DonJoy® LadyStrap – back relief, precisely for women

When it comes to choosing a back support, one of the most important considerations is finding the best fit possible. Male and female spines are fundamentally different in shape; the female spine features a greater curvature, a caudally located lordotic peak, and greater cranial peak height.1

Many back supports are designed for unisex use, meaning they aren’t always made to accommodate the natural differences in shape between men and women.

DonJoy® LadyStrap is made specifically for the female body. Fitted at the waist, with a more pronounced lumbar curvature, it’s shaped to fit a woman’s natural curves. This means women can now get the same support and targeted pain relief they expect from a DonJoy back support, but with improved comfort. And with a host of adjustable features, DonJoy LadyStrap helps provide even more precise back support.

DonJoy LadyStrap’s features

The support’s height-adjustable back pad provides additional support and compression in the back area, and can be placed at different heights to help target low back pain.

A pair of bilateral straps enables the wearer to adjust the level of compression to suit their needs; increased for activity and reduced for periods of relaxation.

Its four semi-rigid dorsal stays are curved for optimal anatomical fit and improved comfort.

The ergonomic front closure with finger loop allows for fast and simple application and adjustment. And lace fabrics create a feminine look.

These features are in addition to those that come as standard with DonJoy back supports. A lightweight, low-profile design helps make extended periods of wear

comfortable, ideal during the acute phase. Optimal thermoregulation allows air circulation under the support for enhanced breathability. And soft and comfortable materials help prevent skin irritation.

Intended use and indications

DonJoy LadyStrap is designed to provide support and stabilization of the lumbar spine and relief of low back pain. It is indicated for:

  • Acute lower back pain
  • Back pain prevention, return to activities
  • Back sprain
  • Muscular weakness
  • Lumbar disc diseases (conservative treatment)

Available in two heights and five sizes, DonJoy LadyStrap fits waists from 56 to 136 cm.

References

  1. Hay, O., Dar, G., Abbas, J., Stein, D., May, H., Masharawi, Y., Peled, N., & Hershkovitz, I. (2015). The Lumbar Lordosis in Males and Females, Revisited. PloS one, 10(8), e0133685.

How a back brace can help patients with osteoporosis

Osteoporosis is a progressive condition that weakens bones, making them fragile and more likely to break.

As a result of this loss of bone, many osteoporosis patients will also suffer spinal compression fractures, with 1.4 million new clinical vertebral fractures reported in the year 2000.1 Such fractures can have a serious impact on a person’s ability to maintain an active lifestyle, with pain and a loss of confidence presenting two formidable challenges to overcome.

One therapeutic option available to osteoporotic patients is semi-rigid back bracing. These kinds of medical orthoses are designed to alleviate the symptoms of vertebral osteoporosis and help patients stay active, but what evidence is there that these products work?

What causes osteoporosis?

Bone naturally becomes thinner as a person ages, but women are especially vulnerable to osteoporosis after the menopause because their ovaries no longer produce oestrogen hormones which help maintain bone mass. Around 200 million women worldwide are estimated to be affected by osteoporosis.2

Other causes of osteoporosis are:

  • Removal of the ovaries
  • A diet lacking sufficient calcium
  • Certain hormonal disorders
  • Prolonged use of corticosteroid drugs
  • Prolonged immobility

Osteoporosis is also more common in heavy smokers and drinkers.

What are the symptoms and signs of osteoporosis?

The first sign of osteoporosis is often a fracture caused by a fall that would not result in a fracture in a young adult. Typical sites for such fractures are the wrist and the top of the femur.

Another type of fracture that occurs in osteoporosis is a spontaneous fracture of one or several vertebrae, which causes the bones to crumble, leading to a progressive loss of height or to pain due to compression of a spinal nerve.

What are spinal compression fractures, and how are they treated?

Spinal compression fractures occur when the combined axial and bending loads on the spine exceed the strength of the vertebral body, resulting in the collapse of the vertebrae.

These fractures are associated with back pain and disability, loss of height, and kyphosis – a spinal disorder in which excessive curving of the spine results in an exaggerated forward rounding of the upper back.3,4,5

Spinal compression fractures involving the anterior elements of the spinal column are considered stable fractures and most patients remain neurologically intact.5,6

Once a diagnosis is confirmed, the first line of treatment is typically conservative pain management, usually involving some form of bracing or physiotherapy.5,6

Some patients who fail conservative treatment may require hospitalization, long term care, and surgical interventions such as percutaneous vertebroplasty and balloon kyphoplasty.5,6

How can bracing help osteoporosis patients?

Orthopedic back braces designed for the management of osteoporosis symptoms should perform some or all of the following functions:

  • Control pain by limiting motion7
  • Stabilize injured structures by immobilizing the spine7
  • Provide pressure to promote correction and prevent deformity7
  • Reduce pain and fatigue8
  • Promote function or participation8

Of the different types, semi-rigid back braces seem to be the most effective, with good clinical evidence supporting their use for osteoporotic patients.

