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Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing.

Katsuhira J, Matsudaira K, Yasui T, Iijima S, Ito A - Clin Interv Aging (2015)

Bottom Line: ES activity significantly decreased while wearing the ORF compared to the other two conditions.Center of pressure did not significantly differ among the conditions.The ORF significantly improved trunk alignment and decreased ES activity in healthy elderly subjects during static standing.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing and Rehabilitation Science at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan.

ABSTRACT

Purpose: Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons.

Patients and methods: Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles.

Results: Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not significant compared to no orthosis. Thorax extension angle and thorax angle on pelvis coordinate system significantly increased while wearing the ORF compared to the other two conditions. ES activity significantly decreased while wearing the ORF compared to the other two conditions. Internal oblique activity was significantly smaller while wearing the LSO than with no orthosis. Center of pressure did not significantly differ among the conditions.

Conclusion: The ORF significantly improved trunk alignment and decreased ES activity in healthy elderly subjects during static standing.

No MeSH data available.


Related in: MedlinePlus

Experimental conditions.Notes: (A) Without an orthosis, (B) with the LSO, (C) with the ORF.Abbreviations: ORF, orthosis with joints providing resistive force; LSO, lumbosacral orthosis.
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f3-cia-10-1413: Experimental conditions.Notes: (A) Without an orthosis, (B) with the LSO, (C) with the ORF.Abbreviations: ORF, orthosis with joints providing resistive force; LSO, lumbosacral orthosis.

Mentions: Participants freely stood for 10 seconds under three conditions in the laboratory setting: with no orthosis, with the ORF, and with an LSO (Damen Corset, Pacific Supply, Osaka, Japan; Figure 3). As the Damen corset is frequently prescribed for patients with LBP, it was selected for use in this study. Our previous study reported carry-over effects of the ORF on body alignment of hemiparetic patients after removal while level walking.11 We therefore decided to measure two trials without intervention (no orthosis) first, after which subjects completed the two orthosis trials in random order. Participants were given 5 minutes to become accustomed to wearing the orthoses, and there was a minimum rest interval of 5 minutes between conditions. Resistive force exerted on the chest was measured in real time with a strain gauge (Compression load cell LCN-A, Kyowa, Tokyo, Japan). The force data were transferred to a laptop via Bluetooth. Force was set to 20–25 N during static standing, and pressure between the corset and abdomen was set to 10 mmHg in all measurement conditions.13 To obtain maximal voluntary contraction (MVC) values for normalization of individual muscle activities, participants performed maximal isometric contractions against gravity, while the experimenter (a licensed therapist) applied maximum resistance.14 After practicing stable isometric contraction efforts, single maximal contractions of each muscle were recorded according to Daniels and Worthingham’s Muscle Testing. Subjects performed contractions against gravity, with maximum resistance applied by the examiner in the supine position to obtain MVC of the left internal abdominal oblique (IO) muscle (lifting head and shoulders from the table with right elbow toward left knee against imposed resistance to the right shoulder region), in the prone position to obtain MVC of the bilateral ES (back extension with hands resting on head against imposed resistance to the scapular region), and in the side-lying position with test leg elevated to obtain MVC of the right GM muscle (abduction with limb slightly extended beyond the midline and the pelvis rotated slightly forward while imposing resistance to the lateral surface of the knee).


Efficacy of a trunk orthosis with joints providing resistive force on low-back load in elderly persons during static standing.

