FR3079136A1 - ORTHESIS CORRECTRICE POSTURES OF THE CERVICO-THORACO-BRACHIAL REGION - Google Patents

Abstract

The invention provides a corrective orthosis for posture and facilitates movements adapted, not fixing the upper limbs against the body, to allow them freedom of movement, while ensuring a relaxing muscle, relaxing and analgesic effects. This orthosis comprises a horizontal band A surrounding the upper part of the chest in the manner of an adjustable belt, and at least one vertical front strap 3 for carrying a forearm 1 extending over the front of the thorax, from top to bottom from an attachment point 3a on the strip A, said vertical strap 3 having, at its lower end, a support means B for a forearm 1. A variant comprises at least one vertical rear strap which , connecting the horizontal strip 2 to a lower abdominal belt, is adjustable in length and tension can stabilize the orthosis and enhance its role posture correction. The orthosis is worn alone or combined with the tablecloths of a garment.

Description

CORRECTIVE ORTHESIS OF POSTURES OF THE CERVICO-THORACOBRACHIAL REGION

The invention relates to an orthosis correcting postures in the cervico-thoracic-brachial region and facilitating movements adapted to this region.

The region of the human body concerned by the invention is that called cervico-thoraco-brachial including the upper body, that is to say the head, the cervical and dorsal part of the spine, the shoulder blades, the thoraco parade -brachial, and upper limbs, including shoulders, arms and forearms with elbows, wrists and hands.

Currently, the pathologies of this region are managed by exclusively therapeutic devices whose aim is to limit the movements and their amplitudes, by keeping them in fixed positions for an analgesic, healing or consolidation purpose, after a surgery, trauma or medical treatment.

Examples of the best known products are cervical or flexible neck braces, semi-rigid or rigid, and flexible or rigid shoulder, collarbone, elbow, wrist, hand, etc.

For other therapeutic indications, there are also splints, aligners, plasters, ...

These devices do not allow a normal or close to normal working life, and, above all, do not integrate the impact of neighboring pathologies and more particularly the tensioning or compression of the brachial plexus responsible for disabling symptoms.

The object of the invention is therefore to provide a device for correcting postures and facilitating adapted movements, neither fixing nor pressing the upper limbs against the body, in order to leave them a freedom of "adapted movements", proper to normal living conditions. The object of the invention avoids excessive and deleterious use of the brachial plexus, while ensuring muscle relaxation, with relaxing and analgesic effects.

Starting from this state of the art and in order to arrive at the orthosis according to the invention, the inventors-depositors combined their knowledge of physiotherapy, biomechanics, vascular medicine, physical medicine and rehabilitation to analyze the stresses and deleterious effects. brachial plexus syndrome (without dynamic compression) and its impact on neighboring structures.

This has been acquired by long medical and physiotherapy practice, by continuous clinical studies and by the use of modern medical imaging (static and dynamic color ultrasound Doppler, MRI, CT).

These scientific works made it possible to study in a precise way and to propose a specific medical care of a hitherto little-known but very frequent syndrome, namely brachial plexus syndrome without dynamic compression, (perceived with the arm carried forward and in elevation). This syndrome, whose effects are comparable to "sciatica of the upper limb", is distinguished from the thoraco-brachial parade syndrome with dynamic neurovascular compression, (perceived with the arm carried on the side, in elevation and behind) , which is the best known and easiest to diagnose today.

Brachial plexus syndrome without dynamic compression is the most resistant to all medical, surgical and physiotherapy treatments. It is often expressed minimally and at a distance from acute pathological episodes. It is very often related to a lack of knowledge of biomechanics and to poor active and passive use of the muscles and joints of the anatomical region.

The work undertaken has made it possible to offer comprehensive care for this region of the “upper body”, similar to that recognized and referenced for the care of the lumbar spine (lower body) with:

The development of specific clinical signs and maneuvers to assess the good or bad functioning of this “upper body” region.

