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Journal of Neurology, Neurosurgery, and... Apr 2024Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and...
BACKGROUND
Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty.
METHODS
We administered to Italian CMT Registry patients an online ad hoc questionnaire investigating use, complications and perceived benefit/tolerability/emotional distress of shoe inserts, orthopaedic shoes, AFOs and other orthoses/aids. Patients were also asked to fill in the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire, rating satisfaction with currently used AFO and related services.
RESULTS
We analysed answers from 266 CMT patients. Seventy per cent of subjects were prescribed lower limb orthoses, but 19% did not used them. Overall, 39% of subjects wore shoe inserts, 18% orthopaedic shoes and 23% AFOs. Frequency of abandonment was high: 24% for shoe inserts, 28% for orthopaedic shoes and 31% for AFOs. Complications were reported by 59% of patients and were more frequently related to AFOs (69%). AFO users experienced greater emotional distress and reduced tolerability as compared with shoe inserts (p<0.001) and orthopaedic shoes (p=0.003 and p=0.045, respectively). Disease severity, degree of foot weakness, customisation and timing for customisation were determinant factors in AFOs' tolerability. Quality of professional and follow-up services were perceived issues.
CONCLUSIONS
The majority of CMT patients is prescribed shoe inserts, orthopaedic shoes and/or AFOs. Although perceived benefits and tolerability are rather good, there is a high rate of complications, potentially inappropriate prescriptions and considerable emotional distress, which reduce the use of AFOs. A rational, patient-oriented and multidisciplinary approach to orthoses prescription must be encouraged.
Topics: Humans; Charcot-Marie-Tooth Disease; Orthotic Devices; Lower Extremity; Shoes; Patient Acuity
PubMed: 37918904
DOI: 10.1136/jnnp-2023-332422 -
Archives of Physical Medicine and... Apr 2023To systematically review perceptions from adults, children, and caregivers in scientific and open sources to determine how well lower extremity orthotic devices (LEODs)... (Review)
Review
OBJECTIVE
To systematically review perceptions from adults, children, and caregivers in scientific and open sources to determine how well lower extremity orthotic devices (LEODs) meet users' functional, expressive, aesthetic, and accessibility (FEA2) needs.
DATA SOURCES
Scientific source searches were conducted in the National Library of Medicine (PubMed/MEDLINE) and Web of Science; open source searches were conducted in Google Search Engine in April 2020.
STUDY SELECTION
Inclusion criteria were reporting of users' perceptions about a LEOD, experimental or observational study design, including qualitative studies, and full text in English. Studies were excluded if the device only provided compression or perception data could not be extracted. One hundred seventy three scientific sources of 3440 screened were included (total of 1108 perceptions); 36 open sources of 150 screened were included (total of 508 perceptions).
DATA EXTRACTION
Users' perceptions were independently coded by 2 trained, reliable coders.
DATA SYNTHESIS
Across both source types, there were more perceptions about functional needs, and perceptions were more likely to be positive related to functional than expressive, aesthetic, or accessibility needs. Perceptions about expression, aesthetics, and accessibility were more frequently reported and more negative in open vs scientific sources. Users' perceptions varied depending on users' diagnosis and device type.
CONCLUSIONS
There is significant room for improvement in how LEODs meet users' FEA2 needs, even in the area of function, which is often the primary focus when designing rehabilitation devices. Satisfaction with LEODs may be improved by addressing users' unmet needs. Individuals often choose not to use prescribed LEODs even when LEODs improve their function. This systematic review identifies needs for LEODs that are most important to users and highlights how well existing LEODs address those needs. Attention to these needs in the design, prescription, and implementation of LEODs may increase device utilization.
Topics: Adult; Child; Humans; Qualitative Research; Lower Extremity; Orthotic Devices; Observational Studies as Topic
PubMed: 36395874
DOI: 10.1016/j.apmr.2022.10.010 -
Ugeskrift For Laeger Oct 2022Congenital talipes equinovarus or clubfoot is a common birth defect which affects the foot and ankle. In most cases, the underlying cause is unknown. The Ponseti method... (Review)
Review
Congenital talipes equinovarus or clubfoot is a common birth defect which affects the foot and ankle. In most cases, the underlying cause is unknown. The Ponseti method has become the gold standard of treatment for clubfoot. It is a non-invasive technique using series of plaster casts and orthoses. Complementary Achilles tenotomy is usually necessary. However, surgery is generally salvaged for more severe, rigid cases of clubfoot, including syndromic clubfeet arisen in neurological and neuromuscular disorders, which is summarized in this review.
