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
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 (AspenQuikDraw 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
improvement in disability (P = 0.01)
• while patients wearing Mueller LSO reported a
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.