comparison groups: 42 subjects without knee pain in either knee and 42 with bilateral knee pain. Both groups were frequency matched to subjects with right knee pain only by sex, age, body mass index, and K/L score. All of the subjects underwent 3T MRI of the right knee. Focal knee lesions were assessed and cartilage T2 measurements were performed. Prevalences of meniscal, bone marrow, and ligamentous lesions and joint effusion were not significantly different between the groups (P > 0.05), while cartilage lesions were more frequent in subjects with right knee pain only compared to subjects without knee pain (P < 0.05). T2 values averaged over all of the compartments were similar in subjects with right knee pain only (mean ± SD 34.4 ± 1.8 msec) and in subjects with bilateral knee pain (mean ± SD 34.7 ± 4.7 msec), but were significantly higher compared to subjects without knee pain (mean ± SD 32.4 ± 1.8 msec; P < 0.05). These results suggest that elevated cartilage T2 values are associated with findings of pain in the early phase of OA, whereas among morphologic knee abnormalities only knee cartilage lesions are significantly associated with knee pain status. Copyright © 2012 by the American College of Rheumatology.

Low risk of perioperative infection without prophylactic antibiotics for transperineal prostate brachytherapy.

PubMed

Wallner, K; Roy, J; Harrison, L

1996-10-01

To determine the incidence of postimplant infection in patients who are not given prophylactic antibiotics (ATBs). One hundred thirty-one patients had computerized tomography (CT)-planned transperineal 125I implantation of the prostate from 1988 through 1995. One hundred fourteen of the patients did not receive prophylactic ATBs, 19 of whom required postimplant Foley catheter drainage for 1 day or more for acute urinary retention. The incidence of postimplant febrile episodes within 2 weeks of surgery among the patients who had not received prophylactic ATBs was 2 of 114 (2%). One of the two patients who developed postimplantation febrile episodes was treated successfully with ATBs as an outpatient. The second patient, who had a history of chronic lymphocytic leukemia (CLL) and immune suppression, developed E. coli sepsis and required intravenous antibiotics. Of 17 patients who received prophylactic ATBs, none had a postoperative febrile episode. We continue to refrain from routinely prescribing prophylactic ATBs unless there is some compelling circumstance including rheumatic heart disease, prosthetic devices, immune compromise, or a previous history of prostatitis.

Prophylactic hyperthermic intraperitoneal chemotherapy in patients with epithelial appendiceal neoplasms.

PubMed

Tuvin, Daniel; Berger, Yaniv; Aycart, Samantha N; Shtilbans, Tatiana; Hiotis, Spiros; Labow, Daniel M; Sarpel, Umut

2016-05-01

Background Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising approach for preventing peritoneal carcinomatosis in high-risk patients. We report our initial experience with prophylactic HIPEC in a series of patients with appendiceal neoplasms. Methods We retrospectively reviewed our prospectively maintained database to identify patients who underwent HIPEC in the absence of peritoneal disease. Patients with previously documented peritoneal surface disease were excluded. Data regarding clinical, operative and pathological features were analysed. Results Out of 322 HIPEC procedures performed between March 2007and August 2015, we identified 16 patients who underwent surgery with prophylactic intent. Primary diagnoses included high-grade and low-grade appendiceal neoplasms. Most patients presented originally with appendiceal perforation; all patients underwent initial surgery during which the appendix or right colon were resected. Following a median time interval of 2.2 months, a second surgery performed at our institution consisted of completion of omentectomy, partial colectomy and oophorectomy, with administration of prophylactic HIPEC (using mitomycin C). A totally laparoscopic approach was attempted and achieved in 11 patients in whom the median duration of surgery, estimated intraoperative blood loss and length of hospitalisation were 251 min, 100 cm(3) and 4 days, respectively. There were no cases of major perioperative morbidity or mortality. Conclusions Prophylactic HIPEC for appendiceal neoplasms is feasible, safe and may be performed laparoscopically. Larger studies with long-term follow-up are needed to determine whether a survival benefit is associated with this treatment.

13. 'Transverse Bracing for 1 208'101/2' C. to C. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. 'Transverse Bracing for 1 - 208'-10-1/2' C. to C. End Pins S. Tr. Thro. Skew Span, 6th Crossing of Sacramento River, So. Pac. Co., The Phoenix Bridge Co., C.O. 836D, Drawing No. 7, Scale - 1' = 1', Engineer - B.M. Krohn, May 11th `01, Slaughter' - Southern Pacific Railroad Shasta Route, Bridge No. 301.85, Milepost 301.85, Pollard Flat, Shasta County, CA

Computer-assisted design and finite element simulation of braces for the treatment of adolescent idiopathic scoliosis using a coronal plane radiograph and surface topography.

