![]() Hence, wearing a collar did influence the patients’ pain. A study evaluating whether or not a soft collar reduced the duration and intensity of the patient’s pain following a whiplash ( 9) showed that test patients wearing a soft collar and control patients not wearing a soft collar reported persistent pain for at least 6 weeks postinjury. The effectiveness of its therapeutic use is under scrutiny. Soft collars are often prescribed for the early management of whiplash injuries. Its use may be appropriate to treat mild muscular spasms associated with arthritic changes and mild soft-tissue injuries. Essentially, this orthoses reminds the patient not to move. Given its soft material construction, the soft collar can only provide warmth, psychological reassurance, and kinesthetic reminders to limit cervical range of motion it cannot provide structural support. The explanation for this is a function of the starting position of the head. If the intent is to limit flexion, then the collar should be worn in the reverse position with the tabs facing anteriorly. Carter and associates reported that the degree of motion restriction achieved with the soft collar was dependent on the velcro closure position ( 5). This measure corresponds with pre-determined sizes. To identify the correct size, circumferential neck measurements are taken. Collars range in size from small to extra large. The manufacturer’s intention was to have these collars worn with the closures facing posteriorly. Depending on the patients dexterity and upper extremity range of motion, some can only fasten the closures anteriorly and rotate the collar around their neck while others leave the Velcro closures in the front. The C2-4 region has the most side bending and rotation.Ī soft cervical collar is prefabricated foam rubber with a cotton stockinette covering and Velcro closures ( Fig. Sagittal motion occurring at C2-7 is uncoupled. As right rotation occurs, it initiates right lateral flexion and as left cervical rotation occurs, it initiates left lateral flexion. Given the configuration of the articulating facets, lateral flexion and rotation are coupled motions. Lateral flexion (lateral side bending), however, occurs between C2 and C7 in the coronal plane. During flexion the vertebral foramina open and with extension close. Occurs, with the greatest motion occurring at C5-6. Between C4 and C7, maximum flexion and extension Approximately, 50% of the total rotation achieved by the cervical vertebral column occurs at C1-2. Cervical rotation begins first at this articulation and then proceeds caudally. Having no vertebral body or disc, the atlas rotates around the odontoid axis. At the atlantoaxial (C1-2) joint, the predominant motion is rotation. Functionally, this synovial joint enables an individual to nod their head. The atlantooccipital joint primarily permits flexion and extension, with minimal axial rotation and lateral flexion. The cervical spine is a highly mobile structure allowing flexion, extension, lateral flexion, and rotation thus, motion occurs in three planes: sagittal, frontal, and transverse. ![]() Follow-up of its continued use is required both for the physician and the patient. In addition, the patient or caregiver must be instructed in the donning and doffing of the orthosis, its wearing schedule, whether or not the patient needs to sleep and shower in the brace, and the length of time the orthosis is recommended. Once the brace is discontinued, a more aggressive strengthening and stretching program is initiated in order to prevent the negative effects of disuse. While in the brace, an exercise program should be implemented, if possible. Skin under the brace needs to be checked and washed daily. Two braces may need to be given to the patient so that one can be washed on a regular basis in order to maintain hygiene. Pendulous breasts, short trunk, thoracic kyphosis, or an obese abdomen make it difficult to comfortably fit cervicothoracic or thoracolumbosacral appliances. Individuals with a short stout neck and no defined chin are harder to fit with a cervical collar. With patients who can volitionally adjust the straps, the effectiveness of the brace may be compromised if they loosen the straps. Discomfort may be related to strap tightness, complaints of confinement, or increased perspiration caused by the brace. Compliance is dependent on the patient’s understanding of the condition, willingness to tolerate a snug fitting appliance, and overall comfort. It is contingent upon correct fit, patient compliance, body habitus, the ability to restrict gross and segmental vertebral motion and the ability to minimize and prevent the negative side effects. Effective spinal bracing, therefore, is a complicated procedure and needs to take into account multiple factors.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |