Iranian Journal of War and Public Health

  Background : Falls in the elderly are common and are associated with appreciable morbidity and mortality. Hyperkyphosis is a risk factor for balance impairment and postural instability. Increased forward curvature of the spine displaces the center of mass anteriorly towards the limits of stability, and thus increases the likelihood of loss of balance and predisposes persons to fall. The orthoses are an option for decreasing the risk of falling in elderly population however, the quantitative evidence to support their application is not convincing. The purpose of this study is to analysis the effects of spinomed orthosis on risk of falling of elderly people with spinal hyperkyphosis.

  Materials & Methods : 18 elderly people with mean age 65.96 ± 4.4 who had thoracic kyphosis of ≥ 50 (cobb angle) were enrolled in the study. Subjects were randomly allocated into either spinomed orthosis or control group. Patients were randomly subjected to computerized dynamic posturography, which contained sensory organization tests and limits of stability. The tests for each person were conducted in two conditions: while wearing and not wearing the orthosis and the order of testing within a patient was randomized.

  Results : Wearing spinomed orthosis significantly increased balance score (p<0.0001) and directional control (p<0.032). Also, significant difference in balance score (p<0.0001) was observed between two groups (spinomed orthosis and control group)

  Discussion & conclusion : The spinomed orthosis improves balance in elderly people with spinal hyperkyphosis. Improved balance could reduce the risk of falls and direct and indirect costs of falls and related fractures.

Abstract: Objective: the main objective is to determine the influence of treatment by Milwaukee and Thoracolumbosacral orthoses on self-image and satisfaction with management of adolescents idiopathic scoliosis.

 Materials and methods: this cross-sectional study investigated the self-image and satisfaction with management of adolescents with idiopathic scoliosis that treated with Milwaukee and Thoracolumbosacral orthoses by the use of the Scoliosis Research Society-22 questionnaire that specifically designed for the assessment of quality of life in spinal deformity patients. In this study 63 subjects divided in two groups, a Milwaukee group of 31 patients and compares the results with an Thoracolumbosacral group of 32 patients matched by age and curve magnitude.

 Result: in this study, there were no statistically significant differences in self-image score between two groups (p=0.7), but Milwaukee brace wearing did higher negative effect the self image. Moreover, the Milwaukee group patients had score of satisfaction better than TLSO patients group, but there was no statistically significant difference in two groups (p=0.8).

 Conclusion: overall, brace wearing did decrease the quality of life of adolescent idiopathic scoliosis in two groups of our study population and this effects are higher in males. More attention will need to be given to those with severe curves, to help improve patients’ understanding of their treatment and hence their compliance and satisfaction. Our study shown that after the initial shock of brace wearing , the patients were able to adjust well about their condition.

Objective: The effects of lateral wedge insoles with and without subtalar strap on vertical component of ground reaction force were compared. Methods: Twenty five patients aged over 40 years with grades I or II of medial compartment knee osteoarthritis based on Kellgrene and Lawrence grading system were participated in this study. They were tested in 3 conditions while walking in a 3-meter walkway: bare foot, lateral wedge insole and lateral wedge insole with subtalar strap. Three successful trials were recorded in each condition. Gait analysis was performed to compare the immediate effect of lateral wedge insole with and without subtalar strap on vertical component of ground reaction force.

Results: There was significant effect of lateral wedge insole with subtalar strap on second peak of vertical ground reaction force related to lateral wedge insole and without insole conditions. But no significant effect of lateral wedge insole with and without subtalar strap was found on first peak of vertical ground reaction force and walking speed.

Conclusion: The results of this study suggest that lateral wedge insole can reduce second peak of vertical ground reaction force. Also it was understood lateral wedge insole with subtalar strap might be more efficacious than lateral wedge insole in mild knee osteoarthritis patients.

Background: Ankle foot orthoses are effective in controlling wide-range orthopedic deformities. Two difference methods (prefabricated and custom-made) were used for construction of AFOs. However, the high cost of custom devices prevents some patients from purchasing them. Some patients and orthotics prefer to prefabricated devices. The purpose of this study was to examine whether the prefabricated AFOs (PAFO) can provide similar pressure distribution as custom-made AFO (MAFO) in healthy people.

Objective: The purpose of the current study was to the comparison of two different fabrication methods of AFO by plantar pressure in asymptomatic adults. Methods: In this study, peak pressures (PP) were recorded with Pedar-x system while pressure insole was placed between foot and AFO. Twenty-four subjects participated in this study completed a total of three 8-m walking trials in each of two types of AFOs.

Results: The PP was significantly decreased in the heel (P < 0.004), first metatarsal (P < 0.001), and second metatarsal head regions (P < 0.003) in MAFO when compared to PAFO but PP was significantly decreased in second toe (P < 0.027) and toes 3-5( P < 0.003) regions in PAFO in comparison with MAFO. No significant differences were observed at the other regions.

Conclusion: The results of this study demonstrated that significant differences were observed in PP at the almost regions when comparing two AFOs. So they should carefully prescribe for using with various disorders.