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Prosthetics and Orthotics International Dec 2022
Topics: Humans; Orthotic Devices; Prostheses and Implants; Artificial Limbs; Prosthesis Implantation
PubMed: 36515899
DOI: 10.1097/PXR.0000000000000203 -
British Journal of Sports Medicine Dec 2023To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis.
DESIGN
Systematic review of randomised controlled trials (RCTs).
DATA SOURCES
AMED, MEDLINE, PEDro, Cochrane, SPORTDiscus, CINAHL, EMBASE and PsycINFO without language or date restrictions up to 3 February 2023.
ELIGIBILITY CRITERIA
RCTs that evaluated the efficacy of any pharmacological and non-pharmacological therapies compared with control (placebo, sham, waiting list or no intervention) on pain intensity and disability in people with plantar fasciitis. Two reviewers independently screened eligible trials, extracted data, assessed the methodological quality of included trials and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Mean differences (MDs) with 95% CIs were reported.
RESULTS
Seventeen different therapies investigated in 28 trials were included in the quantitative analysis. For non-pharmacological therapies, moderate certainty evidence showed short-term effects of customised orthoses on pain intensity when compared with control (MD of -12.0 points (95% CI -17.1 to -7.0) on a 0-100 scale). Low certainty evidence showed short-term effects of taping on pain intensity (-21.3 (95% CI -38.6 to -4.0)). Long-term effects and effects on disability are still uncertain. For pharmacological therapies, low to very low quality evidence from few trials with small samples was inconclusive and supports that high-quality trials are needed.
CONCLUSIONS
Moderate-quality and low-quality evidence demonstrates customised orthoses and taping, respectively, reduce pain intensity in the short term in patients with plantar fasciitis.
PROSPERO REGISTRATION NUMBER
CRD42021224416.
Topics: Humans; Fasciitis, Plantar; Pain Measurement; Orthotic Devices; Quality of Life
PubMed: 37620126
DOI: 10.1136/bjsports-2022-106403 -
Disability and Rehabilitation Sep 2023To explore the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis.
PURPOSE
To explore the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis.
MATERIALS AND METHODS
This mixed-methods, cross-over study utilised qualitative data to investigate acceptability, including perceived effectiveness. Quantitative data included wear times, self-selected walking speed, spatiotemporal gait parameters, and participant-perceived walking ability. Fifteen participants were assessed with and without two pairs of custom-made shorts: one designed as an orthotic and a second looser pair. Each were worn at home for two weeks. Semi-structured interviews were conducted at the first and final appointments. Quantitative data were analysed using Cohen's d; qualitative analysis used a thematic framework. A triangulation protocol integrated qualitative and quantitative data.
RESULTS
Orthotic shorts were acceptable to most users who described improved control, stability, and function. Where shorts were less acceptable, this was due to restriction of hip flexion or appearance. Effect sizes were in the moderate category for participant-perceived walking ability and for those spatiotemporal gait parameters that reflect mediolateral stability. Small effect sizes were seen for walking speed and related spatiotemporal parameters, such as step length.
CONCLUSION
Orthotic shorts are acceptable and potentially efficacious for improving walking, stability, and function in people with multiple sclerosis. Further research and design development are warranted.Implications for rehabilitationOrthotic shorts are a type of fabric orthosis that have not been previously researched but might assist pelvic stability.Orthotic shorts appear to be acceptable to those people with multiple sclerosis who perceive themselves to be unstable around the trunk and hips.Orthotic shorts might improve gait stability and self-perceived walking ability.
Topics: Humans; Multiple Sclerosis; Feasibility Studies; Cross-Over Studies; Gait; Walking; Orthotic Devices
PubMed: 36000829
DOI: 10.1080/09638288.2022.2114018 -
Journal of Back and Musculoskeletal... 2023Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP.
OBJECTIVE
Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP.
METHODS
A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias.
RESULTS
Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P-value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P-value 0.004).
CONCLUSION
Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.
Topics: Humans; Low Back Pain; Braces; Exercise Therapy; Randomized Controlled Trials as Topic
PubMed: 37355884
DOI: 10.3233/BMR-220200 -
The Review of Scientific Instruments Apr 2023Due to the aging of the population or diseases, the number of patients with lower limb disorders has increased, causing social concern. Scholars have designed and... (Review)
Review
Due to the aging of the population or diseases, the number of patients with lower limb disorders has increased, causing social concern. Scholars have designed and developed advanced robotic lower limb orthoses, which can guide patients to perform reasonable rehabilitation training with correct limb postures, enhance their daily life participation and quality of life, and help them recover quickly. In recent years, a large number of new and advanced orthopedic equipment have been developed, which require a systematic summary analysis and comparison. This article reviewed typical newly developed, robotic lower limb orthoses and their use effects, as well as the advanced theories and technologies for their applications, and systematically discussed the problems in the research, design, testing, use, and popularization of robotic lower limb orthoses, and predicted their development direction in the future research and design, to enhance the reliability, convenience, and protection functions of orthotic equipment, make its functions closer to life, and give full play to the initiative of patients in the process of rehabilitation training, and reduce costs. Robotic lower limb orthoses is poised for even greater success and development in the future.