In 2011, Jacobs et al. demonstrated that using a semi-rigid thoracolumbar orthosis seems to have a positive effect on gait and stability in patients suffering from an osteoporotic spinal compression fracture.9  

In the same year, a study by Pfeifer et al. showed that the use of a semi-rigid orthosis increases trunk muscle strength and therefore improves posture in patients with vertebral fractures caused by osteoporosis.10

In Dionyssiotis et al.’s 2015 study, they showed that semi-rigid orthoses could be an effective intervention for improving back pain and muscle strength in osteoporotic women.11

And Meccariello et al. (2017) demonstrated that a semi-rigid orthosis proved to be safe and effective in the treatment of thoracolumbar osteoporotic vertebral fracture, with better functional outcome and less complications compared to a standard rigid 3-point orthosis.12

Introducing DonJoy® Osteostrap – a new back brace for osteoporosis

With its innovative modular design, DonJoy® Osteostrap utilizes a set of adjustable features to aid active relief and postural correction of the thoracic spine.

The brace’s reverse shoulder straps, semi-rigid dorsal frame, and lumbar belt combine to provide patient-specific support and correction of kyphotic posture through active relief and stabilization of the spine. The brace is easy to self-fit, and its intuitive fixtures remain within easy reach for hassle-free adjustment.

Comprised of two separate sections, the brace allows 15 combinations of different lumbar belt and dorsal frame sizes to accommodate spine lengths from C7-S1, as well as waist circumferences from 56 – 130 cm.

Soft, elastic, breathable materials help provide a comfortable fit, allowing extended periods of wear and encouraging patient compliance. Also, the brace’s low-profile shape allows the wearer to maintain freedom of movement while remaining supportive.

User-friendly, comfortable, and available in a wide range of sizes, DonJoy Osteostrap offers patients suffering from osteoporosis and other debilitating back conditions the support they need to help live a normal, active life.

References

  1. Johnell, O., & Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 17(12), 1726–1733.
  2. Reginster, J. Y., & Burlet, N. (2006). Osteoporosis: a still increasing prevalence. Bone, 38(2 Suppl 1), S4–S9.
  3. Mathis, J.M., Barr, J.D., Belkoff, S.M., Barr, M.S., Jensen, M.E. and Deramond, H., 2001. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. American journal of neuroradiology, 22(2), pp.373-381.
  4. Burge, R., Dawson-Hughes, B., Solomon, D.H., Wong, J.B., King, A. and Tosteson, A., 2007. Incidence and economic burden of osteoporosis‐related fractures in the United States, 2005–2025. Journal of bone and mineral research, 22(3), pp.465-475.
  5. Genant, H.K., Cooper, C., Poor, G., Reid, I., Ehrlich, G., Kanis, J., Nordin, B.C., Barrett-Connor, E., Black, D., Bonjour, J.P. and Dawson-Hughes, B., 1999. Interim report and recommendations of the World Health Organization task-force for osteoporosis. Osteoporosis international, 10(4), p.259.
  6. Kanis, J.A., 1999. The burden of osteoporosis. Journal of endocrinological investigation, 22(8), pp.583-588.
  7. Kato, T., Inose, H., Ichimura, S., Tokuhashi, Y., Nakamura, H., Hoshino, M., Togawa, D., Hirano, T., Haro, H., Ohba, T., Tsuji, T., Sato, K., Sasao, Y., Takahata, M., Otani, K., Momoshima, S., Tateishi, U., Tomita, M., Takemasa, R., Yuasa, M., … Okawa, A. (2019). Comparison of Rigid and Soft- Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. Journal of clinical medicine, 8(2), 198.
  8. Newman, M., Lowe, C.M. and Barker, K., 2016. Spinal orthoses for vertebral osteoporosis and osteoporotic vertebral fracture: a systematic review. Archives of physical medicine and rehabilitation, 97(6), pp.1013-1025.
  9. Jacobs, E., Senden, R., McCrum, C., van Rhijn, L. W., Meijer, K., & Willems, P. C. (2019). Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture. Clinical interventions in aging, 14, 671–680.
  10. Pfeifer, M., Kohlwey, L., Begerow, B., & Minne, H. W. (2011). Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. American journal of physical medicine & rehabilitation, 90(10), 805–815.
  11. Dionyssiotis, Y., Trovas, G., Thoma, S., Lyritis, G., & Papaioannou, N. (2015). Prospective study of spinal orthoses in women. Prosthetics and orthotics international, 39(6), 487–495.
  12. Meccariello, L., Muzii, V. F., Falzarano, G., Medici, A., Carta, S., Fortina, M., & Ferrata, P. (2017). Dynamic corset versus three-point brace in the treatment of osteoporotic compression fractures of the thoracic and lumbar spine: a prospective, comparative study. Aging clinical and experimental research, 29(3), 443–449.

Working from Home and the Potential Strain on our Bodies.

