The effect of taping versus semi-rigid bracing on patient outcome and satisfaction in ankle sprains: A prospective, randomized controlled trial

Background: Functional treatment is a widely used and generally accepted treatment for ankle sprain. A meta-analysis comparing the different functional treatment options could not make definitive conclusions regarding the effectiveness, and until now, little was known about patient satisfaction in relation to the outcome. Methods: Patients with acute ankle sprain received rest, ice, compression and elevation with an compressive bandage at the emergency department. After 5-7 days, 100 patients with grade II and III sprains were randomized into two groups: one group was treated with tape and the other with a semi-rigid ankle brace, both for 4 weeks. Post-injury physical and proprioceptive training was standardized. As primary outcome parameter patient satisfaction and skin complications were evaluated using a predefined questionnaire and numeric rating scale. As secondary outcome parameter the ankle joint function was assessed using the Karlsson scoring scale and range of motion. Results: Patient-reported comfort and satisfaction during treatment with a semi-rigid brace was significantly increased. The rate of skin complication in this group was significantly lower compared to the tape group (14.6% versus 59.1%, P < 0.0001). Functional outcome of the ankle joint was similar between the two treatment groups, as well as reported pain. Conclusion: Treatment of acute ankle sprain with semi-rigid brace leads to significantly higher patient comfort and satisfaction, both with similar good outcome

Numerical analysis of the stability of a column laterally restrained by a flexible brace

Thesis (M.S.) University of Alaska Fairbanks, 2014.The paper analyses the behavior of a structure which includes a classically restrained steel column under an axial load and a single flexible brace attached at an arbitrary point along the column to restrict its lateral deformation. The column is assumed to have an initial imperfection limited according to the current code requirements. Focusing on lateral deformations only, the paper studies the maximum load the system can resist before failure, as well as a brace force arisen at this load. Due to the complexity of the problem when it is extended from the elastic region to the plastic domain, a numerical solution is utilized. In the current work, a student version of AbaqusTM provides results of finite-element analysis implemented for a variety of ASTM A992 steel W-Shaped columns. The results confirm that the failure load and brace force highly depend on brace location and its stiffness. It is also shown that the current code provision of a brace load is not always conservative for braces shifted from the center of the column

Supporting brace sizing in structures with added linear viscous fluid dampers: A filter design solution

Viscous fluid dampers have proved to be effective in suppressing unwanted vibrations in a range of engineering structures. When dampers are fitted in a structure, a brace is typically used to attach them to the main structure. The stiffness of this brace can significantly alter the effectiveness of the damper, and in structures with multiple dampers, this can be a complex scenario to model. In this paper, we demonstrate that the effects of the brace compliance on the damper performance can be modelled by way of a first-order filter. We use this result to formulate a procedure that calculates the stiffness required by the supporting brace to provide a specified effectiveness of the damping action. The proposed procedure assumes that viscous dampers have been sized in a previous design step based on any optimal methodology in which, as is usually the case, the presence of supporting braces and their dynamic effects were neglected. Firstly considering a one degree-of-freedom system, we show that the proposed method ensures a desired level of damper efficiency for all frequencies within a selected bandwidth. Then the analysis is extended to the case of multi-degree-of-freedom systems to show that the design criteria can be applied in a straightforward and successful manner to more complex structures

Comparison Between Rigid Double Upright and Lace-up Ankle Braces on Ankle Range of Motion, Functional Performance, and User Satisfaction of Brace Characteristics

Background: Braces are often used before returning to activity following ankle sprains and also prophylactically in sports considered the high risk for ankle sprains. The purpose of this study was to compare range of motion (ROM) limitations, functional performance, and satisfaction of rigid double upright and lace-up braces. Subjects: In total, 30 healthy adults \u3e18 years of age (Mean, 22.6 6 2.7 years) without lower extremity injury and involved in regular physical activity participated in this study. Materials/Methods: Ankle ROM assessment and lower extremity performance testing (figure-of-8 hop, side hop, 6-m single-limb crossover, and square hop) was administered under the following 3 conditions: unbraced, rigid braces, and lace-up braces. A questionnaire was completed following the test protocol on brace characteristics and satisfaction. Repeated-measures ANOVA was used to determine the main effects on outcome variables of ROM, hop performance, and satisfaction. Tukey LSD post hoc comparisons were conducted on significant main or interaction effects (P \u3c .05) to determine differences between group by condition means. Results: In total, 30 participants completed the study. The lace-up brace limited plantarflexion and inversion ROM more than the rigid brace. When compared to the unbraced condition, both braced conditions resulted in better performance times, although not statistically significant. Higher satisfaction was reported with the lace-up brace on appearance, fit, prevention, and overall satisfaction. Conclusions and Clinical Relevance: The ankle braces primarily limited ankle plantarflexion and inversion ROM, which are motions related to common reported mechanisms of ankle sprains. The braces did not negatively affect hop performance, and user satisfaction indicated a slight preference for the lace-up brace