The development of a specific diagnosis by color Doppler echo,

The development of a specific rehabilitation differentiating brachial plexus syndrome (without dynamic compression) from thoracobrachial parade syndrome (with dynamic neurovascular compression).

The development of corrective devices providing proprioceptive correction and postures and a specific therapeutic and preventive postural education adapted to people during the treatment phase, then during the consolidation phase, then in the recurrence prevention phase.

This work resulted in the device according to the invention which is a corrective orthosis for postures in the cervical region, the shoulder girdle and the upper limbs and facilitates in this region movements adapted from a biomechanical and functional point of view.

This orthosis includes:

• a band A horizontally surrounding the upper part of the thorax in the manner of a horizontal thoracic belt, this thoracic band having at its ends detachable connecting means, • and, at least one vertical anterior strap for carrying a front arm, said strap extending on the front of the thorax, going from top to bottom from a point of attachment, permanent or removable, on the horizontal thoracic band A, said vertical anterior strap being of non or inelastic material and comprising, at its lower end, means B able to support a forearm, said means B being associated with means for adjusting their vertical position.

Thus, when the orthosis is worn by the person, the horizontal thoracic band rests on the back and the shoulders, but without exerting excessive tension on them, so as not to produce a forced anterior projection of the shoulders or an excessive rolling up, can be the cause of muscle contractures.

The vertical front strap (s) hang down on the front face of the person's body and, on the one hand, transfer the weight of the forearms carried by the support means to the horizontal thoracic band and, on the other hand, the pulling forces forearms up to ensure optimal muscle relaxation of the entire shoulder girdle, shoulders and cervical spine.

Thanks to this arrangement, each forearm is independent of its neighbor and is free, within the limit of the pendulum movement tolerated by the strap which carries it. It is therefore no longer constrained and allows you to perform the usual movements of everyday life.

The support of the forearms, modulated by the possibility of adjusting their vertical positions, makes it possible to position the forearm, the wrist and the hand in height in adapted postures in order to obtain a muscular relaxation of the whole the shoulder girdle, shoulders and cervical spine.

This relaxation is maximum in the highest position, for the rest and recovery phases.

In the movement phase, the vertical adjustment puts the forearms in the lower position and ensures partial relaxation, providing freedom of action for these forearms and arms, while minimizing the mechanical and biomechanical stresses of the various osteo-articular structures, muscles and brachial plexus.

According to the embodiments, the support means of a forearm is constituted by a sleeve in the form of a sheath or by a sling pocket.

In a conventional embodiment, the point of attachment of each vertical strap to the horizontal thoracic band is located on the front part thereof, in the upper third of the thorax and substantially at the level of the collarbone and its length adjustment means are arranged substantially mid-length of the strap so that the adjustment strand can be grasped by the hand carried by the opposite strap.

This allows, by pulling the strap adjustment strand, to position the forearm, wrist and hand upwards and thus obtain optimal relaxation of the entire shoulder girdle, shoulders and cervical spine .

This adjustment gives the vertical anterior straps the possibility of performing pendulum movements allowing controlled movements of the arms and forearms and obtaining a gesture adapted to everyday life.

In another embodiment and to reinforce the posterior postural correction of the entire back, the orthosis comprises at least one rear reinforcing strap, vertical and extending downward from the vertical thoracic band to its adjustable fixation on a lower abdominal belt.

In an embodiment offering even better postural correction, the orthosis comprises two crossing rear straps whose free ends, passing under the arms to come to the front, are detachably fixed on the front or lateral part of the belt. lower abdominal by means allowing the regulation of their tension.

Due to their structure, the components of the orthosis form an independent structure which can be passed alone over the upper part of the human body, but in a particular application, these components are integrated into the textile layers of a garment opening onto the front, a garment whose layers are reinforced by a lower abdominal belt linked to these layers.

