A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

Esra Giray; Nezih Onur Ermerak; Yeliz Bahar-Ozdemir; Melihat Kalkandelen; Mustafa Yuksel; Osman Hakan Gunduz; Gulseren Akyuz

doi:10.1055/s-0040-1701699

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2021; 31(02): 147-156
DOI: 10.1055/s-0040-1701699

Original Article

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

Esra Giray

¹Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

,

Nezih Onur Ermerak

²Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey

,

Yeliz Bahar-Ozdemir

¹Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

,

Melihat Kalkandelen

¹Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

,

Mustafa Yuksel

²Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey

,

Osman Hakan Gunduz

¹Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

,

Gulseren Akyuz

¹Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

› Author Affiliations

Abstract

Introduction Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC.

Materials and Methods Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23 hours, compression orthosis 8 hours, and control group. All groups received exercises for 1 hour a day for 3 weeks. Additionally, compression orthosis 23 hours group wore the orthosis for 23 hours a day, while compression orthosis 8 hours group wore the orthosis for 8 hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety.

Results The compression orthosis 23 hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups.

Conclusion Compression orthosis use for 23 hours can be recommended rather than its use for 8 hours because 23 hours of orthosis use has better correction and similar adverse effects.

Keywords

exercise - physical therapy - pectus carinatum - compression orthosis - rehabilitation

Full Text

References

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Supplementary Material

Supplementary Material