PubMed

Pea, Rany; Dansereau, Jean; Caouette, Christiane; Cobetto, Nikita; Aubin, Carl-Éric

2018-05-01

Orthopedic braces made by Computer-Aided Design and Manufacturing and numerical simulation were shown to improve spinal deformities correction in adolescent idiopathic scoliosis while using less material. Simulations with BraceSim (Rodin4D, Groupe Lagarrigue, Bordeaux, France) require a sagittal radiograph, not always available. The objective was to develop an innovative modeling method based on a single coronal radiograph and surface topography, and assess the effectiveness of braces designed with this approach. With a patient coronal radiograph and a surface topography, the developed method allowed the 3D reconstruction of the spine, rib cage and pelvis using geometric models from a database and a free form deformation technique. The resulting 3D reconstruction converted into a finite element model was used to design and simulate the correction of a brace. The developed method was tested with data from ten scoliosis cases. The simulated correction was compared to analogous simulations performed with a 3D reconstruction built using two radiographs and surface topography (validated gold standard reference). There was an average difference of 1.4°/1.7° for the thoracic/lumbar Cobb angle, and 2.6°/5.5° for the kyphosis/lordosis between the developed reconstruction method and the reference. The average difference of the simulated correction was 2.8°/2.4° for the thoracic/lumbar Cobb angles and 3.5°/5.4° the kyphosis/lordosis. This study showed the feasibility to design and simulate brace corrections based on a new modeling method with a single coronal radiograph and surface topography. This innovative method could be used to improve brace designs, at a lesser radiation dose for the patient. Copyright © 2018 Elsevier Ltd. All rights reserved.

Improved knee biomechanics among patients reporting a good outcome in knee-related quality of life one year after total knee arthroplasty.

PubMed

Naili, Josefine E; Wretenberg, Per; Lindgren, Viktor; Iversen, Maura D; Hedström, Margareta; Broström, Eva W

2017-03-21

It is not well understood why one in five patients report poor outcomes following knee arthroplasty. This study evaluated changes in knee biomechanics, and perceived pain among patients reporting either a good or a poor outcome in knee-related quality of life after total knee arthroplasty. Twenty-eight patients (mean age 66 (SD 7) years) were included in this prospective study. Within one month of knee arthroplasty and one year after surgery, patients underwent three-dimensional (3D) gait analysis, completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), and rated perceived pain using a visual analogue scale. A "good outcome" was defined as a change greater than the minimally detectable change in the KOOS knee-related quality of life, and a "poor outcome" was defined as change below the minimally detectable change. Nineteen patients (68%) were classified as having a good outcome. Groups were analyzed separately and knee biomechanics were compared using a two-way repeated measures ANOVA. Differences in pain between groups were evaluated using Mann Whitney U test. Patients classified as having a good outcome improved significantly in most knee gait biomechanical outcomes including increased knee flexion-extension range, reduced peak varus angle, increased peak flexion moment, and reduced peak valgus moment. The good outcome group also displayed a significant increase in walking speed, a reduction (normalization) of stance phase duration (% of gait cycle) and increased passive knee extension. Whereas, the only change in knee biomechanics, one year after surgery, for patients classified as having a poor outcome was a significant reduction in peak varus angle. No differences in pain postoperatively were found between groups. Patients reporting a good outcome in knee-related quality of life improved in knee biomechanics during gait, while patients reporting a poor outcome, despite similar reduction in pain, remained unchanged in knee biomechanics one year after

Seismic rehabilitation of skewed and curved bridges using a new generation of buckling restrained braces.

DOT National Transportation Integrated Search

2016-12-01

The objective of this project is to find effective configurations for using buckling restrained braces (BRBs) in both skewed and curved bridges for reducing the effects of strong earthquakes. Verification is performed by numerical simulation using an...

In defense of adolescents: They really do use braces for the hours prescribed, if good help is provided. Results from a prospective everyday clinic cohort using thermobrace

PubMed Central

2012-01-01

Background The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results. Methods Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2±2.4) and 20 already in treatment. Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines. Methods. A heat sensor, “Thermobrace” (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated. Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used. Results Average TB use: 5.5±1.5 months. Brace prescription was 23 hours/day (h/d) (IC95 18–23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11–23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P < 0.05). Sixty percent of the patients had at least 90% compliance, and 45% remained within 1 hour of what had been prescribed. Non-wearing days were 0 (IC95 0–12.95), and involved 29% of patients. Conclusion This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role

ACL reconstruction with hamstring tendon autograft and accelerated brace-free rehabilitation: a systematic review of clinical outcomes

