Efficacy of lumbosacral orthoses in the management of

Efficacy of lumbosacral orthoses in the management of low back pain: biomechanical and clinical comparison of two designs J Cholewicki, DC Morrisette, AS Lee, NP Reeves, GA Seif Michigan State University and Medical University of South Carolina, USA, cholewic@msu. edu

Jacek Cholewicki, co-director of Michigan State University's Center for Orthopedic Research at Ingham Regional Orthopedic Hospital in Lansing.

Objective • To compare the efficacy of an extensible (Mueller Adjustable Back Brace) and nonextensible (Aspen. Quik. Draw Pro) lumbosacral orthoses (LSO) in augmenting trunk stiffness and improving physical function in patients with chronic low back pain (LBP).

Mueller / Aspen rigid

Design • Trunk stiffness was estimated from the trunk's response to a quick force release in trunk flexion, extension, and lateral bending. Twenty subjects performed five trials in each experimental condition: (1) No LSO, (2) Mueller LSO, and (3) Aspen LSO. An additional 63 subjects were randomized to the same 3 treatment groups Iisted above.

Methodology • Subjects in the LSO conditions wore the LSOs daily. • The Oswestry Disability Index questionnaire was administered at baseline and at 2 to 3 weeks from starting treatment.

Results • On average, the Aspen LSO increased trunk stiffness by 14% (P<O. O 1), while the Mueller LSO did not result in any significant change in trunk stiffness. • Patients wearing the Aspen LSO demonstrated a 14% improvement in disability (P = 0. 01) • while patients wearing Mueller LSO reported a 9% improvement in disability (P = 0. 18).

Conclusion • A non-extensible LSO is more effective in augmenting trunk stiffness and in improving physical function in patients with chronic LBP when compared with an extensible LSO.