Advantageously, the chest belt is linked to the textile layers of the garment, and carries, on its front part and laterally, the ends of the two front straps for carrying the forearms, said straps being at least partially linked to the sheets to remain free of movement, these carrying means arranged inside the garment being accessible from the outside by vertical slots formed in each of the side panels of the garment.

Whether the orthosis is worn alone or integrated into a garment, such as a vest, jacket, cape or poncho, it performs its corrective function for posture of the cervico-thoraco-brachial region, while facilitating movement of the arms and forearms , adapted to the needs of normal life, generating relaxing and analgesic effects.

Other characteristics and advantages will emerge from the description which follows with reference to the appended schematic drawings representing several embodiments of the orthosis according to the invention, drawings in which:

Figure 1 is a perspective view of an embodiment of the orthosis with the horizontal chest band, the vertical anterior straps and a support means for each forearm consisting of a sling pocket;

Figure 2 is a perspective view of another embodiment of the orthosis whose means of carrying the forearms are constituted by sleeves, this orthosis worn by a person being being adjusted by the left hand pulling on the extreme end of the left vertical strap by means of the right hand, to bring the right forearm into the high position and maximum relaxation;

Figure 3 is a partial view, in section and on an enlarged scale, of an embodiment of the carrying means of a forearm;

Figures 4 to 7 are back views of a person equipped with various embodiments of the orthosis;

Figure 8 is a partial front elevational view showing, on an enlarged scale, an embodiment of the locking means of the rear straps shown in Figures 7 to 11;

Figure 9 is a perspective view of another embodiment of the orthosis providing very good results;

Figure 10 is a perspective view of the orthosis of Figure 9 when it is passed over a person, and adjusted;

Figure 11 is a perspective view of a garment incorporating the orthosis, of Figures 7 to 10, said garment having the front panels folded laterally, not having passed over the person and the orthosis not yet attached on the person's body;

Figure 12 is a perspective front view of a variant of the embodiment of Figure 1;

Figure 13 is a front perspective view of a variant of the embodiment of Figures 7 to 10 with crossing back straps;

Figure 14 is a plan view from above of another embodiment of the orthosis made in a textile band;

Figure 15 is a front view of the orthosis when the flaps of the textile strip of Figure 14 are folded into the position of use.

The orthosis is generally composed of a horizontal thoracic band A, anterior straps 3, and support means B which can each ensure the carrying of a forearm.

In the embodiment shown in Figures 1 and 2, the strip A is formed by a belt 2 provided with means 5 for adjusting its length, while the straps 3, two in number, are vertical or inclined, and s extending from top to bottom from their upper ends fixed on the horizontal thoracic band A, to their lower end, carrying the support B.

In this embodiment, the belt 2 and the straps 3 are made of non-extensible material, such as textile, leather or any other similar material. To ensure the adjustment of the vertical level of the supports B, the straps include means 6 for adjusting the length and tension.

The attachment of each of the ends of the straps 3 to the strip A is positioned on the front part of the latter and substantially at the upper third of the thorax and at the level of the collarbone. It is provided by seams 7, but these can be replaced by any other equivalent means ensuring a permanent or removable connection, such as rivets, press studs, buttons and buttonholes, and other form of self-fastening of the velvet type. loops and hooks, cohesive tape or any other form.

By the removable link, the straps are removable and can be detached individually from the band A, for example for a treatment involving only one upper limb.

The adjustment means 5 of the headband and 6 of the straps are known to those skilled in the art and include, for example, loops with ties, pins, pliers, hooks, staples, clasps, rings, turnstiles, snap hooks.

The means 5, positioned on the horizontal chest band A, allow the adjustment of length and tension in a position adapted to the morphology of the person, but also adapted to the needs of correction of the postures and movements of the person in everyday life .

The means 6 for adjusting the length of each strap 3 are disposed on the vertical straps 3 substantially at mid-length thereof, so that the strand 3c leaving the loop 6, arranged on one side, can be grasped by the hand close to the opposite strap, as shown in figure 2, and allows the length adjustment of these straps 3, therefore of the support angle of the forearms, indicated in a in figure 2.