PubMed Central

van Melick, Nicky; van Mourik, Jan B A; Reijman, Max; van Rhijn, Lodewijk W

2018-01-01

Objective To investigate the clinical outcomes after hamstring tendon autograft ACL reconstruction (ACLR) with accelerated, brace-free rehabilitation. Design Systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Data sources Embase, MEDLINE Ovid, Web of Science, Cochrane CENTRAL and Google scholar from 1 January 1974 to 31 January 2017. Eligibility criteria for selecting studies Study designs reporting outcomes in adults after arthroscopic, primary ACLR with hamstring autograft and accelerated, brace-free rehabilitation. Results Twenty-four studies were included in the review. The clinical outcomes after hamstring tendon autograft ACLR with accelerated brace-free rehabilitation were the following: (1) early start of open kinetic exercises at 4 weeks in a limited range of motion (ROM, 90°−45°) and progressive concentric and eccentric exercises from 12 weeks did not alter outcomes, (2) gender and age did not influence clinical outcomes, (3) anatomical reconstructions showed better results than non-anatomical reconstructions, (4) there was no difference between single-bundle and double-bundle reconstructions, (5) femoral and tibial tunnel widening occurred, (6) hamstring tendons regenerated after harvest and (7) biological knowledge did not support return to sports at 4–6 months. Conclusions After hamstring tendon autograft ACLR with accelerated brace-free rehabilitation, clinical outcome is similar after single-bundle and double-bundle ACLR. Early start of open kinetic exercises at 4 weeks in a limited ROM (90°−45°) and progressive concentric and eccentric exercises from 12 weeks postsurgery do not alter clinical outcome. Further research should focus on achievement of best balance between graft loading and graft healing in the various rehabilitation phases after ACLR as well as on validated, criterion-based assessments for safe return to sports. Level of evidence Level 2b; therapeutic outcome studies

Varus Thrust and Knee Frontal Plane Dynamic Motion in Persons with Knee Osteoarthritis

PubMed Central

Chang, Alison H.; Chmiel, Joan S.; Moisio, Kirsten C.; Almagor, Orit; Zhang, Yunhui; Cahue, September; Sharma, Leena

2013-01-01

Objective Varus thrust visualized during walking is associated with a greater medial knee and an increased risk of medial knee osteoarthritis (OA) progression. Little is known about varus thrust presence determined by visual observation relates to quantitative gait kinematic We hypothesized that varus thrust presence is associated with greater knee frontal plane dynamic movement during the stance phase of gait. Methods Participants had knee OA in at least one knee. Trained examiners assessed participants for varus thrust presence during ambulation. Frontal plane knee motion during ambulation captured using external passive reflective markers and an 8-camera motion analysis system. To examine the cross-sectional relationship between varus thrust and frontal plane knee motion, used multivariable regression models with the quantitative motion measures as dependent variables and varus thrust (present/absent) as predictor; models were adjusted for age, gender, BMI, gait speed, and knee static alignment. Results 236 persons [mean BMI: 28.5 kg/m2 (SD 5.5), mean age: 64.9 years (SD 10.4), 75.8% women] contributing 440 knees comprised the study sample. 82 knees (18.6%) had definite varus thrust. Knees with varus thrust had greater peak varus angle and greater peak varus angular velocity during stance than knees without varus thrust (mean differences 0.90° and 6.65°/sec, respectively). These patterns remained significant after adjusting for age, gender, BMI, gait speed, and knee static alignment. Conclusion Visualized varus thrust during walking was associated with a greater peak knee varus angular velocity and a greater peak knee varus angle during stance phase of gait. PMID:23948980

KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

PubMed Central

Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

2014-01-01

Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p < 0.0001), patellofemoral forces (p< 0.006), and knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p < 0.001), and patellofemoral forces (p = 0.01) and knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

Knee Instability and Basic and Advanced Function Decline in Knee Osteoarthritis.

PubMed

Sharma, Leena; Chmiel, Joan S; Almagor, Orit; Moisio, Kirsten; Chang, Alison H; Belisle, Laura; Zhang, Yunhui; Hayes, Karen W

2015-08-01

Manifestations of instability in knee osteoarthritis (OA) include low overall knee confidence, low confidence that the knees will not buckle, buckling, and excessive motion during gait. Confidence and buckling may particularly influence activity choices, contributing to events leading to disability. Buckling is more likely to affect advanced than basic functional tasks. In this prospective longitudinal study, we tested the hypothesis that overall knee confidence, buckling confidence, buckling, and frontal plane motion during gait are associated with advanced 2-year function outcomes in persons with knee OA. Persons with knee OA were queried about overall knee confidence (higher score = worse confidence), buckling confidence, and knee buckling, and underwent quantitative gait analysis to quantify varus-valgus excursion and angular velocity. Physical function was assessed using the Late-Life Function and Disability Instrument Basic and Advanced Lower Extremity Domain scores. Logistic regression was used to evaluate the relationship between baseline instability measures and baseline-to-2-year function outcome, adjusting for potential confounders. The sample was comprised of 212 persons (mean age 64.6 years, 76.9% women). Buckling was significantly associated with poor advanced function outcome (adjusted odds ratio [OR] 2.08, 95% confidence interval [95% CI] 1.03-4.20) but not basic function outcome. Overall knee confidence was significantly associated with advanced outcome (adjusted OR 1.65, 95% CI 1.01-2.70), while associations between buckling confidence and both outcomes approached significance. Neither varus-valgus excursion nor angular velocity during gait was associated with either outcome. Knee buckling and low knee confidence were each associated with poor 2-year advanced function outcomes. Current treatment does not address these modifiable factors; interventions to address them may improve outcome in knee OA. © 2015, American College of Rheumatology.

