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1.
BMC Musculoskelet Disord ; 25(1): 728, 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39261824

RESUMEN

BACKGROUND: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. AIM: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. DESIGN: Prospective cohort study, longitudinal. SETTING: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). POPULATION: Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). METHODS: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). RESULTS: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. CONCLUSIONS: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. CLINICAL REHABILITATION IMPACT: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.


Asunto(s)
Tirantes , Pie , Presión , Escoliosis , Humanos , Escoliosis/terapia , Escoliosis/fisiopatología , Adolescente , Femenino , Masculino , Estudios Prospectivos , Niño , Pie/fisiopatología , Estudios Longitudinales , Resultado del Tratamiento , Terapia Combinada , Marcha
2.
Heliyon ; 10(15): e34758, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-39166021

RESUMEN

Objective: This study investigates if an inpatient rehabilitation therapy (brace therapy and Schroth therapy) for six weeks contributes to an improvement in lung function of the patients. Design: Retrospective study. Setting: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). Participants: In 253 female patients a lung function examination was performed at entry and at the end of their inpatient rehabilitation stay. Of these, 61 patients underwent Schroth therapy (group 1); 192 patients underwent the combination of brace and Schroth therapy (group 2). Intervention: Lung function parameters under the influence of Schroth and Schroth and brace therapy within a rehabilitative stay. Main measures: The parameters of IVC (inspiratory vital capacity), FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 s) and the Tiffeneau index (FEV/FVC) related to patient-specific reference values were evaluated with regard to potential ventilation disorders. Results: There were significant improvements for IVC +2.56 %, FVC +3.99 %, FEV1 +2.36 % for the first stay (IVC and FVC 2nd, 3rd stay). The comparison of patients with vs. without additional brace therapy showed no significances. For the long-term analysis the parameters approached the reference values of age-matched, healthy female subjects. The greater the Cobb angle in the thoracic region, the significantly worse almost each of the measured parameters are. Conclusion: An inpatient rehabilitation therapy contributes to an improvement in lung function (IVC, FVC and FEV1). A second, and even a third, follow-up stay still led to a measurable improvement in lung function, albeit to a lesser extent.

3.
Orthopadie (Heidelb) ; 52(8): 677-690, 2023 Aug.
Artículo en Alemán | MEDLINE | ID: mdl-37428228

RESUMEN

Spondylodiscitis is a severe infectious disease of the spine that affects the intervertebral discs and adjacent vertebrae. It can lead to nonspecific pain, limited mobility, and destruction of spinal structures. Various pathogens, such as bacteria, fungi, or parasites, can trigger the disease. An early diagnosis and targeted treatment are crucial to reduce the risk of serious complications. Magnetic resonance imaging (MRI) with contrast agent and blood tests are essential for the diagnosis and assessing the course of the disease. The treatment includes conservative and surgical approaches. Conservative treatment consists of a minimum 6­week antibiotic course and immobilization of the affected area. Surgical interventions, along with several weeks of antibiotic therapy, are indicated for instabilities or complications in order to eliminate the infection focus and to restore spinal stability.


Asunto(s)
Discitis , Disco Intervertebral , Humanos , Discitis/diagnóstico , Disco Intervertebral/diagnóstico por imagen , Imagen por Resonancia Magnética , Antibacterianos/uso terapéutico , Bacterias
4.
Life (Basel) ; 13(6)2023 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-37374124

RESUMEN

Scoliosis and Scheuermann's disease are common spinal deformities that affect a substantial population, particularly adolescents, often impacting their quality of life. This comprehensive review aims to present a detailed understanding of these conditions, their diagnosis, and various treatment strategies. Through an extensive exploration of current literature, the review discusses the etiology of these spinal deformities and the use of diagnostic tools such as X-rays and MRI. It further delves into the range of treatment options available, from conservative approaches such as physiotherapy and bracing to more invasive surgical interventions. The review underscores the necessity of an individualized treatment approach, taking into account factors such as the patient's age, the severity of the curvature, and overall health. This all-encompassing perspective on scoliosis and Scheuermann's disease will aid in evidence-based decision making in their management with the goal of improving patient outcomes.

5.
Orthopade ; 51(4): 339-348, 2022 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-35290495

RESUMEN

Scheuermann's disease represents the second most common deformity of the growing spine after the various forms of scoliosis. In cases of early diagnosis and mild kyphotic deformity conservative treatment with a brace and physiotherapy shows very good results; however, in cases of neurologic deficits, curve progression despite conservative treatment and increasing pain symptoms with a Stagnara angle of more than 70-75°, surgical treatment is meaningful. The surgical strategy can include posterior spondylodesis with prior anterior release or posterior instrumentation with posterior column osteotomy depending on the surgeon's experience. The choice of the extent of the operation with the vertebrae to be instrumented and including the straightening method should be oriented to the avoidance of complications, such as proximal or distal junctional kyphosis.


Asunto(s)
Enfermedad de Scheuermann , Escoliosis , Fusión Vertebral , Humanos , Osteotomía/métodos , Enfermedad de Scheuermann/diagnóstico por imagen , Enfermedad de Scheuermann/cirugía , Escoliosis/diagnóstico , Escoliosis/cirugía , Fusión Vertebral/métodos , Columna Vertebral
6.
Orthopade ; 50(6): 497-508, 2021 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-33950306

RESUMEN

The treatment of early onset scoliosis (EOS) in children is a complex and demanding challenge in the treatment of spinal deformities. Conservative treatment with physiotherapy is indicated in mild forms with a Cobb angle from 10° and additionally a corset treatment with a Cobb angle of more than 20°. After exhaustion of the conservative measures or a progression of spinal scoliosis of 10° or deformities of more than 35°, a surgical approach should be considered in order to prevent respiratory insufficiency as well as severe postural and thoracic deformities. In situations where growth is still ongoing fusion operations can lead to stunted growth, a crankshaft phenomenon or degeneration of alignment. Meaningful alternatives to a fusion are so-called growing rods as a distraction-based nonfusion technique, e.g. traditional growing rods (TGR) and magnetically controlled growing rods (MCGR) or as a further method a vertical expandable prosthetic titanium rib (VEPTR) device. The advantages and disadvantages of each operative procedure must be considered with respect to the risk profile of each patient and the experience of the surgeon in order to guarantee the best possible treatment.


Asunto(s)
Escoliosis , Niño , Humanos , Aparatos Ortopédicos , Prótesis e Implantes , Escoliosis/diagnóstico por imagen , Escoliosis/cirugía , Columna Vertebral , Titanio , Resultado del Tratamiento
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