فاطمه آزادی نیا

Forward head posture, which occurs often in conjunction with increased curvature in the upper body and rounded shoulder, is one of the most common postural deviations. Over time, this poor posture can contribute to the development of neck pain and shoulder dysfunction. Therefore, the purpose of this study is to design and develop a forward head rounded shoulder posture corrective orthosis (FHRSO) and its immediate effect on craniovertebral and protraction-retraction angles in people with postural deviations in the upper body.

Thirty men aged between 18 and 60 years with a forward head posture disorder (craniovertebral angle less than 42.5 degrees) participated in this study. Correspondingly, the immediate effect of the newly designed orthosis, namely FHRSO was investigated via measuring two variables, craniovertebral and protraction-retraction angles in the standing position by taking lateral view photographs.

Both craniovertebral and protraction-retraction angles were significantly increased following the FHRSO wearing in comparison with no orthosis condition (P<0.001).

Our findings indicate that a FHRSO orthosis can be effective for correcting the forward head and rounded shoulder posture in persons with postural deviations in the upper body.

The back extensor muscles are the main spinal supportive factors which function establishes spinal stability and erect posture of the spine. Spine deviation from the ideal alignment, like abnormal increase in the forward curvature of the thoracic spine may cause changes in the trunk muscle activity which can lead to a change in the spinal proprioception. It seems that the corrected spinal alignment as a result of an orthotic treatment course facilitates the back muscles activity and improve proprioception. The present study aimed to investigate the changes occurring in thoracic kyphosis, trunk extensor muscle strength and trunk extensor force sense after using the Spinomed orthosis in elderly people with hyperkyphosis. Twenty-six elderly people with hyperkyphosis who met the eligibility criteria participated in this preliminary study at School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran, from August to November of 2017. Subjects were randomly allocated to the experimental (wearing the orthosis with maintaining the daily physical activities) and control (maintaining daily physical activities) groups. Degree of kyphosis, absolute error of force sense and trunk extensor muscle strength were measured in all participants before and after intervention for 9 weeks. Thirteen elderly people with 63.85±4.63 years old in the experimental group and thirteen elderly people with 66.92±3.25 years old were participated in data analysis. The results showed significant reduction in degree of kyphosis (P<0.001) and absolute error of force sense (P=0.001), and improvement of trunk extensor muscle strength (P=0.021) in the experimental group. Independent t-test results showed a significant difference between experimental and control groups with better outcomes in terms of posture correction (P<0.001) strength (P=0.002) and force sense (P=0.035) in the orthosis group. Using Spinomed orthosis for 2 months (2 hours per day) appears to have some benefit in terms of back extensor muscle strength and muscle force control. Also, Spinomed orthosis can be prescribed to improve spinal posture.

Osteoarthrosis is a common condition in the cervical region due to the high mobility of this region. Despite the clinical popularity of traction that is often prescribed for patients with neck pain, there is no agreement on the effectiveness of traction. Due to the high controversy and the lack of experimental documents in the efficiency of the pneumatic traction device in reducing symptoms of neck pain, present study was conducted to evaluate the efficacy of the pneumatic traction device in reducing pain and amount of drug use, and improving disability level in patients with neck osteoarthrosis compared to the control group.
Twenty-six patients with neck pain aroused by osteoarthrosis were randomly assigned into two groups of control or experimental. The control group received hot pack, TENS, US, exercise therapy and ergonomic training as their usual physical therapy care. Patients in the experimental group also benefited from the sustained traction via the pneumatic traction device too. All participants were treated for 10 sessions. Pain (NPRS), the level of disability (NDI), the number of sedative drugs and NSAIDs were evaluated in the beginning of the first session and at the end of the last session.
A significant decrease in the levels of the pain and disability in both groups were found (P0.05).
Although physical therapy and ergonomic trainings may lead to a significant improvement in neck pain and related disability in the osteoarthrosis patients, the use of pneumatic traction device can increase the rate of improvement.