Real-Time Tracking of Knee Adduction Moment in Patients with Knee Osteoarthritis

PubMed Central

Kang, Sang Hoon; Lee, Song Joo; Zhang, Li-Qun

2014-01-01

Background The external knee adduction moment (EKAM) is closely associated with the presence, progression, and severity of knee osteoarthritis (OA). However, there is a lack of convenient and practical method to estimate and track in real-time the EKAM of patients with knee OA for clinical evaluation and gait training, especially outside of gait laboratories. New Method A real-time EKAM estimation method was developed and applied to track and investigate the EKAM and other knee moments during stepping on an elliptical trainer in both healthy subjects and a patient with knee OA. Results Substantial changes were observed in the EKAM and other knee moments during stepping in the patient with knee OA. Comparison with Existing Method(s) This is the first study to develop and test feasibility of real-time tracking method of the EKAM on patients with knee OA using 3-D inverse dynamics. Conclusions The study provides us an accurate and practical method to evaluate in real-time the critical EKAM associated with knee OA, which is expected to help us to diagnose and evaluate patients with knee OA and provide the patients with real-time EKAM feedback rehabilitation training. PMID:24361759

Knee Deformities in Children With Down Syndrome: A Focus on Knee Malalignment.

PubMed

Duque Orozco, Maria Del Pilar; Abousamra, Oussama; Chen, Brian Po-Jung; Rogers, Kenneth J; Sees, Julieanne P; Miller, Freeman

Patellofemoral instability (PFI) has been the most reported knee abnormality in people with Down syndrome. Other reported knee abnormalities have been associated with PFI and different management approaches have been described with variable outcomes. The aim of this study was to describe the anatomic variations of the knee in children with Down syndrome. A comparison between knees with and without PFI was performed and our experience in treating knee abnormalities in Down syndrome was also reported. Records of all children with Down syndrome were reviewed. Two groups were identified (knees with and without PFI). Radiographic measurements included the mechanical and anatomic lateral distal femoral angles, medial proximal tibial angle, angle of depression of medial tibial plateau, lateral tibial translation, and distal femoral physis-joint angle. On the lateral view, Insall-Salvati and Blackburne-Peel ratios were measured. The sulcus angle was measured on the tangential view. Measurements were compared between the 2 groups (with and without PFI).Knees with PFI were divided into 3 subgroups based on their treatment (group A: surgical valgus correction, group B: surgical soft tissue procedures for PFI, and group C: conservative treatment). Preoperative radiographs were used for the surgical group and last available radiographs were used for the conservative group. Clinical and radiographic data were compared between the groups. For groups A and B, clinical and radiographic data were also compared between preoperative and last visits. Of the 581 children with Down syndrome, 5% (31 children: 22 females, 9 males) had PFI in 56 knees. Mean age at diagnosis was 11.5±3.5 years. Of the remaining 550 children, 75 children had radiographs for 130 knees. Knees with PFI had significantly more valgus and a larger distal femoral physis-joint angle. Depression of the medial tibial plateau and lateral tibial translation were noted in knees with PFI. Insall-Salvati ratio was higher

How does knee pain affect trunk and knee motion during badminton forehand lunges?

PubMed

Huang, Ming-Tung; Lee, Hsing-Hsan; Lin, Cheng-Feng; Tsai, Yi-Ju; Liao, Jen-Chieh

2014-01-01

Badminton requires extensive lower extremity movement and a precise coordination of the upper extremity and trunk movements. Accordingly, this study investigated motions of the trunk and the knee, control of dynamic stability and muscle activation patterns of individuals with and without knee pain. Seventeen participants with chronic knee pain and 17 healthy participants participated in the study and performed forehand forward and backward diagonal lunges. This study showed that those with knee pain exhibited smaller knee motions in frontal and horizontal planes during forward lunge but greater knee motions in sagittal plane during backward lunge. By contrast, in both tasks, the injured group showed a smaller value on the activation level of the paraspinal muscles in pre-impact phase, hip-shoulder separation angle, trunk forward inclination range and peak centre of mass (COM) velocity. Badminton players with knee pain adopt a more conservative movement pattern of the knee to minimise recurrence of knee pain. The healthy group exhibit better weight-shifting ability due to a greater control of the trunk and knee muscles. Training programmes for badminton players with knee pain should be designed to improve both the neuromuscular control and muscle strength of the core muscles and the knee extensor with focus on the backward lunge motion.