Katsuhira J, Matsudaira K, Yasui T, Iijima S, Ito A - Clin Interv Aging (2015)

Experimental conditions.Notes: (A) Without an orthosis, (B) with the LSO, (C) with the ORF.Abbreviations: ORF, orthosis with joints providing resistive force; LSO, lumbosacral orthosis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562746&req=5

f3-cia-10-1413: Experimental conditions.Notes: (A) Without an orthosis, (B) with the LSO, (C) with the ORF.Abbreviations: ORF, orthosis with joints providing resistive force; LSO, lumbosacral orthosis.
Mentions: Participants freely stood for 10 seconds under three conditions in the laboratory setting: with no orthosis, with the ORF, and with an LSO (Damen Corset, Pacific Supply, Osaka, Japan; Figure 3). As the Damen corset is frequently prescribed for patients with LBP, it was selected for use in this study. Our previous study reported carry-over effects of the ORF on body alignment of hemiparetic patients after removal while level walking.11 We therefore decided to measure two trials without intervention (no orthosis) first, after which subjects completed the two orthosis trials in random order. Participants were given 5 minutes to become accustomed to wearing the orthoses, and there was a minimum rest interval of 5 minutes between conditions. Resistive force exerted on the chest was measured in real time with a strain gauge (Compression load cell LCN-A, Kyowa, Tokyo, Japan). The force data were transferred to a laptop via Bluetooth. Force was set to 20–25 N during static standing, and pressure between the corset and abdomen was set to 10 mmHg in all measurement conditions.13 To obtain maximal voluntary contraction (MVC) values for normalization of individual muscle activities, participants performed maximal isometric contractions against gravity, while the experimenter (a licensed therapist) applied maximum resistance.14 After practicing stable isometric contraction efforts, single maximal contractions of each muscle were recorded according to Daniels and Worthingham’s Muscle Testing. Subjects performed contractions against gravity, with maximum resistance applied by the examiner in the supine position to obtain MVC of the left internal abdominal oblique (IO) muscle (lifting head and shoulders from the table with right elbow toward left knee against imposed resistance to the right shoulder region), in the prone position to obtain MVC of the bilateral ES (back extension with hands resting on head against imposed resistance to the scapular region), and in the side-lying position with test leg elevated to obtain MVC of the right GM muscle (abduction with limb slightly extended beyond the midline and the pelvis rotated slightly forward while imposing resistance to the lateral surface of the knee).

Bottom Line: ES activity significantly decreased while wearing the ORF compared to the other two conditions.Center of pressure did not significantly differ among the conditions.The ORF significantly improved trunk alignment and decreased ES activity in healthy elderly subjects during static standing.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing and Rehabilitation Science at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan.

ABSTRACT

Purpose: Postural alignment of elderly people becomes poor due to aging, possibly leading to low-back pain and spinal deformity. Although there are several interventions for treating these conditions, no previous study has reported the effectiveness of a spinal orthosis or lumbosacral orthosis (LSO) in healthy elderly people without specific spinal deformity. We therefore developed a trunk orthosis to decrease low-back muscle activity while training good postural alignment through resistive force provided by joints with springs (here, called the ORF, which stands for orthosis with joints providing resistive force) as a preventive method against abnormal posture and low-back pain in healthy elderly persons.

Patients and methods: Fifteen community-dwelling elderly men participated in this study. Participants stood freely for 10 seconds in a laboratory setting under three conditions: without an orthosis, with the ORF, and with an LSO. The Damen corset LSO was selected as it is frequently prescribed for patients with low-back pain. Postural alignment during static standing was recorded using a three-dimensional motion capture system employing infrared cameras. Two force plates were used to record center of pressure. Electromyograms were obtained for bilateral erector spinae (ES), left internal abdominal oblique, and right gluteus medius muscles.

Results: Pelvis forward tilt angle tended to increase while wearing the ORF and decrease while wearing the LSO, but these results were not significant compared to no orthosis. Thorax extension angle and thorax angle on pelvis coordinate system significantly increased while wearing the ORF compared to the other two conditions. ES activity significantly decreased while wearing the ORF compared to the other two conditions. Internal oblique activity was significantly smaller while wearing the LSO than with no orthosis. Center of pressure did not significantly differ among the conditions.

Conclusion: The ORF significantly improved trunk alignment and decreased ES activity in healthy elderly subjects during static standing.

No MeSH data available.


Related in: MedlinePlus