Spine & UE orthotics - presentation take home points

Question 1

what are the two most common nighttime braces for scoliosis on the market?

Answer 1

Providence and Charleston Braces

Question 2

brace type and treatment recommendations for nighttime braces for scoliosis should be personalized based on what 3 things?

Answer 2

the individual’s stage of growth
curve magnitude
treatment goals

Question 3

what is a good treatment option to increase compliance and QOL for patients with less severe scoliosis curves (<35 deg)?

Answer 3

nighttime bracing

Question 4

where do the majority of spinal burst fractures occur?

Answer 4

thoracolumbar region T11-L5

Question 5

how do you treat burst fractures without neurologic involvement?

Answer 5

conservatively with bracing - they are stable

Question 6

what is the most commonly used brace for conservative treatment of spinal burst fractures?

Answer 6

rigid TLSOs

Question 7

in burst fractures without neurologic involvement, what does the evidence say about treatment outcomes?

Answer 7

there is no significant difference in outcomes when using conservative treatment vs surgical intervention vs no treatment

Question 8

what kind of material do cranial remolding orthoses use & what is their purpose?

Answer 8

flexible polypropylene outer shells lined with soft foam
- mold flatten areas of the skull into a symmetrical shape

Question 9

when is the most effective time to start helmet therapy?

Answer 9

between 4-6 months

Question 10

how long should an infant’s helmet be worn?
– what about in the first 5 days of wear?

Answer 10

23 hours a day
– number of hours should be gradually progressed for the first 5 days

Question 11

do cervical collars provide enough stability following whiplash disorder?

Answer 11

no - do not provide enough stability & do not limit ROM enough

Question 12

what phase should cervical collars be worn following whiplash disorder?

Answer 12

acute phase only

Question 13

what are cervical collars indicated for?

Answer 13

cervical fracture, surgery and stabilizing the spine from trauma if suspected SCI

Question 14

what is the main goal of a shoulder orthotic post stroke?

Answer 14

prevention of GH subluxation by way of eliminating the vertical and horizontal pull of gravity

Question 15

what benefits do a shoulder orthosis in post stroke patients provide when combined with exercise?

Answer 15

pain relief
stability
improved function

Question 16

when should shoulder orthosis be applied to a post stroke patient?

Answer 16

when they are able to be positioned upright and utilize until patient has returned proper stability for shoulder joint

Question 17

what kind of carpal tunnel orthoses should be worn?

Answer 17

neutral positioned wrist orthosis worn at night for short term relief

Question 18

when thinking short term, which treatment option showed better than surgery for carpal tunnel?

Answer 18

orthoses

Question 19

when night time only brace wearing is ineffective for carpal tunnel, what should the next steps be?

Answer 19

adjust wear time to include daytime, full time use, or when symptomatic

Question 20

is there one wrist orthosis better than another for carpal tunnel syndrome?

Answer 20

no, no design or position is more favorable