Knee pain (image)

MedlinePlus

... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

Varus thrust and knee frontal plane dynamic motion in persons with knee osteoarthritis.

PubMed

Chang, A H; Chmiel, J S; Moisio, K C; Almagor, O; Zhang, Y; Cahue, S; Sharma, L

2013-11-01

Varus thrust visualized during walking is associated with a greater medial knee load and an increased risk of medial knee osteoarthritis (OA) progression. Little is known about how varus thrust presence determined by visual observation relates to quantitative gait kinematic data. We hypothesized that varus thrust presence is associated with greater knee frontal plane dynamic movement during the stance phase of gait. Participants had knee OA in at least one knee. Trained examiners assessed participants for varus thrust presence during ambulation. Frontal plane knee motion during ambulation was captured using external passive reflective markers and an 8-camera motion analysis system. To examine the cross-sectional relationship between varus thrust and frontal plane knee motion, we used multivariable regression models with the quantitative motion measures as dependent variables and varus thrust (present/absent) as predictor; models were adjusted for age, gender, body mass index (BMI), gait speed, and knee static alignment. 236 persons [mean BMI: 28.5 kg/m(2) (standard deviation (SD) 5.5), mean age: 64.9 years (SD 10.4), 75.8% women] contributing 440 knees comprised the study sample. 82 knees (18.6%) had definite varus thrust. Knees with varus thrust had greater peak varus angle and greater peak varus angular velocity during stance than knees without varus thrust (mean differences 0.90° and 6.65°/s, respectively). These patterns remained significant after adjusting for age, gender, BMI, gait speed, and knee static alignment. Visualized varus thrust during walking was associated with a greater peak knee varus angular velocity and a greater peak knee varus angle during stance phase of gait. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The feasibility of short term prophylactic antibiotics in gastric cancer surgery.

PubMed

Lee, Jun Suh; Lee, Han Hong; Song, Kyo Young; Park, Cho Hyun; Jeon, Hae Myung

2010-12-01

Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.

Prophylactic Transcatheter Arterial Embolization After Successful Endoscopic Hemostasis in the Management of Bleeding Duodenal Ulcer.

PubMed

Mille, Markus; Huber, Juliane; Wlasak, Rüdiger; Engelhardt, Thomas; Hillner, Yvette; Kriechling, Henri; Aschenbach, Rene; Ende, Katrin; Scharf, Jens-Gerd; Puls, Ralf; Stier, Albrecht

2015-10-01

The aim of this study was to demonstrate the new strategy of prophylactic transcatheter arterial embolization (TAE) of the gastroduodenal artery after endoscopic hemostasis of bleeding duodenal ulcers. TAE is a well-established method for the treatment of recurrent or refractory ulcer bleeding resistant to endoscopic intervention, which increasingly replaces surgical procedures. A new approach for improving outcome and reducing rebleeding episodes is the supplemental and prophylactic TAE after successful endoscopic hemostasis. This retrospective study included all patients (n=117) treated from 2008 to 2012 for duodenal ulcer bleeding. After initial endoscopic hemostasis, patients were assessed regarding their individual rebleeding risk. Patients with a low rebleeding risk (n=47) were conservatively treated, patients with a high risk for rebleeding (n=55) had prophylactic TAE of the gastroduodenal artery, and patients with endoscopically refractory ulcer bleeding received immediate TAE. The technical success of prophylactic TAE was 98% and the clinical success was 87% of cases. Rebleeding occurred in 11% of patients with prophylactic TAE and was successfully treated with repeated TAE or endoscopy. The major complication rate was 4%. Surgery was necessary in only 1 prophylactic TAE patient (0.9%) during the whole study period. Mortality associated with ulcer bleeding was 4% in patients with prophylactic TAE. Prophylactic TAE in patients with duodenal ulcers at high risk for rebleeding was feasible, effective at preventing the need for surgery, and had low major complication rates. Given these promising outcomes, prophylactic TAE should be further evaluated as a preventative therapy in high-risk patients.

Associated lateral/medial knee instability and its relevant factors in anterior cruciate ligament-injured knees.