Topics: Humans; Quality of Life; Reproducibility of Results; Robotic Surgical Procedures; Orthotic Devices; Lower Extremity
PubMed: 38081284
DOI: 10.1063/5.0140319 -
Disability and Rehabilitation.... Aug 2021Orthotic management is frequently part of the rehabilitation of various neurological conditions in adults such as stroke, peripheral neuropathies, spinal cord injuries...
AIM
Orthotic management is frequently part of the rehabilitation of various neurological conditions in adults such as stroke, peripheral neuropathies, spinal cord injuries and multiple sclerosis. Despite this, there are limited data available on the implementation of orthotic care in practice. The primary aim of this study is to establish the proportion of inpatients in a mixed neurorehabilitation cohort which receive orthotic assessment and treatment. The secondary aim was to document the overall care pathway.
METHODS
Existing data were reviewed retrospectively. Data gathered included patient demographics such as age, gender and diagnosis, type of orthoses prescribed, number of orthotic treatment sessions required and outcome measures used. The paper was prepared in accordance with the STROBE statement for observational studies.
RESULTS
During a 6 month period, 54 patients were admitted as inpatients. Of these, 25 (46%) were referred to the orthotic service for assessment, with 23 (43%) receiving a lower limb orthosis and 19 (35%) subsequently being discharged using either an ankle-foot orthosis or knee-ankle-foot orthosis. The conditions most commonly seen were stroke (40%), incomplete spinal cord injuries (28%) and peripheral neuropathies (16%). Significant improvements were recorded at discharge using the Functional Independence Measure (FIM) and Functional Assessment Measure (FAM). Various aspects of the orthotic care process are described.
CONCLUSIONS
This study suggests that orthotic treatment is needed with high frequency in a mixed inpatient neurorehabilitation cohort. In terms of service planning, these data support existing the recommendation that neurological rehabilitation centres should have good access to orthotic services.Implications for rehabilitationCustom orthoses such as AFOs and KAFOs are frequently needed by neurological rehabilitation inpatients.Orthoses may facilitate standing and walking at an earlier stage during rehabilitation.Those responsible for neurological rehabilitation services should ensure appropriate access to orthotic services.
Topics: Activities of Daily Living; Humans; Inpatients; Neurological Rehabilitation; Orthotic Devices; Peripheral Nervous System Diseases; Retrospective Studies; Stroke Rehabilitation
PubMed: 31746242
DOI: 10.1080/17483107.2019.1685018 -
Neurology India 2022Prescription of orthoses and assistive devices that facilitate physical function is a major component of the rehabilitation process in spinal cord injury (SCI).
BACKGROUND
Prescription of orthoses and assistive devices that facilitate physical function is a major component of the rehabilitation process in spinal cord injury (SCI).
OBJECTIVE
To evaluate the long-term use of orthoses prescribed during inpatient rehabilitation in people with SCI and investigate the factors related to discarding the device.
MATERIALS AND METHODS
Medical records of 202 SCI patients who were included in an inpatient rehabilitation program of a tertiary research hospital were reviewed retrospectively. Patients' demographic data, neurological level of spinal cord injury functional state and use of assistive devices for ambulation (orthoses, walkers, etc.) at discharge were recorded. At follow-up, study participants were contacted by telephone and queried regarding the frequency and duration of use of orthoses; if the individual had discontinued using the orthoses, the reasons for discarding the device were sought.
RESULTS
The majority of the study participants (62.7%) had been prescribed a knee-ankle-foot orthosis during their inpatient stay. At follow-up, the regular use of orthoses was ongoing in 67.6% of the participants, and nonuse was determined in 32.4%. The most common cited reasons for discarding the device were difficulty in donning and doffing, functional improvement, and mechanical problems of the orthoses.
CONCLUSIONS
A significant number of patients had discarded their orthoses at the long-term follow-up and the main reasons for discarding the devices were orthotic factors. Timely reevaluation of the patient and orthosis modification according to patients' needs is necessary to achieve long-term compliance.
Topics: Humans; Orthotic Devices; Retrospective Studies; Spinal Cord Injuries; Surveys and Questionnaires; Walking
PubMed: 35532629
DOI: 10.4103/0028-3886.344618 -
Prosthetics and Orthotics International Oct 2019Evidence-based recommendations are lacking for prosthetic and orthotic services in low- and lower-middle-income countries.
BACKGROUND
Evidence-based recommendations are lacking for prosthetic and orthotic services in low- and lower-middle-income countries.
