Spinal Orthosis and Back Braces Flashcards
What are the functions of spinal orthoses? (5)
- Correct deformity
- Limit spinal motion
- Stabilize part of the spine
- Reduce mechanical uploading
- Provide miscellaneous effects of tactile information, massage, heat, placebo
Lumbar supports leads to increased intra-abdominal pressure (IAP) in the lumbar spine. Therefore, increased IAP could be detrimental to the spine and lumbar orthoses should be [used/avoided]
avoided…possibly
T/F Lumbar supports result in decreased muscular fatigue and strain in the lumbar spine.
False, EMG activity is the same in those with orthoses and those without
T/F Lumbar supports limit spinal range of motion.
True, belts reduce ROM and increase stiffness in the transverse and frontal planes (not sagittal plane); and lumbar orthoses (semirigid TLSO) reduce intervertebral flexion motion by 30-50% at L3-4 and L4-5 (not L5-S1)
What other two potential mechanisms of action may lumbar supports have?
(1) proprioceptive input reinforces biomechanically sound lifting techniques
(2) increased local tissue temperature
* there hasn’t been research to support or deny this*
T/F Lumbar supports are effective in preventing LBP.
False, research has shown that it is not effective in preventing LBP!
T/F Lumbar support as treatment of LBP reduces LBP.
True and False…But most likely False.
Weak evidence that it provides pain relief
Stronger evidence that it provides not more pain relief than other interventions for LBP
…However, the participants in the studies didn’t just have instability LBP, but also had other classifications of LBP making the braces possibly less effective!
T/F Lumbar supports enhance function in those with LBP.
False, there hasn’t been improvements found in those with LBP but studies don’t properly classify participants before assessing the effectiveness of the back braces
Do lumbar supports worsen muscle function?
No, there hasn’t been found to be any significant changes in flexor or extensor muscle performances with the use of back braces
What are the potential mechanisms of action for pelvic belts (2) and maternity belts (1)?
Pelvic Belts:
- articular surfaces of SI joint compress to enhance stability
- SI joint placed at end range to provide stability
Maternity Belts:
•provide support for expanding belly
Do pelvic belts improve pain levels and function?
No, there is no evidence to support these things occur with the use of pelvic belts
T/F Maternity belts improve LBP while sitting and standing.
True, although the study that reported this did not have quantitative data for this
Do pelvic belts provide additional benefit beyond exercise and using muscles to provide stability?
No, it may be more beneficial in the long run to exercise and learn how to use the muscles for this rather than a belt
What impacts the quality of studies for lumbar supports? (2)
(1) poor adherence or not documenting adherence
(2) poor classification of LBP → instability would benefit most from lumbar supports; and short term use is also probably best
Why is education on body mechanics and lifting mechanics critical when giving out a lumbar support?
Because otherwise, the support would give out a false sense of security about protection from injury, even though it may not provide that
