-
Gait & Posture Jan 2022Post-stroke, patients exhibit considerable variations in gait patterns. One of the variations that can be present in post-stroke gait is knee hyperextension in the... (Review)
Review
BACKGROUND
Post-stroke, patients exhibit considerable variations in gait patterns. One of the variations that can be present in post-stroke gait is knee hyperextension in the stance phase.
RESEARCH QUESTION
What is the current evidence for the effectiveness of the treatment of knee hyperextension in post-stroke gait?
METHODS
MEDLINE, EMBASE, PEDro, CINAHL, and the Cochrane library were searched for relevant controlled trials. Two researchers independently extracted the data and assessed the methological quality. A best evidence synthesis was conducted to summarize the results.
RESULTS
Eight controlled trials (5 RCTs, 3 CCTs) were included. Three types of interventions were identified: proprioceptive training, orthotic treatment, and functional electrostimulation (FES). In the included studies, the time since the stroke occurrence varied from the (sub)acute phase to the chronic phase. Only short-term effects were investigated. The adjustment from a form of proprioceptive training to physiotherapy training programs seems to be effective (moderate evidence) for treating knee hyperextension in gait, as applied in the subacute phase post-stroke. Neither evidence for effects on gait speed nor gait symmetry were found as a result of proprioceptive training. Orthoses that cover the knee have some effects (limited evidence) on knee hyperextension and gait speed. No evidence was found for FES.
SIGNIFICANCE
This is the first systematic literature review on the effectiveness of interventions on knee hyperextension in post-stroke gait. We found promising results (moderate evidence) for some "proprioceptive approaches" as an add-on therapy to physiotherapy training programs for treating knee hyperextension during the subacute phase post-stroke, in the short-term. Therefore, initially, clinicians should implement a training program with a proprioceptive approach in order to restore knee control in these patients. Because only studies reporting short-term results were found, more high-quality RCTs and CCTs are needed that also study mid- and long-term effects.
Topics: Gait; Gait Disorders, Neurologic; Humans; Orthotic Devices; Stroke; Stroke Rehabilitation
PubMed: 34695721
DOI: 10.1016/j.gaitpost.2021.08.016 -
Journal of Long-term Effects of Medical... 2022Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disorder of the infant age. Its incidence ranges from 0.06/1000 to 76.1/1000 live births and... (Review)
Review
Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disorder of the infant age. Its incidence ranges from 0.06/1000 to 76.1/1000 live births and is more frequent in female infants. Breech position, family history and firstborn children are the main risk factors for DDH and this disorder is also associated with the presence of other congenital deformities. Anatomically, the acetabulum remains shallow and the femoral head grows in a wrong position. Clinical examination is important and tests such us Barlow and Ortolani give indications only for a part of the spectrum of this entity. Nowadays the sonographic examination is the most accurate option for the diagnosis. Graf classification categorizes the DDH cases in four types, from normal to dislocated hip, by description and measuring specific angles in sonographic examination. The wide usage of ultrasonography has decreased the non-diagnosed or neglected cases; treatment begins immediately in young age and is usually conservative with the usage of devices such as Pavlik harness and hip spica. To enhance the literature, we searched for published studies on DDH, to summarize the pathogenesis and the diagnosis and to discuss the treatment and outcome of the patients with this disorder.
Topics: Acetabulum; Child; Developmental Dysplasia of the Hip; Female; Hip Dislocation, Congenital; Humans; Infant; Orthotic Devices; Retrospective Studies
PubMed: 35993988
DOI: 10.1615/JLongTermEffMedImplants.2022040393 -
Journal of Foot and Ankle Research Nov 2021Flatfoot is characterised by the falling of the medial longitudinal arch, eversion of the hindfoot and abduction of the loaded forefoot. Furthermore, flatfoot leads to a... (Review)
Review
BACKGROUND
Flatfoot is characterised by the falling of the medial longitudinal arch, eversion of the hindfoot and abduction of the loaded forefoot. Furthermore, flatfoot leads to a variety of musculoskeletal symptoms in the lower extremity, such as knee or hip pain. The standard conservative treatment for flatfoot deformity is exercise therapy or treatment with foot orthoses. Foot orthoses are prescribed for various foot complaints. However, the evidence for the provision of foot orthoses is inconsistent. The aim of this systematic review is to synthesize the evidence of foot orthoses for adults with flatfoot.
METHODS
A computerized search was conducted in August 2021, using the databases PubMed, Scopus, Pedro, Cochrane Library, and the Cochrane Central Register of Controlled Trials. Intervention studies of any design investigating the effects of foot orthoses were included, apart from case studies. Two independent reviewers assessed all search results to identify eligible studies and to assess their methodological quality.
RESULTS
A total of 110 studies were identified through the database search. 12 studies met the inclusion criteria and were included in the review. These studies investigated prefabricated and custom-made foot orthoses, evaluating stance and plantar pressure during gait. The sample sizes of the identified studies ranged from 8 to 80. In most of the studies, the methodological quality was low and a lack of information was frequently detected.