OBJECTIVES
The aim of this study was to compare and synthesise findings related to experiences of prosthetic and orthotic service delivery in Tanzania, Malawi, Sierra Leone and Pakistan from the perspective of local professionals.
STUDY DESIGN
This is a qualitative inductive study.
METHODS
A total of 49 associated prosthetists/orthotists and prosthetic/orthotic technicians participated in individual interviews. The second-order concept analysis was applied to the data.
RESULTS
Four common themes emerged: low awareness and prioritisation of prosthetic and orthotic services; difficulty managing specific pathological conditions and problems with materials; limited access to prosthetic and orthotic services; and the need for further education and desire for professional development. A further theme was unique to Sierra Leone: people with disabilities have low social status.
CONCLUSION
Local professionals felt unable to deliver high-quality prosthetic and orthotic services. Prosthetic and orthotic education needs to be adjusted to various countries' regulations to be recognised as allied health professions. Rehabilitation and prosthetic and orthotic service delivery need to be further integrated in low- and lower-middle-income countries' regular health systems to increase effective person-centred rehabilitation and to address governments' low awareness and low prioritisation of prosthetic and orthotic services.
CLINICAL RELEVANCE
The results can inform international guidelines and curriculum development for associate prosthetist/orthotist education to better prepare graduates for the clinical scenario and attempts to improve prosthetic and orthotic service delivery programmes in low- and lower-middle-income countries.
Topics: Adult; Allied Health Personnel; Attitude of Health Personnel; Delivery of Health Care; Female; Health Services Accessibility; Humans; Malawi; Male; Middle Aged; Orthotic Devices; Pakistan; Prostheses and Implants; Qualitative Research; Sierra Leone; Tanzania
PubMed: 31303112
DOI: 10.1177/0309364619863617 -
Research in Veterinary Science Sep 2023Orthoses and socket prostheses are rarely used orthopaedic devices in veterinary medicine. Recently, more pet owners have sought these treatments for pets with...
Orthoses and socket prostheses are rarely used orthopaedic devices in veterinary medicine. Recently, more pet owners have sought these treatments for pets with orthopaedic conditions. However, veterinarians often lack substantial scientific evidence on device outcomes and may expect high costs, the main limiting factor, if human orthopaedic market prices are assumed. This discrepancy creates an imbalance between pet owners' expectations, veterinarians' recommendations, and actual patient benefits. To address economic constraints and enhance knowledge about these devices, this study used 3D technology-namely 3D scanning and printing via fused deposition modelling-to design, modify, and manufacture orthoses and socket prostheses for ten patients, including nine dogs and one calf. An equation was devised and applied to all printed devices to streamline the resizing process for sockets and orthoses. The 3D-printed devices were fitted to the patients, and their adaptation was assessed using three novel scales based on prior scientific literature in the small animal orthopaedic field. The orthoses were well-tolerated, with successful and straightforward adaptation. Although socket prostheses were tolerated, the dogs' adaptation was suboptimal, while the calf demonstrated excellent and immediate adaptation.
Topics: Humans; Animals; Dogs; Prostheses and Implants; Orthotic Devices; Printing, Three-Dimensional; Orthopedics; Seizures; Dog Diseases
PubMed: 37480718
DOI: 10.1016/j.rvsc.2023.104960 -
Sensors (Basel, Switzerland) Nov 20203D digital models of the upper limb anatomy represent the starting point for the design process of bespoke devices, such as orthoses and prostheses, which can be modeled... (Review)
Review
3D digital models of the upper limb anatomy represent the starting point for the design process of bespoke devices, such as orthoses and prostheses, which can be modeled on the actual patient's anatomy by using CAD (Computer Aided Design) tools. The ongoing research on optical scanning methodologies has allowed the development of technologies that allow the surface reconstruction of the upper limb anatomy through procedures characterized by minimum discomfort for the patient. However, the 3D optical scanning of upper limbs is a complex task that requires solving problematic aspects, such as the difficulty of keeping the hand in a stable position and the presence of artefacts due to involuntary movements. Scientific literature, indeed, investigated different approaches in this regard by either integrating commercial devices, to create customized sensor architectures, or by developing innovative 3D acquisition techniques. The present work is aimed at presenting an overview of the state of the art of optical technologies and sensor architectures for the surface acquisition of upper limb anatomies. The review analyzes the working principles at the basis of existing devices and proposes a categorization of the approaches based on handling, pre/post-processing effort, and potentialities in real-time scanning. An in-depth analysis of strengths and weaknesses of the approaches proposed by the research community is also provided to give valuable support in selecting the most appropriate solution for the specific application to be addressed.
Topics: Artifacts; Artificial Limbs; Humans; Imaging, Three-Dimensional; Orthotic Devices; Upper Extremity
PubMed: 33217994
DOI: 10.3390/s20226584