Purpose: The 2021 SOSORT guidelines stipulated that braces be prescribed for adult scoliosis with chronic pain and progressive curve. Yet, there have been no objective protocols relating to the prescription of the brace. Therefore, this review investigates if there are any objective criteria or generally agreed on protocols for brace prescription in adult scoliosis patients. Methods: Relevant papers were searched in PUBMED. Only articles that are in English and cover the clinical aspect of adult scoliosis bracing are included. Results: A total of twelve papers were identified. They include different adult scoliosis braces, ranging from elastic belts to rigid braces. The treatment protocol varied tremendously. No objective criteria were found concerning the prescription of a brace, daily wearing time, duration of the intervention, and weaning protocol. The brace treatment was primarily employed to manage low back pain. Conclusion: Our search showed no objective criteria and clear indications for bracing and no consensus concerning the prescription of braces, daily wearing time, and duration of the intervention for patients with adult scoliosis. The authors proposed prescription of a brace be based on more objective radiological criteria and severity of low back pain. Brace prescription should depend on the flexibility of the curve and can range from accommodative to rigid braces of corrective design. “Corrective” brace has to be worn at least 14 hours daily for six months or until the low back pain subsides to the extent that permits daily activities with minimal discomfort. “Accommodative” brace can be worn when required.
Bell’s palsy (BP) is a common condition; its incidence rate has increased during the COVID-19 pandemic. The standard treatment for facial nerve palsy includes corticosteroids alone or in combination with antiviral agents. However, the treatment is contraindicated in some patients, including hypertensive or diabetic patients. Also, the medication combination may result in inadequate recovery when complementary and alternative approaches are indicated. This chapter reviewed the literature on managing BP with different types of photobiomodulation (PBM) therapies. Fourteen papers were included. The results show that despite the different kinds of photo energy used, varying laser parameters, and the heterogeneity of patients, the outcome of PBM was similar among studies. Of interest is that acute and subacute BP respond more favorably to PBM than chronic cases. Hence, it is suggested to apply PMB as a complementary treatment in the early stage of the disease to enhance the recovery rate of BP patients. However, the risk of bias in these studies was relatively high. Therefore, further randomized, double-blind placebo-controlled studies are needed to determine the effectiveness of PBM in treating BP.
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