As a result, the length adjustment of each strap 3 modifies the vertical position of the support means B and brings the forearm 1, the wrist and the hand, either in a position higher than the elbow (as shown in FIG. 2) , or in a lower position, adapted to the needs of posture correction, muscle relaxation and obtaining "adapted movements".

The horizontal thoracic band A comprises, at each of its ends, hooking means 8 and 9, such as buckle, bolt or hook, allowing it, when it is in place on the body of the person, to form a continuous belt passing over the top of the shoulder girdle and shoulders to transfer the forces transmitted to it by the vertical anterior straps 3 supporting the load of the arms and forearms.

In FIG. 1, the means B for supporting the forearms 1 are constituted by through pockets 10 of textile nature, worn in a sling, while in FIG. 2, they are constituted by tubular sleeves, each composed of a sheath 12, for example made of elastically compressible foam, and a textile pocket in a scarf 13, linked to the corresponding strap 3, as shown in FIG. 3.

When the orthosis is placed on the person's torso and the forearms 1 are engaged in the sleeves 12, the person adjusts by the means 6 the length of the straps 3, so that the forearms 1 are positioned, by the support means B, with a greater or lesser flexion, namely by bringing these forearms either substantially at the horizontal level of the elbows, or above or below these elbows, depending on the desired posture correction.

It should be noted that in each of these positions, each of the forearms is free in translation in its support B and can therefore be removed from it in case of necessity or emergency.

In this configuration, the adjustment of the orthosis relieves the cervicodorsal column, the shoulder girdle and the two upper limbs which, in everyday life, undergo significant biomechanical stresses. As a result, the maintenance and support of the forearms and arms by means A and B cause the relaxation of certain muscles of the cervical spine and upper limbs, reduce muscle contractures and provide relaxing and analgesic effects.

The orthosis according to the invention is not intended for the treatment of pathologies of the cervico-thoraco-brachial region, but is usable by any person, without acute pathology, exercising a domestic, professional, leisure or sporting activity or in the as part of primary and secondary prevention against Musculoskeletal Disorders (MSD), during periods of rest and recovery.

To reduce the support of the posterior part 2d of the thoracic belt 2 on the back of the person and reduce the stresses resulting therefrom, the embodiment shown in FIG. 4 comprises, above this part 2d, an extension 2f upwards which increases the support surface and reduces the pressure on the neck, as shown by the hatching 15.

In FIG. 5 and for the same purpose, the extension 2f is provided with a notch 2g thanks to which the support is carried out only on the sides of the neck and up to the shoulders, as shown by the hatching 16. This arrangement replaces the three areas of support and pressure on the two shoulders and on the cervical spine with only two areas 16 of support and pressure on the two shoulders, thereby reducing the support and pressure on the area posterior cervical.

FIG. 6 shows another embodiment in which the orthosis is reinforced by at least one, and in this case two vertical posterior straps 20, which extend parallel downwards from the thoracic belt 2, to which their upper ends are fixed, up to an abdominal belt 22. The lower ends of the straps 20 are fixed to the abdominal belt 22, either by sewing stitches 7, or by equivalent means, or by a buckle adjustment system. voltage, not shown. Of course, the abdominal belt 22 is provided with means for adjusting its length, not shown, and means for hooking its ends 28-29, similar to means 5 and 8-9, described for the chest belt 2.

When the orthosis is placed on the person's body, the posterior vertical straps 20 maintain and stabilize the dorsal part of this orthosis, limit the support on the back and contribute to the correction of the postures of the whole. the shoulder girdle, the dorso-lumbar spine and the upper limbs.

Figure 7 shows the back of the embodiment of Figures 9 and 10. This embodiment differs from the previous one by the presence of rear straps 30 which cross in the back. These straps are linked at 33 to the thoracic belt 2 and are linked to each other at their crossing point 31. They have lower free ends 30a intended to pass under the arms going forward towards fastening means 32, arranged on the lateral or anterior part of the abdominal belt 22.