PubMed

Yuuki, Arata; Muneta, Takeshi; Ohara, Toshiyuki; Sekiya, Ichiro; Koga, Hideyuki

2017-03-01

Associations of lateral/medial knee instability with anterior cruciate ligament (ACL) injury have not been thoroughly investigated. The purposes of this study were to investigate whether lateral/medial knee instability is associated with ACL injury, and to clarify relevant factors for lateral/medial knee instability in ACL-injured knees. One hundred and nineteen patients with unilateral ACL-injured knees were included. Lateral/medial knee instability was assessed with varus/valgus stress X-ray examination for both injured and uninjured knees by measuring varus/valgus angle, lateral/medial joint opening, and lateral/medial joint opening index. Manual knee instability tests for ACL were evaluated to investigate associations between lateral/medial knee instability and anterior and/or rotational instabilities. Patients' backgrounds were evaluated to identify relevant factors for lateral/medial knee instability. Damage on the lateral collateral ligament (LCL) on MRI was also evaluated. All parameters regarding lateral knee instability in injured knees were significantly greater than in uninjured knees. There were significant correlations between lateral knee instability and the Lachman test as well as the pivot shift test. Patients with LCL damage had significantly greater lateral joint opening than those without LCL damage on MRI. Sensitivity of LCL damage on MRI to lateral joint opening was 100%, while its specificity was 36%. No other relevant factors were identified. In medial knee instability, there were also correlations between medial knee instability and the Lachman test/pivot shift test. However, the correlations were weak and other parameters were not significant. Lateral knee instability was greater in ACL-deficient knees than in uninjured knees. Lateral knee instability was associated with ACL-related instabilities as well as LCL damage on MRI, whereas MRI had low specificity to lateral knee instability. On the other hand, the association of medial knee

CRPS Knee: How frequently encountered in differential diagnosis of Knee pain?

PubMed

Aggarwal, Aakanksha; Agarwal, Anil

2018-04-13

We have read with great interest the paper by Catelijne M. van Bussel [1] recently published in Pain Practice. I wish to congratulate the authors for their valuable contributions. In the said article, 12 patients who had complex regional pain syndrome confined to the knee have been included. Though reports have been published involving primarily the knee after total knee arthroplasty [2,3] the incidence of CRPS knee following trauma or otherwise is not well appreciated. We would have appreciated if presence or absence of any inciting event for the development CRPS knee in these 12 patients could be mentioned, which could be helpful in a better diagnosis and management of the patients with CRPS knee. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy.

PubMed

Wren, Tishya A L; Dryden, James W; Mueske, Nicole M; Dennis, Sandra W; Healy, Bitte S; Rethlefsen, Susan A

2015-01-01

To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy. A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions. Children demonstrated better stride length (11-12 cm), hip extension (2°-4°), and swing-phase dorsiflexion (9°-17°) in both braces versus barefoot. Push-off power (0.3 W/kg) and knee extension (5°) were better in ADR-AFOs than in DAFOs. Parent satisfaction and walking activity (742 steps per day, 43 minutes per day) were higher for DAFOs. ADR-AFOs produce better knee extension and push-off power; DAFOs produce more normal ankle motion, greater parent satisfaction, and walking activity. Both braces provide improvements over barefoot.

Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis.

PubMed

Misterska, Ewa; Głowacki, Jakub; Głowacki, Maciej; Okręt, Adam

2018-01-01

We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group's SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group's results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had a

Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis

PubMed Central

2018-01-01

We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients’ perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group’s SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group’s results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had

Difference in knee rotation between total and unicompartmental knee arthroplasties during stair climbing.

PubMed

Jung, Myung-Chul; Chung, Jun Young; Son, Kwang-Hyun; Wang, Hui; Hwang, Jaejin; Kim, Jay Joong; Kim, Joon Ho; Min, Byoung-Hyun

2014-08-01

The purpose of this study was to compare knee kinematics during stair walking in patients with simultaneous total knee arthroplasty (TKA) and unicompartmental knee arthroplasties (UKA). It was hypothesized that UKA would reproduce more normalized knee kinematics than TKA during stair ascent and descent. Six patients who received UKA in one knee and TKA in the other knee were included in the study. For this study, a four-step staircase was assembled with two force platforms being positioned at the centre of the second and third steps. Each patient was attached with 16 reflective markers at both lower extremities and was asked to perform five roundtrip trials of stair climbing. Kinematic parameters including stance duration, knee angle, vertical ground reaction force (GRF), joint reaction force, and moments were obtained and analysed using a10-camera motion system (VICON, Oxford, UK). Nonparametric Friedman test was used to compare the results between two arthroplasty methods and between stair ascent and descent. Compared to TKA, UKA knees exhibited significantly greater degree of rotation in transverse planes (5.0 degrees during ascent and 6.0 degrees during descent on average), but showed no difference in terms of the other parameters. When comparing the results during stair ascent with descent, overall greater knee angle, vertical GRF, joint reaction force, and moment were observed during stair descent. Both UKA and TKA knees have shown overall similar knee kinematics, though UKA knee may allow greater degree of rotation freedom, which resembles normal knee kinematics during stair walking.

Knee Dislocations

PubMed Central

Schenck, Robert C.; Richter, Dustin L.; Wascher, Daniel C.

