Effects of Lateral Trunk Supports on Spinal and Pelvic alignment for Persons with Spinal Cord Injury

• Main Authors: Sheau-Ling Huang, 黃小玲
• Other Authors: Hui-Fen Mao
• Format: Others
• Language: en_US
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/62086757726719668292

碩士 === 國立臺灣大學 === 職能治療研究所 === 92 === Objective. To investigate the effects of lateral trunk supports (LTSs) on spinal and pelvic alignment for the spinal cord injured (SCI) persons with scoliosis. Background. Special seating has been widely used in clinic to improve sitting postures of SCI persons. However, little has been known about the effects of LTSs on the scoliotic curve and buttock pressures. Methods. Eight male SCI subjects with scoliosis participated in this study. The shapes of the spine and pelvis were measured with subjects sitting on an experimental chair in two seating configurations. Radiographs were taken first and then 3-dimensional (3-D) spine-pelvis curve and buttock pressures were measured simultaneously using a motion analysis system (Vicon 512, Oxford Metrics, U. K.) and a pressure plate (Tekscan Advanced Clinseat, U.S.A.). The severity of scoliosis was described by Cobb angles, spinous process angles, and scoliotic index calculated from the radiographic images. Paired-t test was used to compare differences of the Cobb angles, spinous process angles and scoliotic index as well as the corresponding angles calculated from the coronal projection of the 3-D spine-pelvis curve between two seating configurations. Relationships between the results from 2-D radiographs and coronal projection of the 3-D spine-pelvis curves, and between the results from 3-D spine-pelvis curves and COP movements were analyzed by Pearson’s correlation. Results. The results of the radiographic data revealed that Cobb angles, spinous process angles, and scoliotic index with LTSs were all significantly smaller than those without LTSs (p = 0.005 ~ 0.043). The scoliosis correction rate in terms of Cobb angles, spinous process angles, and scoliotic index from the radiographs were 31.38% (14% ~ 50%), 31.69% (-7% ~ 69%), 23.71% (-27% ~ 54%) respectively. Spinous process angles on A-P radiographs and coronal projection of the 3-D spine-pelvis curves were obviously correlated (r = 0.624, p = 0.010). But there was no significant difference in relative positions of the 3-D spine-pelvis curves between the two seating configurations. With LTSs, peak pressures at the buttock were smaller than those without LTSs for all subjects, but symmetry index and center of pressure displacement (COPd) did not change significantly. None of the relative movements among the spinal segments and pelvis were related to the movement of center of pressure percentage (COPp) on the pressure plate. Conclusions. Significant static correction of the scoliotic spine could be achieved by special seating with lateral trunk supports as shown by radiographic analysis results. But kinematic analysis of 3-D spine-pelvis movements did not show the same phenomenon, which could be related to the calculated methods. Further study on this issue is necessary. Peak pressures at the buttock were decreased after using LTSs. Nevertheless, symmetry index and COPd were not reduced accordingly. The results implied that spine and pelvis should be regarded as a whole when prescribing the special seating for SCI persons with scoliosis.