A pragmatic benchmarking study of an evidence-based personalised approach in 1938 adolescents with high-risk idiopathic scoliosis

Combining evidence-based medicine and shared decision making, current guidelines support an evidence-based personalised approach (EBPA) for idiopathic scoliosis in adolescents (AIS). EBPA is considered important for adolescents\u2019 compliance, which is particularly difficult in AIS. Benchmarking to existing Randomised Controlled Trials (RCTs) as paradigms of single treatments, we aimed to check the effectiveness and burden of care of an EBPA in high-risk AIS. This study\u2019s design features a retrospective observation of a prospective database including 25,361 spinal deformity patients &lt; 18 years of age. Participants consisted of 1938 AIS, 11\u201345\u25e6 Cobb, Risser stage 0\u20132, who were studied until the end of growth. EBPA included therapies classified for burdensomeness according to current guidelines. Using the same inclusion criteria of the RCTs on exercises, plastic, and elastic bracing, out of the 1938 included, we benchmarked 590, 687, and 884 participants, respectively. We checked clinically significant results and burden of care, calculating Relative Risk of success (RR) and Number Needed to Treat (NNT) for efficacy (EA) and intent-to-treat analyses. At the end of growth, 19% of EBPA participants progressed, while 33% improved. EBPA showed 2.0 (1.7\u20132.5) and 2.9 (1.7\u20134.9) RR of success versus Weinstein and Coillard\u2019s studies control groups, respectively. Benchmarked to plastic or elastic bracing, EBPA had 1.4 (1.2\u20131.5) and 1.7 (1.2\u20132.5) RR of success, respectively. The EBPA treatment burden was greater than RCTs in 48% of patients, and reduced for 24% and 42% versus plastic and elastic bracing, respectively. EBPA showed to be from 40% to 70% more effective than benchmarked individual treatments, with low NNT. The burden of treatment was frequently reduced, but it had to be increased even more frequently

7th SOSORT consensus paper: conservative treatment of idiopathic & Scheuermann's kyphosis

<p>Abstract</p> <p/> <p>Thoracic hyperkyphosis is a frequent problem and can impact greatly on patient's quality of life during adolescence. This condition can be idiopathic or secondary to Scheuermann disease, a disease disturbing vertebral growth. To date, there is no sound scientific data available on the management of this condition. Some studies discuss the effects of bracing, however no guidelines, protocols or indication's of treatment for this condition were found. The aim of this paper was to develop and verify the consensus on managing thoracic hyperkyphosis patients treated with braces and/or physiotherapy.</p> <p>Methods</p> <p>The Delphi process was utilised in four steps gradually modified according to the results of a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ), and during a Consensus Session at the SOSORT Lyon Meeting with a Meeting Questionnaire (MQ).</p> <p>Results</p> <p>There was an unanimous agreement on the general efficacy of bracing and physiotherapy for this condition. Most experts suggested the use of 4-5 point bracing systems, however there was some controversy with regards to physiotherapeutic aims and modalities.</p> <p>Conclusion</p> <p>The SOSORT panel of experts suggest the use of rigid braces and physiotherapy to correct thoracic hyperkyphosis during adolescence. The evaluation of specific braces and physiotherapy techniques has been recommended.</p

The Effect of Three Different Ankle Braces on Vertical Jump Performance in Female College Volleyball Players

Background/Purpose: Ankle braces are often used to stabilize the ankle joint of an athlete to reduce the risk of initial injury while participating in athletic activity or to protect the joint from re-injury when returning to play. The purpose of this study was to examine the effects of application of three different braces on vertical jump performance in collegiate female volleyball players. A secondary aim was to compare participant preference and satisfaction on selected characteristics of each of the three different braces. Subjects: 31 female varsity/club college volleyball players \u3e18 years of age. Materials/Methods: Health History Assessment and a dynamic warm-up were administered prior to performing vertical jump testing in four randomized conditions: unbraced, lace-up, single upright semi-rigid, and double upright semi-rigid ankle braces worn bilaterally. Vertical jump was calculated using the Just Jump® mat and the VERT® instrumented systems. Repeated measures ANOVA was employed to determine main effects on outcome variables of vertical jump performance and t-tests were implemented to assess brace satisfaction. Results: The braced conditions resulted in similar but slightly lower vertical jump height than the unbraced condition (~2.5%). The lace-up brace was rated higher by the participants in overall user satisfaction in the majority of characteristics (5 of 7). The double upright semi-rigid brace was reported by the participants to provide the greatest stability and believed to be most effective at preventing a future injury. Conclusions and Clinical Relevance: Female volleyball players often wear ankle braces during practice or competition to prevent new or recurrent ankle injury. The braces used in this study appeared to have minimal impact on vertical jump performance of less than 2.5% compared to the unbraced condition. Whether this small effect on performance is an acceptable trade-off for reducing the risk of ankle injuries may be a matter of opinion especially at high levels of performance and requires future investigation