Topics: Achilles Tendon; Casts, Surgical; Child; Clubfoot; Humans; Infant; Orthotic Devices; Tenotomy; Treatment Outcome
PubMed: 36205151
DOI: No ID Found -
Journal of Manipulative and... Feb 2022The aim of this scoping review was to identify information on compliance with wearing orthoses and other supportive devices, to discuss the barriers to adherence, and to... (Review)
Review
OBJECTIVE
The aim of this scoping review was to identify information on compliance with wearing orthoses and other supportive devices, to discuss the barriers to adherence, and to suggest strategies for improvement based on these findings.
METHODS
Online databases of PubMed, Web of Science, and the Cochrane Library were searched for articles about patients' compliance with regard to lower limb assistive devices. In addition, a methodological quality control process was conducted. Studies were included if in the English language and related to compliance and adherence to the lower limb assistive device. Exclusion was based on first reading the abstract and then the full manuscript confirming content was not related to orthotic devices and compliance.
RESULTS
Twelve studies were included. The data revealed between 6% and 80% of patients were not using a prescribed device. Barriers to the use of the orthotic device included medical, functional, device properties and lack of proper fit. Strategies for improved compliance included better communication between patient and clinician, patient education, and improved comfort and device esthetics.
CONCLUSIONS
Individualized orthotic adjustments, rehabilitation, and patient education were promising for increasing adherence. Despite positive aspects of improvements in gait, balance in elderly, and a sense of security produced by using assistive devices, compliance remains less than ideal due to barriers. As compliance in recent studies has not improved, continued work in this area is essential to realize the benefits of technological advances in orthotic and assistive devices.
Topics: Aged; Humans; Lower Extremity; Orthotic Devices; Patient Compliance; Self-Help Devices
PubMed: 35753880
DOI: 10.1016/j.jmpt.2022.04.003 -
Foot and Ankle Clinics Sep 2022Conservative treatment of Charcot neuro-osteoarthropathy (CN) aims to retain a stable, plantigrade, and ulcer-free foot, or to prevent progression of an already existing... (Review)
Review
Conservative treatment of Charcot neuro-osteoarthropathy (CN) aims to retain a stable, plantigrade, and ulcer-free foot, or to prevent progression of an already existing deformity. CN is treated with offloading in a total contact cast as long as CN activity is present. Transition to inactive CN is monitored by the resolution of clinical activity signs and by resolution of bony edema in MRI. Fitting of orthopedic depth insoles, orthopedic shoes, or ankle-foot orthosis should follow immediately after offloading has ended to prevent CN reactivation or ulcer development.
Topics: Arthropathy, Neurogenic; Conservative Treatment; Humans; Magnetic Resonance Imaging; Orthopedics; Orthotic Devices
PubMed: 36096554
DOI: 10.1016/j.fcl.2022.05.002 -
Journal of Prosthodontics : Official... Jul 2022To systematically review studies on various materials and methods used for wear testing of occlusal devices and their antagonists in vitro and in vivo. (Review)
Review
PURPOSE
To systematically review studies on various materials and methods used for wear testing of occlusal devices and their antagonists in vitro and in vivo.
METHODS
An electronic search in OVID, Web of Science, PubMed and Scopus was conducted using the following terms (MeSH words) with any synonyms and closed terms: "Splint*" OR "occlusal splint*" OR "night guard" OR "occlusal device" OR "occlusal devices" OR "deprogrammer" OR "bite splint" OR "bite plane" OR "orthotic appliance*" OR "orthotic devices" AND "wear" OR "two-body wear" OR "three-body wear" OR "tooth wear" OR "wear measurement*" OR "wear behaviour" OR "wear behavior" OR "abrasion" AND "Polymethyl Methacrylate" OR "PMMA" OR "acrylic resin*" OR "dental material*" OR "dental enamel" OR "CAD" OR "CAM" OR "PEEK" OR "material* testing". Database search was limited to English-language publications and published between 2001 and 1st of September 2021. A further hand search was done to ensure all materials were captured.
RESULTS
After the removal of duplicates, 115 studies were identified, and 11 were chosen for review. Studies showed that the lowest volumetric loss was observed in PEEK occlusal device materials, whereas heat-cure, CAD-milled, and 3D printed occlusal device materials had no significant difference in wear. Vacuum-formed materials showed the highest wear among all groups. Testing parameters were found to be inconsistent across all studies.
CONCLUSION
There is a need for standardization of in vitro and in vivo wear measurement and testing protocols as this study revealed a wide variety of testing protocols which potentially could influence the outcome. Polishing procedures are required for the material. Limited studies are available on 3D printed occlusal device materials and would therefore require further investigation, especially on printing build angles and settings. Further clinical studies would be advantageous to provide guidance on the selection of the best occlusal device material that would last the longest without remake.