FIG. 8 shows that, in one embodiment, each of the straps 30 is wide in the part by which it bears on the back of the person and has, at its free end 30a, a part of lesser width facilitating its convolutions around the torso and its sliding engagement in the fixing means 32 provided with a tension adjustment. This fixing means 32 makes it possible, by the oblique traction of the straps 30 towards the front, to harmoniously and effectively adjust the posterior parts of these straps towards the lateral and anterior plane and to apply the tension necessary to stabilize and properly hold the entire back structure of the orthosis against the back.

FIG. 9 shows that, when the orthosis has not passed over the person's body, the lap belt 22 is not necessarily linked to the orthosis. On the other hand and as shown in FIG. 10, when the orthosis is passed over the body, the abdominal belt 22 is linked to the thoracic belt A by the crossed straps 30 which extend from their upper dorsal ends to their lower ends and anterior 30a, then pinched in the means 32. During its return towards the front, each end 30a forms a half loop which partially envelops the bottom of the torso until it is fixed to the belt 22.

This arrangement makes it possible to reduce the value of the pressure on the upper back and to obtain the maximum correction of the postures of the entire shoulder girdle, the dorso-lumbar spine and the upper limbs.

The various embodiments which have been described above as independent structures which can be passed as such over a person's body, can also be combined with clothing.

Thus, in FIG. 11, the structure which has just been described with reference to FIGS. 7 to 10, that is to say with horizontal thoracic strip A, with extension 2f and notch 2g, carrying vertical anterior support straps 3 with carrying sleeves 12-13 or pockets 10, rear straps 30 intersecting and having ends 30a cooperating with an abdominal belt 22, is associated with textile plies 40, forming a garment 41, such as an opening jacket on the front, in the middle of the torso.

The textile tablecloths 40 extend vertically across the back and front, up to the lumbar level. In FIG. 11, the front panels 42 and 43 of the jacket 41 are folded laterally around the lines L1 and L2, to reveal the structure of the orthosis placed inside the garment. Their folding conceals slots 44 and 45 formed in the garment to allow the engagement of each forearm in the garment, as shown schematically by the hands in phantom.

In this embodiment, the strip A formed by the horizontal thoracic belt 2 is sewn against the internal faces of the textile sheets 40, like the abdominal belt 22, while the vertical anterior straps 3 with the pockets 10, arranged inside, do not are linked to the belt 2 only by their ends.

It should be noted that the lower abdominal belt 22, linked to the textile plies 40 with the part of the posterior straps 30 going to their crossing point 31, limits the floating of these plies, reinforces them and improves the resistance to the garment.

After having passed over him, the orthosis and the garment, the person adjusts the length of the two belts 2 and 22, joins the ends of each of them, then adjusts the length of the back straps 30 and those of the anterior straps 3. A At this stage, he can close the jacket by folding down his front panels and by binding them, for example by a zipper 46. He can then engage each forearm 1 in the slot 44 or 45 of the garment, then in the sleeve 10 beforehand. positioned vertically.

Such clothing, for city or work, can be made with specific orthosis of comfort and prevention in the form of a coat, jacket, jacket, vest, anorak, parka, cape, cape, sweatshirt, poncho. Whatever their shape, these garments do not immobilize the upper limbs, do not prevent movements and are adapted to a normal or closer to normal life.

FIG. 12 represents an alternative embodiment of the embodiment of FIG. 1, variant according to which each attachment point 3a on the thoracic belt 2 receives two straps 3g and 3h having different lengths so that the support means B, constituted for example 10g and 10h bags, are at different vertical levels. Thus, the position of the forearms 1 is adjusted by the person when he engages his forearms in one or the other of the two pockets. The straps are shown without the adjustment means 6 of FIG. 1, but at least the strap 3g in front with the pocket 10g may include such means.

