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題名 | Effectiveness of the Osaka Medical College Brace for the Treatment of Idiopathic Scoliosis: A 1-Year Outcome Analysis=大阪醫科大學背架治療原發性脊椎側彎之效果:穿戴一年結果分析 |
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作者 | 蔡承芳; 賴伯亮; 黃美涓; 陳智光; Tsai, Cheng-fang; Lai, Po-liang; Wong, Alice M. K.; Chen, Chih-kuang; |
期刊 | 臺灣復健醫學雜誌 |
出版日期 | 20110300 |
卷期 | 39:1 2011.03[民100.03] |
頁次 | 頁9-16 |
分類號 | 418.92 |
語文 | eng |
關鍵詞 | 大阪醫科大學; 背架; 原發性脊椎側彎; Osaka Medical College; Brace; Idiopathic scoliosis; |
中文摘要 | 大阪醫科大學背架爲治療脊椎側彎之腋下型背架,它由塑膠骨盆基座延伸之側邊金屬連桿固定上端墊片,藉以矯正脊椎曲度。其包覆在軀幹之塑膠面積比例較低,因此可減少軀幹皮膚與塑膠材質因接觸悶熱所造成之流汗,而這有利於怕熱或生活在濕熱環境之病患穿著。由於大阪醫科大學背架具有透氣、重量輕、與拘束少的特點,在台灣的使用日漸普及,然而其治療脊椎側彎之效果,在國內外之文獻報導都很有限。本研究收集了81位在本院訂作大阪醫科大學背架之原發性脊椎側彎病患,分析他們穿著背架一年後之效果。81位病患中有23位(28.4%)在一年後失去追蹤,被歸入流失組。在剩下58位中,13位(22.4%)爲背架失敗組(一年後側彎角度的增加大於5度),45位(77.6%)爲背架成功組(一年後側彎角度的增加小於或等於5度),兩組間無論在性別分佈、側彎型態、側彎方向、與側彎位置上,均無統計差異存在(p>0.05)。背架失敗組開始穿戴背架之平均年齡(10.7±3.2歲)明顯低於背架成功組開始穿戴背架的平均年齡(12.4±2.1歲)(p=0.028),顯示較小年紀就達到須以背架治療脊椎側彎的條件而開始穿戴背架,其預後較差。根據此研究,我們認爲大阪醫科大學背架不失爲治療原發性脊椎側彎的有效方法,但仍需進一步研究發展更爲有效的脊柱側彎背架治療策略,並降低病患追蹤流失率。 |
英文摘要 | The Osaka Medical College (OMC) brace is an underarm spinal orthosis for the treatment of scoliosis. It consists of a plastic pelvic section with a pad extended from the lateral bar to correct the convexity of the curve. The plastic cover on the trunk is minimized, and thus perspiration under the plastic contour is reduced. This is favorable for people who are heat intolerant or for those living in a hot and humid climate. In Taiwan, the use of the OMC brace has been increasing because it allows for good ventilation, is light, and has a less-restrictive design, yet its effectiveness has not been described adequately in the literature. In the present study, we analyzed the change in the Cobb angle 1 year after bracing in 81 patients fitted with an OMC brace for the treatment of idiopathic scoliosis. During the study, 23 patients (28.4%) were lost to follow-up and were regarded as dropouts. Among the 58 patients remaining for analysis, 13 (22.4%) belonged to the brace failure group (curve progression>5° at 1 year after bracing) and 45 (77.6%) belonged to the brace success group (curve progression≦5° at 1 year after bracing). No statistically significant difference existed between these 2 groups in terms of gender, curve type, side of curve vertex, and major curve level (p>0.05). There was a significant difference in the mean age at which the need for bracing was presented between the brace failure group (10.7±3.2 years) and brace success group (12.4±2.1) years) (p=0.028); this indicates that patients who present with symptoms at a young age have poor prognosis. We suggest the OMC brace is an effective spinal orthosis for the treatment of idiopathic scoliosis, and further research is needed to investigate what kind of brace will be suitable for individuals with early onset of scoliosis in the future. |
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