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Lumbar orthoses in the treatment of muscular atrophy Mobility comes from stability

Issue 02/2017

Restoring movement quickly – this is the motto when treating most patients suffering from problems with their musculoskeletal system. However, meeting this objective means breaking the vicious circle of pain, adopting a posture to help relieve this pain, and muscle wastage. There are still many people who are convinced that orthoses worsen muscular atrophy instead of helping patients to combat it.

The times when patients were confined to bed for weeks following a hip replacement operation or were forced to rest their knee after surgery are a distant memory. It has long been recognized that early mobilization has a host of benefits, including the ability to relieve pain, reduce the risk of thrombosis, and rebuild the muscle strength lost as a result of immobility and the habit of adopting a different posture in order to avoid pain. As explained by this focus feature on lumbar orthoses, orthoses can play an important role in this. Lumbar orthoses flexibly stabilize the lumbar spine. This means that they only limit undesired movements, giving patients a greater sense of stability and security.
Instead of restricting movement as a whole, orthoses allow the spine to dynamically keep itself in balance to a certain degree. This helps patients to regain a good posture and enables them to move less painfully and more efficiently. Far from causing problems such as muscular atrophy, in many cases orthoses are actually responsible for getting patients back on their feet for the first time.

Recent study rebuts presumption that orthoses cause atrophy

Evidence dispelling the idea that orthoses lead to atrophy has already been found for patients receiving purely nonsurgical treatment. Recently, however, Dr. med. Yorck Rommelspacher set himself the task of investigating the effect of the Spinova Support Plus lumbar orthosis on patients who have undergone surgery. During his research, the orthosis had no negative effect whatsoever on muscle regeneration and was even discovered to improve it slightly. Turn to page 22 to read an interview with the physician in which he explains exactly which orthopedic methods he used during his study. His investigation also revealed that patients regain confidence when wearing the orthosis. The lumbar orthosis was found to help them lead more active lives again, improving their quality of life enormously.

Less discomfort , greater confidence to move

Prof. Dr. Hee Hwan Tak from Singapore (see interview opposite) repeatedly observes how lumbar orthoses give patients the courage to get moving again. He believes that the reduced reliance on painkillers and the ability of patients to return to work provide strong indications that lumbar orthoses have a therapeutic effect. Prof. Dr. med. Rolf Haaker stresses that it is especially important to restore mobility as quickly as possible in older patients in order to counter the known consequences of being confined to bed. You can find out what he has to say about the use of SacroLoc in patients with pubic rami fractures on pages 20–21. The orthosis also considerably eases the pain caused by pelvic fractures by bringing relief to the posterior pelvic ring and restricting nutation movement at the sacroiliac joints. The three interviews making up our focus feature all conclude that lumbar orthoses often help patients to get back on their feet more quickly and confidently.

Image: Fotolia.com/CLIPAREA.com