CONCLUSION
There is a lack of evidence on the effect of foot orthoses for flatfoot in adults. This review illustrates the importance of conducting randomized controlled trials and the comprehensive development of guidelines for the prescription of foot orthoses. Given the weak evidence available, the common prescription of foot orthoses is somewhat surprising.
Topics: Adult; Flatfoot; Foot; Foot Orthoses; Gait; Humans; Lower Extremity
PubMed: 34844639
DOI: 10.1186/s13047-021-00499-z -
Journal of Sport Rehabilitation Jul 2020Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to...
CONTEXT
Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to relieve the symptoms of plantar fasciitis.
OBJECTIVES
To investigate the effectiveness of mechanical treatment in the management of plantar fasciitis.
EVIDENCE ACQUISITION
The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. A systematic search was performed in PubMed, CINAHL, Embase, and Cochrane up to March 8, 2018. Two independent reviewers screened eligible articles and assessed risk of bias using the Cochrane Collaboration's risk of bias tool.
EVIDENCE SYNTHESIS
A total of 43 articles were included in the study, evaluating 2837 patients. Comparisons were made between no treatment and treatment with insoles, tape, ankle-foot orthoses including night splints and shoes. Tape, ankle-foot orthoses, and shoes were also compared with insoles. Follow-up ranged from 3 to 5 days to 12 months. Cointerventions were present in 26 studies.
CONCLUSIONS
Mechanical treatment can be beneficial in relieving symptoms related to plantar fasciitis. Contoured full-length insoles are more effective in relieving symptoms related to plantar fasciitis than heel cups. Combining night splints or rocker shoes with insoles enhances improvement in pain relief and function compared with rocker shoes, night splints, or insoles alone. Taping is an effective short-term treatment. Future studies should aim to improve methodological quality using blinding, allocation concealment, avoid cointerventions, and use biomechanical measures of treatment effects.
Topics: Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Bandages; Bias; Cohort Studies; Controlled Clinical Trials as Topic; Extracorporeal Shockwave Therapy; Fasciitis, Plantar; Female; Foot Orthoses; Humans; Male; Middle Aged; Orthotic Devices; Shoes; Splints; Treatment Outcome; Young Adult
PubMed: 31629333
DOI: 10.1123/jsr.2019-0036 -
Annals of Palliative Medicine Nov 2020Recently, three-dimensional (3D) printing technology has gradually been applied to the field of orthoses. This narrative review aimed to investigate the effect of 3D... (Review)
Review
Recently, three-dimensional (3D) printing technology has gradually been applied to the field of orthoses. This narrative review aimed to investigate the effect of 3D printed orthoses compared to conventional orthoses (non-3D printed orthoses). We searched MEDLINE for articles published up to July 27, 2020, and the main search phrases for identifying related articles were "3D printed orthosis", "3D printed orthoses", "3D printed braces", "3D printed splints", "3D printing orthosis", "3D printed orthoses", "3D printing braces" and "3D printing splints". We included articles that applied 3D printed orthoses to patients or healthy participants and excluded those not written in English, conference abstracts or presentations, and reviews. A total of 237 papers were identified, and qualifications were evaluated based on the title, abstract, and full text. A total of 22 articles were finally included in the analysis. The 3D printed orthoses showed similar or superior effects on biomechanical parameters and kinematic parameters such as wrist-hand function, wrist spasticity, arch height index, foot plantar pressure, and joint range of motion (ROM). In addition, 3D printed orthoses had high satisfaction and comfort compared to conventional orthoses. We believe that 3D printed orthoses can replace conventional ones, and they are expected to gain more popularity in the future.
Topics: Braces; Humans; Orthotic Devices; Printing, Three-Dimensional
PubMed: 33040564
DOI: 10.21037/apm-20-1185 -
Scandinavian Journal of Trauma,... Aug 2019Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation...
Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard backboard has been considered to be the most appropriate procedure to prevent secondary spinal cord injuries during patient transportation. However, the procedure has been questioned in recent years, due to the lack of high-quality studies supporting its efficacy. A national interdisciplinary task force was therefore established to provide updated clinical guidelines on prehospital procedures for spinal stabilisation of adult trauma patients in Denmark. The guidelines are based on a systematic review of the literature and grading of the evidence, in addition to a standardised consensus process.This process yielded five main recommendations:A strong recommendation against spinal stabilisation of patients with isolated penetrating trauma; a weak recommendation against the prehospital use of a rigid cervical collar and a hard backboard for ABCDE-stable patients; and a weak recommendation for the use of a vacuum mattress for patient transportation. Finally, our group recommends the use of our clinical algorithm to ensure good clinical practice.