2014-01-01

Background: Traumatic knee dislocation is becoming more prevalent because of improved recognition and increased exposure to high-energy trauma, but long-term results are lacking. Purpose: To present 2 cases with minimum 20-year follow-up and a review of the literature to illustrate some of the fundamental principles in the management of the dislocated knee. Study Design: Review and case reports. Methods: Two patients with knee dislocations who underwent multiligamentous knee reconstruction were reviewed, with a minimum 20-year follow-up. These patients were brought back for a clinical evaluation using both subjective and objective measures. Subjective measures include the following scales: Lysholm, Tegner activity, visual analog scale (VAS), Short Form–36 (SF-36), International Knee Documentation Committee (IKDC), and a psychosocial questionnaire. Objective measures included ligamentous examination, radiographic evaluation (including Telos stress radiographs), and physical therapy assessment of function and stability. Results: The mean follow-up was 22 years. One patient had a vascular injury requiring repair prior to ligament reconstruction. The average assessment scores were as follows: SF-36 physical health, 52; SF-36 mental health, 59; Lysholm, 92; IKDC, 86.5; VAS involved, 10.5 mm; and VAS uninvolved, 2.5 mm. Both patients had excellent stability and were functioning at high levels of activity for their age (eg, hiking, skydiving). Both patients had radiographic signs of arthritis, which lowered 1 subject’s IKDC score to “C.” Conclusion: Knee dislocations have rare long-term excellent results, and most intermediate-term studies show fair to good functional results. By following fundamental principles in the management of a dislocated knee, patients can be given the opportunity to function at high levels. Hopefully, continued advances in the evaluation and treatment of knee dislocations will improve the long-term outcomes for these patients in the

Soft tissue knee contracture of the knee due to melorheostosis, treated by total knee arthroplasty.

PubMed

Moulder, Elizabeth; Marsh, Clayton

2006-10-01

Melorheostosis is a rare condition which can cause soft tissue joint contractures. We present a case of melorheostosis causing disabling knee joint contracture, treated successfully by total knee arthroplasty.

Knee Injuries and Disorders

MedlinePlus

Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

Knee joint replacement

MedlinePlus

... Knee joint replacement - series References American Academy of Orthopedic Surgeons (AAOS) website. Treatment of osteoarthritis of the knee: evidence-based guideline 2nd edition (summary) . www.aaos.org/research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf . Updated May 18, 2013. Accessed ...

The effect of compliance to a Rigo System Cheneau brace and a specific exercise programme on idiopathic scoliosis curvature: a comparative study: SOSORT 2014 award winner

PubMed Central

2014-01-01

Background There is controversy as to whether conservative management that includes wearing a brace and exercises is effective in stabilising idiopathic scoliosis curves. A brace only prevents progression of the curve and has been shown to have favourable outcomes when patients are compliant. So the aim of this study was to: determine the effect of compliance to the Rigo System Cheneau (RSC) brace and a specific exercise programme on Idiopathic Scoliosis curvature; and to compare the Quality of Life (QoL) and psychological traits of compliant and non compliant subjects. Methods A pre/post test study design was used with a post study comparison between subjects who complied with the management and those who did not. Fifty one subjects, girls aged 12-16 years, Cobb angles 20-50 degrees participated in the study. Subjects were divided into two groups, according to their compliance, at the end of the study. The compliant group wore the brace 20 or more hours a day and exercised three or more times per week. The non-compliant group wore the brace less than 20 hours a day and exercised less than three times per week. Cobb angles, vertebral rotation, scoliometer readings, peak flow, quality of life and personality traits were compared between groups, using the student’s two sample t-test and an analysis of covariance. Results The compliant group, wore the brace 21.5 hours per day and exercised four times a week, and significantly improved in all measures compared to non compliant subjects, who wore the brace 12 hours per day, exercised 1.7 times a week and significantly deteriorated (p < 0.0001). The major Cobb angles in the compliant group improved 10.19°(±5.5) and deteriorated 5.52°(±4.3) in the non compliant group (p < 0.0001). Compliant subjects had a significantly better QoL than the non compliant subjects (p = 0.001). The compliant group were significantly more emotionally mature, stable and realistic than the non compliant group (p = 0

Three-dimensional action of Chêneau brace on thoracolumbar scoliosis.

PubMed

Kotwicki, Tomasz; Pietrzak, Szymon; Szulc, Andrzej

2002-01-01

We treated 18 girls for idiopathic thoracolumbar scoliosis with Chêneau brace. The apex of the curve was at Th12 or at L1 or at the disc Th12/L1. The initial Cobb angle varied from 21 to 42 degrees, mean 28. The follow up period was of 2 years and 6 months on the average. We noted the rib hump height on Adams' forward bending test. We measured Cobb angle, apical vertebra transposition and apical vertebra rotation (according to Perdriolle method) on antero-posterior standing radiograms before the treatment had started and at the moment of the best correction. We digitized antero-posterior and lateral standing radiograms with sonic digitizer GP-9 and we prepared computed reconstruction of the transversal plane of the spine with Hecquet and Graf's software RACHIS 91TM. The best clinical and radiological correction was achieved after 3 to 8 months of treatment (mean 5,5 months). We considered it as the fitting period and we analysed the correction achieved at that moment and at last follow-up. Cobb angle in brace ranged from 0 to 18 degrees, mean 9 degrees. The correction of apical vertebra transposition ranged from 51% to 100%, mean 80%. The correction of apical vertebra rotation ranged from 0% to 100%, mean 52%. The correction of rib hump ranged from 0 to 100%, mean 42%. Normal sagittal contour was established in 15 patients. important correction was present in each of the three planes.

