The influence of orthotic treatment of idiopathic scoliosis on gait

Uvod: Skolioza je lateralna deviacija, odmik hrbtenice od navidezne črte mediane, ki jo pogosto spremlja še rotacija posameznih vretenc, idiopatska skolioza pa je krivina hrbtenice, večja od 10° po Cobb-ovem kotu, s pridruženo rotacijo teles vretenc in je neznanega izvora. Je najpogostejša strukturna deformacija hrbtenice pri otrocih in mladostnikih. Določimo jo glede na parametre, ki jih zabeležimo s pomočjo meritev, opazovanja in ocene drže. Pomembno določilo skolioze je rentgenska slika hrbtenice, s katere razberemo Cobb-ov kot. Večina idiopatskih skolioz nastane v mladostniških letih (med 10-18 letom) in prizadene 2-3% populacije te starostne skupine. Idiopatsko skoliozo se zdravi s konzervativno terapijo, ki vključuje opazovanje,fizioterapijo in aplikacijo ortoz ter operacijsko. Na hojo ima skolioza velik vpliv, saj povzroči razvoj patološkega vzorca hoje. Zdravljenje skolioze z ortozo oziroma steznikom je najpogostejše ne-operativno zdravljenje skolioze in ima tako pozitivne, kot tudi negativne učinke. Namen: Namen diplomskega dela je ugotoviti vpliv ortotične obravnave idiopatske skolioze na hojo. Metode dela: Uporabljena je bila deskriptivna metoda, saj so bili pregledani in med sabo primerjani znanstveni članki na področju ortotične obravnave skolioze Rezultati: V diplomskem delu so vključeni rezultati 9 raziskav, katere raziskujejo vpliv ortotične obravnave idiopatske skolioze na hojo. Tabele prikazujejo značilnosti pacientov, vrsto ortotične obravnave in vpliv ortotične obravnave na hojo. Razprava in sklep: Ortotična obravnava idiopatske skolioze ima največji vpliv na zmanjšanje krivine skolioze, s tem pa je boljša tudi hoja. Ortoza pozitivno vpliva na stojo, saj izboljša ravnotežje, stabilnost in propriocepcijo. Na parametre stoje in hoje najbolj vpliva rigidnost steznika. Z odstranitvijo rigidnega steznika, se nekateri parametri bistveno poslabšajo. Obravnava idiopatske skolioze s steznikom pozitivno vpliva na dolžino koraka, dolžino faze opore in kadenco. Steznik nima pomembnega vpliva na povišano porabo energije in na povišane vrednosti električne mišične aktivnosti merjenih mišic pri hoji. Potrebne so nadaljnje raziskave o vplivu steznika na parametre stoje in hoje tudi po odstranitvi le tega.Introduction: Scoliosis is a lateral deviation, an offset of the spine from the apparent median line. Scoliosis is often accompanied with rotation of the vertebra. Idiopathic scoliosis is a spinal curvature, that has Cobb\u27s angle greater than 10° and rotation of the vertebra. Its origin is unknown. It is the most common structural deformation of the spine among children and youngsters. Scoliosis is determined regarding to the parameters, which are obtained with measurements, observation and posture assessment. Cobb\u27s angle of the scoliosis is determined from X-ray images. Idiopathic scoliosis is most common in adolescent years (between 10-18 years of age) and affects 2-3% of adolescents. It can be treated with conservative therapy, which includes observing, physiotherapy, orthotic treatment with a brace and with operation. Scoliosis has a major effect on gait, because it develops phatological gait patern. Orthotic treatment of scoliosis is the most common non-operative treatment of scoliosis and has both positive and negative effects. Purpose: The purpose of the diploma thesis is to determine the influence of orhotic treatment with a brace on gait. Methods: A descriptive method was used in the study to review and compare scientific papers related to orthotic treatment of scoliosis. Results: Diploma includes results of 9 studies, which researched the influence of orhotic treatment of idiopathic scoliosis on gait. The tables present the data about patients features, type of the orthotic treatment and influence of orthotic treatment on gait. Discussion and conclusion: Orthotic treatment of idiopathic scoliosis has its greatest impact on reducing the curvatures of the scoliosis and beceause of that, the gait is better too. Orthosis has a positive effect on stance because it improves balance, stability and proprioception. Rigidity of the brace has the biggest impact on the stance and gait parameters. With the removal of the rigid brace some of those parameters get significantly worse. Treatment of idiopathic scoliosis with a brace has a positive effect on step length, length of stance phase and cadence. The brace has no significant effect on high energy consumption and on high values of electrical activity od measured muscles during gait. Further research of the brace impact on stance and gait are needed, including when the brace is remove