Topics: Adult; Algorithms; Denmark; Evidence-Based Emergency Medicine; Humans; Immobilization; Moving and Lifting Patients; Orthotic Devices; Spinal Cord Injuries; Stretchers; Triage; Wounds, Penetrating
PubMed: 31426850
DOI: 10.1186/s13049-019-0655-x -
Practical Neurology Aug 2022Patients with weakness or abnormal posture of their lower leg may benefit greatly from appropriate orthoses. This paper describes the sorts of problems that can be...
Patients with weakness or abnormal posture of their lower leg may benefit greatly from appropriate orthoses. This paper describes the sorts of problems that can be helped in neurological practice and the range of devices commonly used, and also highlights some of the factors influencing selection. With greater understanding of their use, clinicians will feel more confident about referring patients for early orthotic assessment.
Topics: Ankle; Cerebral Palsy; Gait; Humans; Lower Extremity; Orthotic Devices
PubMed: 35332078
DOI: 10.1136/practneurol-2022-003357 -
Journal of Plastic Surgery and Hand... 2023Mallet finger is a commonly encountered condition in daily practice. However, there is currently no consensus on whether surgical intervention or conservative treatment... (Meta-Analysis)
Meta-Analysis Review
Mallet finger is a commonly encountered condition in daily practice. However, there is currently no consensus on whether surgical intervention or conservative treatment with orthosis splint is superior. In this systematic review and meta-analysis, we compare the treatment outcomes between surgery and orthosis for bony and tendinous mallet finger. We searched PubMed, Embase, and the Cochrane Library according to the PRISMA guidelines from inception to January 15, 2021. The primary outcome was distal interphalangeal (DIP) joint extension lag angle, and secondary outcomes were DIP joint flexion and range of motion (ROM) angle. A total of 297 studies were initially identified, of which 13 (ten retrospective non-randomized controlled studies (non-RCTs) and three RCTs) were included in the final analysis. The results of this systematic review and meta-analysis showed that there was no high level of evidence supporting the superiority of surgery over orthosis in the treatment of mallet finger. Based on the available evidence, surgical intervention and conservative treatment with splint may offer similar clinical outcomes in both bony and tendinous mallet finger.
Topics: Humans; Splints; Retrospective Studies; Orthotic Devices; Finger Injuries; Treatment Outcome; Tendon Injuries; Finger Joint; Hand Deformities, Acquired; Range of Motion, Articular
PubMed: 36625383
DOI: 10.1080/2000656X.2022.2164291 -
Expert Review of Medical Devices Jan 2021Foot Drop (FD) is a condition, which is very commonly found in post-stoke patients; however it can also be seen in patients with multiple sclerosis, and cerebral palsy....
INTRODUCTION
Foot Drop (FD) is a condition, which is very commonly found in post-stoke patients; however it can also be seen in patients with multiple sclerosis, and cerebral palsy. It is a sign of neuromuscular damage caused by the weakness of the muscles. There are various approaches of FD's rehabilitation, such as physiotherapy, surgery, and the use of technological devices. Recently, researchers have worked on developing various technologies to enhance assisting and rehabilitation of FD.
AREAS COVERED
This review analyzes different types of technologies available for FD. This include devices that are available commercially or still under research101 studies published between 2015 and 2020 were identified for the review, many were excluded due to various reasons, e.g., were not robot-based devices, did not include FD as one of the targeted diseases, or was insufficient information. 24 studies that met our inclusion criteria were assessed. These studies were further classified into two different categories: robot-based ankle-foot orthosis (RAFO) and Functional Electrical Stimulation (FES) devices.
EXPERT OPINION
Studies included showed that both RAFO and FES showed considerable improvement in the gait cycle of the patients. Future trends are inclining towards integrating FES with other neuro-concepts such as muscle-synergies for further developments.
Topics: Humans; Ankle; Electric Stimulation Therapy; Foot; Orthotic Devices; Peroneal Neuropathies
PubMed: 33249938
DOI: 10.1080/17434440.2021.1857729 -
Prosthetics and Orthotics International Dec 2020In the original edition of , Dr Sidney Fishman identified what he anticipated as foundational educational needs for the emerging field of clinical prosthetics and...
In the original edition of , Dr Sidney Fishman identified what he anticipated as foundational educational needs for the emerging field of clinical prosthetics and orthotics. Within the broader construct of the physical sciences, this included mathematics, physics, chemistry, biomechanics, and material sciences. The clinical application of these disciplines to expanding the collective understanding within the field is described, including the biomechanics of able-bodied and prosthetic gait, the material science of socket construction, the physics of suspension and load distribution, and the engineering of prosthetic components to mimic human biomechanics. Additional applications of the physical sciences to upper limb prosthetics and lower limb orthotics are also described. In contemplating the continued growth and maturation of the field in the years to come, mechatronics and statistics are suggested as future areas where clinical proficiency will be required.
Topics: Artificial Limbs; Biomechanical Phenomena; Forecasting; Gait; Gait Analysis; Humans; Natural Science Disciplines; Orthotic Devices; Prosthesis Design
PubMed: 33158407
DOI: 10.1177/0309364620969994