Topics: Acrylic Resins; Humans; Materials Testing; Occlusal Splints; Polymethyl Methacrylate; Tooth Wear
PubMed: 34516696
DOI: 10.1111/jopr.13432 -
Haemophilia : the Official Journal of... May 2022Haemarthrosis is a clinical feature of haemophilia leading to haemarthropathy. The ankle joint is most commonly affected, resulting in significant pain, disability and a... (Review)
Review
INTRODUCTION
Haemarthrosis is a clinical feature of haemophilia leading to haemarthropathy. The ankle joint is most commonly affected, resulting in significant pain, disability and a reduction in health-related quality of life. Footwear and orthotic devices are effective in other diseases that affect the foot and ankle, such as rheumatoid arthritis, but little is known about their effect in haemophilia.
AIMS
To review the efficacy and effectiveness of footwear and orthotic devices in the management of ankle joint haemarthrosis and haemarthropathy in haemophilia.
METHODS
A systematic literature review was conducted. Two review authors independently screened studies for inclusion and appraised methodological quality using Joanna Briggs Institute Critical Appraisal checklists. A narrative analysis was undertaken.
RESULTS
Ten studies involving 271 male participants were eligible for inclusion. All studies were quasi-experimental; three employed a within-subject design. Two studies included an independent comparison or control group. A range of footwear and orthotic devices were investigated. Limited evidence from non-randomised studies suggested that footwear and orthotic devices improve the number of ankle joint bleeding episodes, gait parameters and patient-reported pain.
CONCLUSION
This review demonstrates a lack of robust evidence regarding the efficacy and effectiveness of footwear and orthotic devices in the management of ankle joint haemarthrosis and haemarthropathy in haemophilia. Methodological heterogeneities and limitations with the study designs, small sample sizes and limited follow-up of participants exist. Future studies utilising randomised designs, larger sample sizes, long-term follow-up and validated patient-reported outcome measures are needed to inform the clinical management of ankle joint haemarthrosis and haemarthropathy.
Topics: Ankle; Ankle Joint; Female; Hemarthrosis; Hemophilia A; Humans; Male; Orthotic Devices; Pain; Quality of Life
PubMed: 35245413
DOI: 10.1111/hae.14521 -
Prosthetics and Orthotics International Dec 2020In the inaugural edition of in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional... (Review)
Review
In the inaugural edition of in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic-orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of in shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.
Topics: Disabled Persons; Humans; Orthotic Devices; Prostheses and Implants; Quality of Life; Self-Help Devices
PubMed: 33164660
DOI: 10.1177/0309364620967780 -
Orthopedic Nursing 2020Nonspecific back pain is a common complaint, especially among older people. Traditionally, nonspecific back pain has been associated with heavy physical activities.... (Review)
Review
Nonspecific back pain is a common complaint, especially among older people. Traditionally, nonspecific back pain has been associated with heavy physical activities. However, static activities such as prolonged sitting and standing are contributing factors to nonspecific lumbar pain as well. Lumbar orthoses, such as belts, have been used for heavy physical activity to alleviate or even prevent back pain; however, studies have been inconclusive as to their effectiveness. Furthermore, the use of lumbar orthosis for prolonged sitting and standing is questionable. This case study and review examines the general effectiveness of lumbar orthosis for a variety of activities, including prolonged standing and sitting. The findings provide implications for orthopaedic nurses in occupational settings.
Topics: Female; Humans; Low Back Pain; Lumbosacral Region; Middle Aged; Orthopedic Nursing; Orthotic Devices; Posture
PubMed: 33234911
DOI: 10.1097/NOR.0000000000000712 -
Clinics in Podiatric Medicine and... Jan 2020The adult acquired flatfoot deformity resulting from posterior tibial tendon dysfunction is the result of rupture of the posterior tibial tendon as well as key ligaments... (Review)
Review
The adult acquired flatfoot deformity resulting from posterior tibial tendon dysfunction is the result of rupture of the posterior tibial tendon as well as key ligaments of the ankle and hindfoot. Kinematic studies have verified certain levels of deformity causing hindfoot eversion, lowering of the medial longitudinal arch and forefoot abduction. The condition is progressive and left untreated will cause significant disability. Bracing with ankle-foot orthoses has shown promising results in arresting progression of deformity and avoiding debilitating surgery. Various types of ankle-foot orthoses have been studied in terms of effects on gait as well as efficacy in treatment.
Topics: Adult; Aged; Flatfoot; Humans; Middle Aged; Orthotic Devices; Posterior Tibial Tendon Dysfunction
PubMed: 31735271
DOI: 10.1016/j.cpm.2019.08.007