S3 L2: Spinal Orthosis Flashcards
2 types of spinal orthosis
Flexible & Rigid
Components are mostly cloth & bendable
material, do not have components to restrict movement
Flexible orthosis
Purpose of a flexible orthosis
For sensorium/sensory feedback, does not
restrict movement at all (not entirely); biofeedback for postural correction
How do flexible orthoses provide spinal
stability? (2)
By helping to strengthen the abdominal muscles for proper stabilization of the spine
Bracing increases intra-abdominal pressure for pneumatic support
T/F: Spinal orthoses generally limit movement, esp for traumatic cases such as fx of the spine (e.g. vertebral fracture)
True: Fx could endanger spinal cord
Feature:
Pre-fabricated belt, 5.1 cm to 10.2 cm wide
Encircles the pelvis b/w the iliac crests and
trochanters
Sacroiliac belt
Function of a sacroiliac belt
Stabilizes Sacroiliac joints
Additional:
Squeezes pelvis together
Pushes on perineum to increase intra-pelvic pressure
Special considerations for sacroiliac belt
Used in post-partum and posttraumatic sacroiliac separations
○ Pelvic inlet is traumatized
○ Used during the latter part of pregnancy
trimester, prevents low back strain
○ 4th-5th month of pregnancy referred to rehab
Where is the sacroiliac belt placed?
At the level of the sacrum
The belt is placed under the perineum for further support and pushes the pelvis up
Traditional Type
Acts as support to push/approximate pubis symphysis and SI joint together.
Sacroiliac corset
A disadvantage of a traditional type
Approximates/gumagasgas sa singit, irritating for the pt
An advantage of a traditional type
Lifts the entire perineum up which lessens pain.
Features:
○ A cloth garment with the superior border located at the iliac crest both anterior and posterior sides.
○ Inferior border is located at the pubic symphysis and gluteal bulge, respectively.
Entire pelvis + gluteus maximus muscles are
lifted up
Sacroiliac corset
Functions of a sacroiliac corset (3)
Assist in elevating intra-abdominal pressure for pts who suff er from pelvic pain
Post-partum
Post-traumatic stabilization of pelvic joints (SI and pubic symphysis)
Special considerations for a sacroiliac corset (3)
○ Posterior rigid - lessen movement of the pelvis
○ Sacral pad - prevent irritation on the sacrum
○ Has pocket to conform to pt’s sacrum
Difference between a sacroiliac belt and corset
Belt:
Only at the level of the sacrum and does not reach iliac crest
Primary function is to stabilize SI joints, push on perineum to increase intra-pelvic pressure
Corset:
Strings features placed anteriorly
Reaches iliac crest
Primary function is to approximate symphysis + SI joint
It is wrapped around lumbar spine & does not restrict movement
Lumbar binder
Feature: wrapped around the lumbar region and held in place by velcro closure
Lumbar binder
Function of a lumbar binder
Trunk support through increasing intra-abdominal pressure (which provides increased pneumatic support)
Provides sensory feedback for proper posture
Additional function of a lumbar binder
For low back pain & body shaping
○ Gives sensory feedback on when to avoid
movements that aggravates lumbar pain
○ Mild cases of lumbar sprain
Feature:
○ Most common flexible orthosis for pts c LBP
○ Encompasses the torso and hips (entire lumbar
spine)
Lumbosacral corset
Where does the anterior superior border of a lumbosacral corset end?
xiphoid process
Where does the posterior superior border of a lumbosacral corset end?
inferior angle of the scapula
Functions of a lumbosacral corset (5)
○ Decrease loading on the vertebrae and discs by
inc pneumatic support of the spine and structural
support
○ Sensory feedback to restrict motion
○ May limit FEL (flexion, extension, lateral flexion)
but not rotation (rot happens on thoracic level)
○ Unloading any pain on pelvis & lumbar spine
○ Only for minimal cases
Coverage of a lumbosacral corset
Xiphoid process up to level of sacrum
What restricts lateral movement in a lumbosacral corset
Strings at the side acts as a pillar which restrict
lateral movements
What restricts extension in a lumbosacral corset
Rigid structure at the back restricts extension
Rigid structure at the back limits flexion
Rigid strap-like structure in front limits flexion
Feature:
○ Encompasses torso and hips
○ Anterior sup border: xiphoid area
○ Posterior sup border: level of scapular spines (middle level)
○ Velcro closure
Coverage is not up to breasts
■ Esp for females - painful
■ Compromise breathing
Thoracolumbar corset
Functions of a thoracolumbar corset
○ Trunk stabilization
○ Dec loading on vertebrae and discs
○ May restrict motion: FELR (flexion, extension,
lateral rotation, rotation)
Fit of a thoracolumbar corset
Require straps that wind around shoulder and
axillary area to provide support on thoracic spine and limit rotational movement
Require snug fit on the abdomen to increase
intraabdominal pressure