Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2017; 84(2):91-96 | DOI: 10.55095/achot2017/013

Páteřní ortézy: rozhodující vliv komfortu na dodržení režimu nošení - monocentrická prospektivní pilotní randomizovaně překřížená studiePůvodní práce

G. W. HERGET^1,2,*, S. PATERMANN³, P. C. STROHM⁴, J. ZWINGMANN¹, P. EICHELBERGER⁵, N. P. SÜDKAMP¹, A. HIRSCHMÜLLER¹

¹ Department of Orthopedics and Traumatology, University Medical Center Freiburg, Freiburg i. Br., Germany

² Comprehensive Cancer Center Freiburg CCCF, University Medical Center Freiburg, Freiburg i. Br., Germany

³ Department of Orthopedics, Loretto-Hospital Freiburg, Freiburg i. Br., Germany

⁴ Department of Orthopedics and Traumatology, Sozialstiftung Bamberg, Bamberg, Germany

⁵ University of Applied Sciences - Health Division, Bern, Switzerland

PURPOSE OF THE STUDY:
Various spine disorders are regularly treated by orthoses, and success of treatment depends on wearing these devices. In this study we examined the compliance, wear comfort, subjective stabilization and side effects associated with spinal orthoses using an individualized questionnaire and the Compact Short Form-12 Health Survey (SF-12).

MATERIAL AND METHODS:
In this prospective pilot study of randomized cross-over design, twelve healthy volunteers with a mean age of 31.2 years wore three different types of orthoses, each for one week: A hyperextension brace (HB), a custom-made semirigid orthosis (SO) and a custom-made rigid orthosis (RO). The daily duration of wearing the orthosis was defined as primary endpoint; contentment was measured using an individualized questionnaire and the standardized SF-12.

RESULTS:
In the study population calculated probability of wearing the HB and RO was between 0.2 und 38.5% (95% confidence interval). No volunteer wore the SO orthosis for the predefined time. The SO and RO each displayed high subjective stabilization, while the RO was more often associated with side effects like skin pressure marks than the SO. The need for rework due to discomfort was mainly necessary with the RO. We observed no substantial differences in feeling compression and sweating. Noteworthy, eight of 12 subjects complained of uncomfortable sternal pressure due to the upper pad of the HB. The SF-12: scores ranged from 52.1 to 48.6 on the physical (PCS), and from 53.7 to 50.8 on the mental component score (MCS), demonstrating an influence on QoL.

DISCUSSION: AND CONCLUSIONS
The design as well as the orthosis itself influence the compliance of wearing and exert a moderate negative, but acceptable impact on QoL. The SO appeared to correlate with the best overall compromise between comfort and subjective stabilization. Further investigations are necessary in patients with spinal diseases, for whom the effect of orthosis wearing may surpass the potential discomfort.

Klíčová slova: thoracolumbar spine, orthoses, SF-12 - Quality of Life - QoL, comfort, compliance

Zveřejněno: 1. duben 2017  Zobrazit citaci