FIG. 13 represents an alternative embodiment of the embodiment of FIGS. 7 to 10, according to which each of the back straps 30 has an end strand 30a and a part 30b which, passing over the shoulder, is connected to a support means forearm B, by a 3d strap.

The two straps 30 pass over the thoracic belt 2, to which they are not linked. In their dorsal crossing zone, they pass through a guide piece 35 allowing, during an asymmetrical drawing on the extreme strand 30a of one of them to modify the vertical level of a support means B, the imbalance of the felt efforts decreases and generates only reduced efforts on the shoulder girdle.

Moreover, and in a preferred form avoiding the asymmetrical postponement of the forces due to the adjustments, each 3d strap is equipped with a length adjustment means, such as a buckle 6.

Thus, the vertical level of each support means B can be adjusted by the person by increasing or decreasing the length of each 3d strap, without this affecting the strap 30-30b. As a result, the horizontal chest band A, which rests on the back, chest and shoulders, does not exert excessive tension on them and helps correct the person's posture by straightening the shoulder girdle.

The continuity between the posterior and anterior straps provides firm support for the entire vertebral plane, the shoulder girdle and the upper limbs. In particular, this avoids producing a forced anterior projection of the shoulders or excessive winding which can cause harmful muscular contractures.

Figures 14 and 15 relate to an embodiment of the orthosis which provides the same general results by means of a textile strip 50 adapted to be passed like a cape or stole over the person and each of whose ends is provided of a through pocket 51. Each pocket 51 is formed by the right or left end of the textile strip which is folded back on itself and is linked to the strip 50 by a seam 52.

Each end pocket 51 is associated with a complementary through pocket 53 which is composed of a section of textile strip of the same kind, folded back on itself and linked to the main strip 50 by a seam 54. The shape of the pockets and their positions on the main strip 50 are determined so that, when the orthosis is shaped into a cape, as shown in FIG. 15, the bottom 51a of each of the pockets 51 is at a different vertical level, and for example higher, than that of the bottoms 53a of the pockets 53.

In this embodiment, the chest belt of the band A is constituted by the upper edge 50a of the textile band 50, while the support means B of the forearms 1 are constituted by the pockets 51 and 53, including the points of attachment to the chest belt. are constituted by the seams 52 and 54. The level adjustment means of the support means B, have only two degrees of adjustment, corresponding to each of the two pockets 51 53, this choice being made by the person passing the conforming orthosis in cape.

The upper edge of the textile strip 50 is provided with means for connecting the ends of the thoracic belt A, means comprising, for example, a swivel loop 6a and a strap 6b. When the cape is passed over the person it can not only connect its two edges, but also adjust its tightening on the shoulder girdle, so that it is not annoying.

Each of the variants which have just been described with reference to FIGS. 12 to 15, can be combined with a garment opening on the front and each of the front panels of which, referenced 42 and 43 in FIG. 11, then has two slots superimposed, to allow the forearm to pass into the position chosen by the person.

It emerges from the above description that, in all embodiments, the horizontal thoracic band A surrounding the shoulder girdle is comparable to the support beam of a building and ensures, in addition to correcting the vertebral posture and the upper limbs , maintaining and supporting the vertical anterior straps 3 and the posterior straps 30, and of the garment, if these straps 3 and 30 are combined with textile plies 40.

The adjustment of the tension of the horizontal thoracic band A makes it possible to control its action on the cervico-dorsal area and on the shoulders, so that the latter are not subjected to forced projection on the front, nor to excessive winding. , generators, on the one hand, of harmful and unsuitable muscular contractures and, on the other hand, of inappropriate postures.

The vertical anterior straps 3 transmit to the support means B, 10, or 12-13, a vertical force, making it possible to raise the forearms 1 relative to the lowest position, without changing the positioning of the elbow, of the arm and shoulder. This is intended to produce maximum relaxation depending on postures, positions and movements.

