Spinal braces such as the Soft Boston Orthosis (SBO) help stabilize scolios
is and improve sitting, positioning, and head control in individuals with c
erebral palsy. However, their impact on pulmonary mechanics in this populat
ion has not been studied. We examined the effect of a Soft Boston Orthosis
on the pulmonary mechanics and gas exchange in 12 children and young adults
(5-23 years of age) with severe cerebral palsy. Pulmonary resistance, comp
liance, tidal volume, minute ventilation, work of breathing, oxygen saturat
ion, and end-tidal CO, tension were measured with the subjects seated both
with and without the orthosis and in the supine position without the orthos
is.
There were no significant differences in the measured parameters when compa
ring subjects with and without their orthoses in the sitting or in the supi
ne position. As would be expected in individuals with severe cerebral palsy
, pulmonary resistance was increased (7.33 cm H2O/L/s) and compliance was d
ecreased (0.12 L/cm H2O) compared to reported normal values. Work of breath
ing was greatest in the sitting position without the orthosis (1.2 dynes/cm
), suggesting that the improved positioning achieved with the orthosis may
decrease the work of breathing.
We conclude that the application of a Soft Boston Orthosis does not impact
negatively on pulmonary mechanics and gas exchange in young people with sev
ere cerebral palsy. (C) 1999 Wiley-Liss, Inc.