Braces, wheelchairs, and iron lungs: the paralyzed body and the machinery of rehabilitation in the polio epidemics.

PubMed

Wilson, Daniel J

2005-01-01

The successful fund raising appeals of the March of Dimes employed images of cute crippled children standing on braces and forearm crutches, sitting in wheelchairs, or confined to iron lungs. Those who had to use these devices as a result of polio, however, were often stigmatized as cripples. American cultural antipathy to these assistive devices meant that polio survivors often had to overcome an emotional and psychological resistance to using them. Whatever their fears, polio survivors quickly discovered the functionality of braces and wheelchairs. By confronting the cultural stigma associated with these devices and in some sense embracing these mechanical "friends," polio survivors compensated for their paralyzed bodies and became active in the wider world of home, school and work.

Advanced concepts in knee arthrodesis.

PubMed

Wood, Jennifer H; Conway, Janet D

2015-03-18

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty.

Advanced concepts in knee arthrodesis

PubMed Central

Wood, Jennifer H; Conway, Janet D

2015-01-01

The aim is to describe advanced strategies that can be used to diagnose and treat complications after knee arthrodesis and to describe temporary knee arthrodesis to treat infected knee arthroplasty. Potential difficult complications include nonunited knee arthrodesis, limb length discrepancy after knee arthrodesis, and united but infected knee arthrodesis. If a nonunited knee arthrodesis shows evidence of implant loosening or failure, then bone grafting the nonunion site as well as exchange intramedullary nailing and/or supplemental plate fixation are recommended. If symptomatic limb length discrepancy cannot be satisfactorily treated with a shoe lift, then the patient should undergo tibial lengthening over nail with a monolateral fixator or exchange nailing with a femoral internal lengthening device. If a united knee arthrodesis is infected, the nail must be removed. Then the surgeon has the option of replacing it with a long, antibiotic cement-coated nail. The authors also describe temporary knee arthrodesis for infected knee arthroplasty in patients who have the potential to undergo insertion of a new implant. The procedure has two goals: eradication of infection and stabilization of the knee. A temporary knee fusion can be accomplished by inserting both an antibiotic cement-coated knee fusion nail and a static antibiotic cement-coated spacer. These advanced techniques can be helpful when treating difficult complications after knee arthrodesis and treating cases of infected knee arthroplasty. PMID:25793160

Quality of Life After Prophylactic Oophorectomy

DTIC Science & Technology

2002-09-01

information about the effects of prophylactic oophorectomy, this pilot study will provide significant information on the broader quality of life issues...They also need the opportunity to choose from an array of coping strategies to manage their health decisions. Studying multidimensional quality of life issues

Knee arthrodesis – ultima ratio for the treatment of the infected knee

PubMed Central

Tiemann, Andreas H. H.

2013-01-01

The irretrievable destruction of the knee due to trauma, tumor or infection is the indication for knee arthrodesis. The main reason for knee arthrodesis in terms of infection ist the infected total knee arthroplasty. Central problem is the definition of the term “irretrievable”. It is based on the subjective opinion of the attending physician and depends on his expert knowledge of this specific entity. The preservation of a functioning extremity is the main goal. This article shows the typical indications and contraindications for knee arthrodesis following septic knee diseases. In addition it gives insight into the biomechanical and technical considerations to be kept in mind. Finally the postoperative care and outcome of different techniques are analysed. PMID:26504699

Effect of prophylactic CPAP in very low birth weight infants in South America.

PubMed

Zubizarreta, J R; Lorch, S A; Marshall, G; D'Apremont, I; Tapia, J L

2016-08-01

The objective of this study was to examine the effect of prophylactic continuous positive airway pressure (CPAP) on infants born in 25 South American neonatal intensive care units affiliated with the Neocosur Neonatal Network using novel multivariate matching methods. A prospective cohort was constructed of infants with a birth weight 500 to 1500 g born between 2005 and 2011 who clinically were eligible for prophylactic CPAP. Patients who received prophylactic CPAP were matched to those who did not on 23 clinical and sociodemographic variables (N=1268). Outcomes were analyzed using the McNemar's test. Infants not receiving prophylactic CPAP had higher mortality rates (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.17, 2.46), need for any mechanical ventilation (OR=1.68, 95% CI 1.33, 2.14) and death or bronchopulmonary dysplasia (BPD) (OR=1.47, 95% CI 1.09, 1.98). The benefit of prophylactic CPAP varied by birth weight and gender. The implementation of this process was associated with a significant improvement in survival and survival free of BPD.