Happenings RESEARCH ROUNDUP
Early Spinal Patterns in Younger Children May Predict Future Scoliosis Saba Pasha, PhD, a researcher at Children’s Hospital of Philadelphia (CHOP), has completed a study identifying patterns of spinal curvature among younger children that may develop into scoliosis by adolescence. The study by Pasha, director of orthopedic engineering and 3D musculoskeletal imaging at CHOP, could serve as a first step in developing methods to prevent scoliosis, according to her team. Pasha used computer simulations to investigate how elastic rods—models of children’s spines—change shape in response to mechanical loading. She designed the study by borrowing concepts from researchers who simulate how DNA molecules and proteins change their structure in response to various factors. Pasha studied the spinal X-rays of 129 adolescents with and without scoliosis. She studied 2D patterns of the X-rays, called sagittal spinal profiles, and used those patterns to
create S-shaped elastic rods in the computer simulations. She then applied simulated mechanical forces to observe how those rods deformed in 3D shapes. By studying the rods in models of subjects both with and without scoliosis, she found strong evidence that the shape of a person’s sagittal profile can be a leading cause of scoliosis. “This was the first study to quantitatively explain how variation in spinal patterns may lead to the spinal deformities seen in scoliosis, and may eventually guide us to early interventions for children at risk,” said Pasha, adding that follow-up studies are needed to determine whether the spinal shapes seen in images from younger patients could be developed into a risk-assessment tool to predict likelihood of scoliosis during the teen years. She theorized that it may be determined that wearing an orthosis at a younger age could prevent scoliosis from developing. The study was published in the November 11 issue of Nature Scientific Reports.
Researchers Investigate Hands-Free Crutch Preferences Lauren Schimandle used an iWALK 2.0 after sustaining a Lisfranc injury
JANUARY 2020 | O&P ALMANAC
discomfort using the hands-free single crutch. “The results of the current study in our relatively healthy cohort found that foot and ankle patients who were non-weight-bearing preferred the hands-free single crutch over standard axillary crutches,” said the researchers. “They experienced less physiologic demand as well as discomfort and perceived less exertion.” The hands-free device offers an alternative for patients with lower leg injuries or illnesses, including foot and ankle fractures, calf muscle strain, Achilles tendon ruptures, and below-knee amputation. The researchers concluded that further research is needed to help establish clinical practice guidelines and educate providers to prescribe assistive devices “based on individual patient physiological and environmental needs.”
PHOTO: iWalkFree
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Non-weight-bearing foot and ankle patients requiring crutches preferred using a new type of orthosis—a hands-free single crutch—to using standard axillary crutches, according to a study published in the October issue of Foot and Ankle International. Subjects in the randomized, controlled study, led by orthopedic foot and ankle surgeon Kevin D. Martin, DO, included 44 preoperative foot and ankle patients who were randomly assigned a device where a series of tests were carried out. The subjects subsequently tested the alternative device. The researchers found that 86 percent of subjects preferred the orthosis—an iWALK 2.0—to traditional crutches. While 68 percent of users reported axillary or hand pain using standard crutches, only 7 percent reported