Effect of Thoracolumbosacral Orthoses on Reachable Workspace Volumes in Children With Spinal Cord Injury

J Spinal Cord Med, 2007 · DOI: · Published: January 16, 2007

Spinal Cord Injury Assistive Technology Pediatrics

Simple Explanation

This study investigates how wearing a Thoracic Lumbar Sacral Orthosis (TLSO) affects the reach of children with Spinal Cord Injury (SCI). Children with SCI often wear TLSOs to prevent scoliosis. The study found that wearing a TLSO significantly reduces the reachable workspace volume in children with SCI, meaning they can't reach as far. This limitation in reach may contribute to children not wanting to wear their braces, impacting the effectiveness of the treatment.

Study Duration

Not specified

Participants

20 children with SCI aged 5 to 18 years

Evidence Level

Not specified

Key Findings

1
Reachable workspace volumes were significantly greater without the TLSO compared to with the TLSO (112,836 vs 80,711 cm3; P ¼ 0.0002), a 28% reduction.
2
Anterior-posterior and medial-lateral ranges of reach were statistically greater in the non-TLSO condition (P ¼ 0.002, P ¼ 0.01).
3
Nondominant hand medial lateral reaches were statistically greater in the non-TLSO condition (P ¼ 0.003). Dominant hand anterior posterior reaches were greater in the non-TLSO condition (P ¼ 0.009).

Research Summary

This study aimed to quantify the effect of a TLSO on reachable workspace volumes and reach of children with SCI using three-dimensional upper extremity motion analysis. The results indicated that the reachable workspace of children with SCI is significantly lessened with the use of a TLSO, potentially impacting brace compliance. The study highlights the need for physicians to discuss the potential benefits and disadvantages of TLSO brace wear with patients and families, especially for children with tetraplegia.

Practical Implications

Brace Compliance

Decreased reachable workspace may lead to reduced brace compliance in children with SCI.

Functional Performance

The functional penalty of TLSO brace wear should be minimized through adaptive aids, environmental modifications, or altered wearing schedules.

Clinical Discussion

Physicians need to discuss both the benefits and disadvantages of TLSO wear with patients and families, especially those with tetraplegia.

Study Limitations

1
Children may not have been reaching to their full potential during testing, even with encouragement.
2
The bench used for testing had an armrest on only one side, potentially interfering with arm movements for some targets.
3
Some subjects held onto the arm rest with one hand, but could not do the same when reaching with the opposite arm.

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