This study focuses on the fabrication of an anisotropic textile brace that exerts corrective forces based on the three-point pressure system to treat scoliosis, which is a medical condition that involves deformity of the spine. The design and material properties of the proposed anisotropic textile brace are discussed in detail here. A case series study with 5 scoliosis patients has been conducted to investigate the immediate in-brace effect and biomechanics of the proposed brace. Radiographic examination, three-dimensional scanning of the body and interface pressure measurements have been used to evaluate the immediate effect of the proposed brace on reducing the spinal curvature and asymmetry of the body contours and its biomechanics. The results show that the proposed brace on average reduces the spinal curvature by 11.7° and also increases the symmetry of the posterior trunk by 14.1% to 43.2%. The interface pressure at the corrective pad ranges from 6.0 to 24.4 kPa. The measured interface pressure shows that a sufficient amount of pressure has been exerted and a three-point pressure distribution is realized to reduce the spinal curvature. The obtained results indicate the effectiveness of this new approach which uses elastic textile material and a hinged artificial backbone to correct spinal deformity.
Background: The school scoliosis screening aims to identify students with spinal deviations by trunk asymmetry. The objective of this study is to investigate the accuracy of scoliosis screening with a low ATR cutoff and occurrence of shoulder obliquity. Methods: 443 schoolgirls aged between 10-13 years participated in this school scoliosis screening. During the screening, a forward bending test with ATR measurement using scoliometer were adopted to detect the trunk asymmetry and the backside photographs were captured for shoulder obliquity measurement. The ATR cutoff point was 3°. Participants with ATR ≥3° were invited to conduct an ultrasound spinal examination for Cobb's angle measurement. The positive predictive value of ATR≥3° was calculated. Findings: It is found that 17.8% of the screened students possibly have early scoliosis. The positive predictive value of ATR ≥3° was 0.717. There is a significant negative correlation between the BMI range and occurrence of ATR ≥3°. 55.7% of girls with ATR≥3° had shoulder obliquity. There is a significant positive correlation between the occurrence of shoulder obliquity and ATR ≥3°.
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis, and affects up to 4% of adolescents in early stages. The deformity can develop during any of the rapid periods of growth in children, and the time of pubertal growth spurt also plays a role in spinal curve progression. Hence it is crucial to detect the disease early, to provide timely intervention. Detection of scoliosis when it is mild or before the growth spurt can be conducted via various screening methods. Adam's forward bend test (FBT) and scoliometer measurement of the angle of trunk rotation (ATR) are commonly used, to observe lateral bending and rotation of the spine, causing a visible rib hump. Moire topography can also be used, but is reserved for second tier due to some degree of ambiguity. X-rays (XR) remain the best way to diagnose scoliosis, as it provides a clear image of the spine and allows measurement of Cobb angle; however it has risks associated including requirement of the use of ionising radiation. Infrared (IR) thermography can be used to measure surface temperature and is performed with an IR camera. The temperature distribution and data matrix can be visualised into a thermal map, which has previously been studied and associated with the thermal asymmetry in paraspinal muscles, as well as significant temperature differences between the convex and concave side of the spinal curvature for idiopathic scoliotic patients. We hypothesize that such asymmetry and temperature differences may produce a detectable pattern on IR thermography, which would prompt further confirmatory investigations to reach a fast and non-radiation screening of AIS.
Background Rigid bracing is a universal effective treatment for scoliosis. However, body movement restriction and discomfort usually are its shortcomings. The purpose of this case series study was to investigate the feasibility of novel anisotropic textile braces with an artificial hinge adopting the direct three-point pressure system for the initial spinal correction and its biomechanics. Methods Five scoliotic female patients who were on average 12.2 years old with a BMI of 18.7, Risser grade of 1.6 and Cobb’s angle of 22.3˚ were recruited. The outcome measures are spinal correction, contour asymmetry, and interface pressure distribution of the brace. The correlation between the rate of in-brace correction and variables such as the Cobb’s angle, posterior trunk asymmetry index and interface pressure were studied. Results The initial in-brace rate of spinal correction ranged between 9.7% and 87%. The rate of correction based on posterior trunk asymmetry index ranged between 14.1% and 43.2%. The interface pressure from the brace ranged from 4.1 kPa to 25.6 kPa, which is comparable to that exerted by rigid braces. Based on the data in this study, no correlation was found between the in-brace rate of correction and the Cobb’s angle and the pressure exerted by the pads. Conclusions The main finding is that the anisotropic textile brace offers good initial in-brace correction through the application of the three-point pressure system with textile materials. Nevertheless, further follow-up work is recommended to investigate its long-term efficacy. Trial registration: This study was registered at ClinicalTrials.gov (NCT02271256 – Registration date 22nd October 2014).
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