Effects of bracing on lung function in idiopathic juvenile kyphosis

• Published in: Pediatric pulmonology Vol. 35; no. 2; pp. 83 - 86
• Main Authors: Priftis, Kostas N., Hager, John, Vlachou, Maria, Anthracopoulos, Michael B.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.02.2003; Wiley-Liss
• Subjects: Adolescent; Age Factors; arterial oxyhemoglobin saturation; Biological and medical sciences; brace; Braces - adverse effects; Child; Female; forced vital capacity in 1 sec; functional residual capacity; Humans; idiopathic juvenile kyphosis; Investigative techniques of respiratory function; Investigative techniques, diagnostic techniques (general aspects); Kyphosis - blood; Kyphosis - physiopathology; Kyphosis - therapy; Lung - physiopathology; lung function; Lung Volume Measurements; Male; Medical sciences; Oxyhemoglobins - analysis; Respiratory Insufficiency - blood; Respiratory Insufficiency - etiology; Respiratory Insufficiency - physiopathology; Respiratory Mechanics - physiology; Severity of Illness Index; Spirometry; total lung capacity; vital capacity; Human; Blood gas; Kyphosis; Deformation; Orthopedic treatment; forced vital capacity in 1 sec; Diseases of the osteoarticular system; Exploration; brace; Spine disease; functional residual capacity; Orthopedic brace; Lung function; Treatment; vital capacity; total lung capacity; Dorsal spine; idiopathic juvenile kyphosis; arterial oxyhemoglobin saturation; Child
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.10220

Although considerable information is available on the effects of bracing on lung function in kyphoscoliosis, there is a paucity of data on idiopathic juvenile kyphosis (IJK). The present study was designed to investigate the immediate effect of bracing on lung function in children and adolescents with mild‐to‐moderate IJK. Spirometry, measurement of lung volumes, and arterial oxyhemoglobin saturation (SaO2) were performed in 24 patients, 9–17 years of age, who were treated with a corrective brace for mild‐to‐moderate IJK (Cobb angle, 46–75°). Children were studied when braced and unbraced. When children were unbraced, mean percent predicted values (±standard deviation) for total lung capacity (TLC), vital capacity (VC), functional residual capacity (FRC), and forced expiratory volume in 1 sec (FEV1) were 100.0% (±13.0%), 92.7% (±14.2%), 108.2% (±20.4%), and 95.0% (±16.3%), respectively. With the brace on, significant reductions occurred in all lung function measurements: TLC decreased by 9.5% (P < 0.001), VC by 9.3% (P = 0.001), FRC by 14.2% (P = 0.005), and FEV1 by 8.9% (P = 0.009). SaO2 decreased from 96.2% (±1.6%) to 95.2% (±1.4%) (P = 0.027). An inverse relationship was observed between pre‐ and postbracing change in TLC and Cobb angle children (P = 0.021). Our findings indicate that corrective bracing in mild‐to‐moderate IJK results in mild lung restriction and a clinically insignificant drop in SaO2. The effect of bracing on TLC decreases as the severity of kyphosis increases in these patients. Pediatr Pulmonol. 2003; 35:83–86. © 2003 Wiley‐Liss, Inc.