Treating low back pain with electrotherapy

Among the many impacts of the coronavirus pandemic, one of the least publicised is that of low back pain. Far more of us are currently working from home, often without the necessary ergonomic support of chairs and desks designed to prevent back problems, and as a result, physiotherapists are seeing a growing number of patients presenting with low back pain.

Among the many impacts of the coronavirus pandemic, one of the least publicised is that of low back pain. Far more of us are currently working from home, often without the necessary ergonomic support of chairs and desks designed to prevent back problems, and as a result, physiotherapists are seeing a growing number of patients presenting with low back pain.

One way of treating low back pain is with electrotherapy. The practice takes advantage of the high excitability of nerve fibres, stimulating them with electrical pulses to achieve a number of therapeutic effects. As well as pain relief, this includes stimulation to help strengthen muscles, meaning it can be used to address both the symptoms and causes of low back pain.

Treating the SYMPTOMS of low back pain with electrotherapy

Most acute low back pain is a result of injury to the muscles, ligaments, joints, or discs. The body’s reaction to injury is to instigate an inflammatory healing response, which can cause severe pain.

TENS (Transcutaneous Electrical Nerve Stimulation) uses electrical pulses to provide pain relief by blocking pain signals from reaching the brain. High frequency (HF) TENS, or sensory stimulation, uses pulses of 80-100 Hz and works via the gate control mechanism, inhibiting the transmission of pain signals to the brain while producing a pleasant tingling sensation. As a result, HF TENS is effective for providing patients with relief from the symptoms of lumbar pain.1

However, rather than just treat the cause of the pain, it’s important to also address the cause of the injury. Thankfully, electrostimulation also has an answer for this.

Treating the CAUSES of low back pain with electrotherapy

Sitting slumped over a desk while you work puts increased strain on the muscles and ligaments in your back, which can then lead to injury and low back pain. To address the cause of posture-related low back pain, we need to restore balance between the trunk flexors and extensors and strengthen our paraspinal and abdominal muscles to improve spinal stability and help us sit up straight. This is where NMES can help. 2,3

NMES (Neuro Muscular Electrical Stimulation) uses electrical pulses to produce muscle contractions, mirroring the impulse sent from the brain. NMES can be used as a standalone treatment, but is most effective when used in combination with voluntary exercise such as proprioceptive or functional rehabilitation.

By safely controlling the contractions, the muscles can be made to exert themselves much more than the patient would be capable of voluntarily, and without placing additional stress on joints. Additionally, NMES can help the patient to recruit the deep lumbar stabilizers.3,4 This allows patients to effectively and safely strengthen their trunk muscles during exercise, thereby helping to address the causes of low back pain.2,3

However, if symptoms remain, functional rehabilitation for low back pain can still be carried out by combining NMES and TENS in a single treatment. One device with this function is Chattanooga’s Intelect Mobile 2.

Intelect Mobile 2 – the next generation in electrotherapy

Intelect Mobile 2 is an innovative device designed to provide clinicians with everything they need for effective electrotherapy treatment, and comes in three different configurations, STIM, ULTRASOUND, and COMBO.

All three options include an intuitive touchscreen user interface, a library of suggested protocols, and Bluetooth connectivity for easy software updates. And as the name suggests, the device is truly mobile, enabling it to be easily carried or mounted on a wheeled cart.

Intelect Mobile 2 STIM and COMBO provide 2-channel electrotherapy with over 20 different waveforms, offering therapists multiple treatment options. For instance, when treating a patient with low back pain, Channel 1 can be used to deliver TENS treatment for pain relief, while Channel 2 provides muscle stimulation to support functional rehabilitation exercises. Or therapeutic ultrasound can be used as an adjunct pain-relieving modality. 5

Altogether, Intelect Mobile 2 is an excellent option for therapists interested in using electrostimulation for treating not only low back pain, but also a range of other neuromuscular conditions.

References

1 Jauregui JJ, Cherian JJ, Gwam CU, Chughtai M, Mistry JB, Elmallah RK, Harwin SF, Bhave A, Mont MA. A Meta-Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain. Surg Technol Int. 2016 Apr;28:296-302.

2 Durmus D, Akyol Y, Alayli G, Tander B, Zahiroglu Y, Canturk F. Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.

3 Baek SO, Cho HK, Kim SY, Jones R, Cho YW, Ahn SH. Changes in deep lumbar stabilizing muscle thickness by transcutaneous neuromuscular electrical stimulation in patients with low back pain. J Back Musculoskelet Rehabil. 2017;30(1):121-127.

4 Coghlan S, Crowe L, McCarthypersson U, Minogue C, Caulfield B. Neuromuscular electrical stimulation training results in enhanced activation of spinal stabilizing muscles during spinal loading and improvements in pain ratings. Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:7622-5.

5 Goren A, Yildiz N, Topuz O, Findikoglu G, Ardic F. Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial. Clin Rehabil. 2010 Jul;24(7):623-31.