Impact of Prophylactic Thoracolumbosacral Orthosis Bracing on Functional Activities and Activities of Daily Living in the Pediatric Spinal Cord Injury Population

J Spinal Cord Med, 2007 · DOI: · Published: January 1, 2007

Spinal Cord Injury Assistive Technology Pediatrics

Simple Explanation

This study looks at how wearing a back brace (TLSO) affects the ability of children with spinal cord injuries to do everyday tasks. The study measured how long it took children to do certain activities with and without the brace, and also asked them which they preferred. The results showed that wearing a TLSO can make some tasks more difficult and time-consuming, and that the children often preferred not wearing the brace while doing these activities.

Study Duration

2-120 months

Participants

14 subjects, ages 6 to 14 years, with thoracic SCI

Evidence Level

Not specified

Key Findings

1
Subjects were slower with a TLSO when donning a shirt or pants, with even and uneven transfers and hallway propulsion.
2
Lower functional activity scores were recorded while wearing a TLSO for upper-extremity dressing, lower-extremity dressing, bladder management, transferring to bed, and reaching for objects on the floor.
3
Subjects preferred not wearing a TLSO for the following activities: lower-extremity dressing, bladder management, reaching for an object on the floor, and transfer from a supine to a sitting position.

Research Summary

The purpose of this study is to assess the impact of a thoracolumbosacral orthosis (TLSO) on children with spinal cord injuries (SCI) in terms of functional independence and time requirements for performance of functional activities and to ascertain the children’s preference for TLSO use. Wearing a TLSO adversely affected independence level and time requirements for selected functional activities. Subjects preferred not wearing a TLSO while performing the activities. Activities that required hip flexion, such as donning pants or transitioning from a supine to a sitting position were restricted by the TLSO.

Practical Implications

Tailored TLSO Design

TLSO design should be tailored to allow for more hip flexion or moving straps to the front of the brace, potentially improving comfort and function.

Compliance Strategies

Clinicians and parents should consider strategies to improve TLSO compliance, addressing the 'hassle factor' and psychological impact of wearing the brace.

Individualized Assessment

Assess each patient individually to determine if they functionally benefit from a TLSO, especially those with high-cervical-level injuries.

Study Limitations

1
Small sample size
2
Self-reporting may not accurately depict what actually occurs
3
Convenience sample of subjects who agreed to be tested when a tester was available

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