Claims (11)

1.) Correct orthosis of postures in the cervico-thoraco-brachial region characterized in that it includes: a strip A horizontally surrounding the upper part of the thorax in the manner of a horizontal thoracic belt (2), this horizontal thoracic strip having at its ends detachable connecting means (8-9), and, at least one vertical anterior strap (3) for carrying a forearm (1) extending over the front of the thorax, going from top to bottom from a fixing point (3a), permanent or removable, on the horizontal thoracic band A , said vertical anterior strap (3) being of inelastic or not very elastic material and comprising, at its lower end, a means B capable of supporting a forearm, said means being associated with means for adjusting its vertical position. 2.) posture correcting orthosis according to claim 1 characterized in that the support means B for a forearm (1) is constituted by a sleeve (12-13) in the form of a sheath or by a pocket (10, 51, 53) worn as a sling. 3.) Posture correcting orthosis according to claims 1 and 2, taken together, characterized in that the point of attachment (3a) of each vertical strap (3) on the horizontal thoracic band A is located on the front part thereof. ci, substantially at the upper third of the thorax and at the collarbone, while the means (6) for adjusting the length of each strap (3) are arranged substantially at mid-length of the strap so as to the means for adjusting a strap (3) can be grasped by the hand close to the opposite strap. 4.) Posture correcting orthosis according to any one of claims 1 to 3, characterized in that it comprises at least one rear reinforcement strap (20 or 30), vertical and extending downward from the thoracic band horizontal A until it is fixed to a lower abdominal belt (22). 5.) Posture correcting orthosis according to all of claims 1, 3 and 4, characterized in that it comprises two posterior straps (30) crossing each other (at 31) and whose free ends (30a), passing under the arms to come on the front, are detachably fixed on the lateral or anterior part of the lower abdominal belt (22) by means (32) allowing the adjustment of their tension. 6.) Posture correcting orthosis according to all of claims 1 and 3 to 5, characterized in that each of the posterior straps (30 or 20) has a part (30b) which, passing over the shoulder and extending in front on the thorax by exceeding the thoracic belt A, without discontinuity or fixation, is connected to the carrying means B by a strap (3d), equipped or not with a means for adjusting its vertical position. 7.) Posture correcting orthosis according to claim 1 and any one of claims 1 to 6, characterized in that the upper thoracic belt A has in its dorsal part (2d) an extension (2f) of support on the top thorax, said extension (2f) having a posterior notch (2g) relieving the cervico-dorsal support and optimizing muscle relaxation. 8.) Posture correcting orthosis according to claim 1 and any one of claims 1 to 7, characterized in that the components of the orthosis are integrated into the textile sheets (40) of a garment (41) opening on the front, a garment whose plies are reinforced by a lower abdominal belt (22) linked to these plies. 9.) Posture correcting orthosis according to claims 1 and 8, taken together, characterized in that the thoracic belt A is integrated into the textile layers (20) of the garment, and carries, on its front part and laterally, the ends of the two front straps (3) for carrying the forearms (1), the said straps being linked only to the plies (40) only partially to remain free to move, while these two straps (3) and their means of carrying B (10 or 1213) are arranged inside the garment and are accessible from the outside by vertical slots (44, 45) formed in each of the side panels (42 and 43) of the garment (41). 10.) Posture correcting orthosis according to claims 1 and 2, taken together, characterized in that, each fixing point (3a) on the chest belt A receives two straps (3) having different lengths so that the support means B which they carry, are at different vertical levels. 11) Corrective posture orthosis according to claim 1, characterized in that the strip A horizontally surrounding the upper part of the thorax comprises a textile strip (50) integrated into a garment, one of the edge (50a) of the strip (50 ), being equipped with means (6a and 6b) for connecting the edges of the strip A, while each of its ends carries two means B for carrying the forearms, constituted by a through pocket (51), formed by the end ( 50a or 50b) of the textile band folded back on itself, and by a complementary through pocket (53), the bottoms (51a and 53a) of these pockets being situated at different vertical levels, when the orthosis is integrated into a clothing.