Neck pain is one of the most prevalent disorders in the world and became a major public health problem. It is a common condition affecting as much as two-thirds or more of the general population at one point of time during their life. Cervical collars have been approved to be effective on neck pain and disability as a conservative treatment. Actually most of patients refused to use them because of their appearance and raise temperature by wearing them. So we introduced a new design of cervical collar called Open-design collar, it seems that could be accepted better by patients because of its different appearance. The purpose of the current study was to investigate the effect of Open-design collar on user’s acceptance and cervical range of motion in asymptomatic adults. Seventy-two healthy subjects (36 women and 36 men) aged 18 to 29 years oldwere recruited for this study. Neck movements were measured using JTECH Medical Dual Digital Inclinometer. Active flexion, extension, right and left lateral flexion, and right and left rotation were assessed in each subject 3 times with and without Open-design collar. To assessthe acceptance of wearing Open-design collar, each subject was asked to fill an acceptance questionnaire of five criteria about the Open-design collar. Open-design collar significantly reduced cervical motions. It reduced flexion and extension on average by 78.24 ± 8.03%, 79.91 ± 8.02%, and right lateral flexion and left lateral flexion by 56.70 ± 13.91%, 54.34 ± 13.39% and right axial rotation and left axial rotation on average by 82.22 ± 5.48 and 82.60 ± 6.77. Based on the data of the 72 subjects presented in this study, the Open-design collar adequately immobilized the cervical spine as a semi-rigid collar while the subjects accepted it by a good score.

Radiography is a common، highly reliable and valid method of measuring spinal kyphosis. However، it may be considered unsuitable for regular use because of radiation exposure and particular cost. Other clinical methods may provide safe and rapid assessment of spinal curvature. The purpose of this study was، therefore، to verify the reliability and validity of the flexicurve to measure thoracic kyphosis. One hundred and five subjects with hyperkyphosis were enrolled in this study (aged 10-80 years). The Cobb angle was measured on a posterior-anterior x-ray by a spine specialist. Two other examiners، blinded to the results of previous measurement، evaluated thoracic kyphosis using the flexicurve. Finding showed that the validity of flexicurve was in poor range while compared with established radiologic measurement. There was an acceptable reliability on the intra-rater evaluation with flexicurve measurement method in participants aged < 30 and > 50 years. However، it was poor on inter-rater reliability evaluation in subjects aged < 30 years but an acceptable option in those aged > 50 years. The flexicurve is barely valid for thoracic kyphosis measurement. So، despite it has been identified as a safe، non-invasive and cost-effective method، but because of its low reliability and validity could not be recommended for regular screening.

Flat foot is a common musculoskeletal deformity but there is no consensus about the incidence of this deformity in literature. Development of the longitudinal arch of the foot depends on the individual’s age, gender, and race and also can be influenced by footwear properties or the age show-wearing has been started.This survey is to determine the prevalence of this deformity in students who were aged 7-14 in Isfahan. 671 participants who were met the inclusion criteria were recruited. Subject was selected by multi stage sampling from five educational areas in Isfahan.age, gender, height, and weight of subjects were recorded and a footprint were taken to extract an index(foot print Arch Index) indicating the height of the foot arch. the results of this study showed 23.5% loss of longitudinal arch including 14.1% the unilateral loss of the longitudinal foot arch and 9.5% the bilateral loss of the longitudinal foot arch. Frequency of longitudinal arch loss in both genders was almost the same (24.5%& 23% in boys and girls, respectively).The incidence of the flat foot showed an increase from the age of 7 years toward 10 but decreases after the age of 10. the data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. Especially in overweight children a highly significant prevalence of flat foot was observed.

Falls in the elderly are common and are associated with appreciable morbidity and mortality. Hyperkyphosis is a risk factor for balance impairment and postural instability. Increased forward curvature of the spine displaces the center of mass anteriorly towards the limits of stability, and thus increases the likelihood of loss of balance and predisposes persons to fall. The orthoses are an option for decreasing the risk of falling in elderly population; however, the quantitative evidence to support their application is not convincing. The purpose of this study is to analysis the effects of spinomed orthosis on risk of falling of elderly people with spinal hyperkyphosis. 18 elderly people with mean age 65.96 ± 4.4 who had thoracic kyphosis of ≥ 50 (cobb angle) were enrolled in the study. Subjects were randomly allocated into either spinomed orthosis or control group. Patients were randomly subjected to computerized dynamic posturography, which contained sensory organization tests and limits of stability. The tests for each person were conducted in two conditions: while wearing and not wearing the orthosis and the order of testing within a patient was randomized. Wearing spinomed orthosis significantly increased balance score (p<0.0001) and directional control (p<0.032). Also, significant difference in balance score (p<0.0001) was observed between two groups (spinomed orthosis and control group)Discussion & The spinomed orthosis improves balance in elderly people with spinal hyperkyphosis. Improved balance could reduce the risk of falls and direct and indirect costs of falls and related fractures.