Authors (including presenting author) :
Yeung CW(1),Kwok AWL (2)
Affiliation :
(1)Prosthetist-Orthotist II, Prosthetic and Orthotic Department, Tseung Kwan O Hospital
(2)Department of Orthopaedics and Traumatology, Prince of Wales Hospital
Introduction :
Osteoporosis is an aging problem that the porous bones become more susceptible for fracture. Vertebral fracture is one of the common osteoporotic fracture sites that associated to mortality, morbidity and poor quality of life. Osteoporotic vertebral fracture usually presence earlier than other osteoporotic fractures and relates to higher risk of subsequent vertebral and other osteoporotic fracture. The spinal deformity from vertebral fracture related to back muscle weakness and poor balance. These contribute to fall, which is the major cause of fractures in elderly. Posture brace is a newly developed spinal orthosis in recent decade that targeted to patients with osteoporotic vertebral fracture. It initiates patients to maintain upright posture in order to strengthen back extensor muscle and maintain balance. However, posture brace is not common in Hong Kong and lack of local data to prove its effectiveness. This study aims to investigate 1) the effect on body balance of posture brace in osteoporotic vertebral fracture patients, and 2) the effect of posture brace in improving back pain and quality of life in osteoporotic vertebral fracture patients.
Objectives :
The aims of this study are: 1) to investigate the effect on body balance of posture brace in osteoporotic vertebral fracture patients, 2) to investigate if the posture brace can reduce back pain and improve quality of life in osteoporotic vertebral fracture patients
Methodology :
This is a prospective pre-post study. The subjects enrolled had at least one osteoporotic vertebral fracture at levels from T7 to L4 and did not have other neuromuscular problems that affect balance. The subjects were given a Medex Osteoporosis Spinal Brace to wear for at least 2 hours a day for 6 to 8 weeks. Body sway (CoP path length and 95% confidence ellipse area) and quality of life (QUALEFFO-31 questionnaire) were the outcome measures. The data were collected before bracing and after bracing.
Result & Outcome :
The CoP path length was reduced 47.80±51.05 and 95% confidence ellipse area was reduced 15.20±14.87; Both parameters had significant change after bracing. For the quality of life questionnaire, there was significant improvement in the pain domain with the domain score reduced -13.13±12.66. However, the domain score for physical and mental domain as well as the total score of the questionnaire did not show significance difference. Both the CoP path length and 95% confidence ellipse area showed significant reduction, implying there was reduced body sway. Similarly, pain was significantly improved after bracing. The overall quality of life although did not have significant difference, it still had trend for improvement. The result showed that the posture brace can help patients with osteoporotic vertebral fracture in body balance and pain reduction as well as improvement in quality of life. As this is a pilot study, further investigation is needed to confirm the effectiveness of the posture brace on patients with osteoporotic vertebral fracture.
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