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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 -
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 -
Journal of Ayub Medical College,... 2017Lateral Epicondylitis (LE), is a condition characterized by the pain and tenderness over the lateral epicondyle of the humerus. LE is commonly seen among people who are... (Review)
Review
BACKGROUND
Lateral Epicondylitis (LE), is a condition characterized by the pain and tenderness over the lateral epicondyle of the humerus. LE is commonly seen among people who are involved in sports such as tennis and golf. Any activity that repeatedly overstrains the extensor carpi radialis brevis tendon can lead to LE. The management of lateral epicondylitis generally involves the use of counterforce orthosis. The aim of this review is to summarize the evidence regarding the effectiveness of counterforce orthoses on the clinical outcomes of patients with lateral epicondylitis.
METHODS
The PubMed, Ovid, and ProQuest databases were searched for potential studies which explored the use of counterforce orthosis in the management of lateral epicondylitis.
RESULTS
To have a better understanding of the effectiveness of various types of orthoses, the review is organized into four sections. The first section explores the use of a single orthotic device, the second section focuses on the combined use of orthotic devices, the third section explore studies that compared the effect of local steroid injection along with orthosis and the last section narrate the studies that compared various types of orthotic devices. The studies support the use of orthotic devices as a treatment modality for lateral epicondylitis. There is rising evidence which supports the use of a comprehensive approach, (by combining routine physiotherapy with orthotic devices) in the management of LE.
CONCLUSIONS
Orthosis alone or in combination with routine physical therapy can be considered as an evidence-based treatment strategy for patients with lateral epicondylitis. However, on the basis of the literature review conducted, the authors recommend that further high-quality clinical trials regarding the management of lateral epicondylitis are necessary to strengthen the evidence-based physiotherapy practice.
Topics: Disease Management; Humans; Orthotic Devices; Physical Therapy Modalities; Tennis Elbow
PubMed: 28718259
DOI: No ID Found -
Ugeskrift For Laeger Sep 2017The use of knee braces is common, and there is an abundance of different brace types available both "over the counter" and as "prescription devices". The braces are used... (Review)
Review
The use of knee braces is common, and there is an abundance of different brace types available both "over the counter" and as "prescription devices". The braces are used for a range of knee problems ranging from minor knee discomfort to post-surgical rehabilitation. The available evidence is generally in favour of brace applications although the amount and quality of evidence is moderate to low with a positive benefit-harm balance. However, braces should generally not be used as a stand-alone or primary treatment strategy, but can be used as a potentially beneficial supplement to patients with knee disorders if needed.
Topics: Bandages; Braces; Humans; Knee Injuries; Knee Joint; Orthotic Devices; Osteoarthritis, Knee; Patellofemoral Pain Syndrome
PubMed: 28918790
DOI: No ID Found -
Deutsches Arzteblatt International Nov 2013Orthoses are external aids that are often used to treat pain and diseases affecting the spine, such as lumbago, whiplash, and disc herniation. In this review, we assess... (Review)
Review
BACKGROUND
Orthoses are external aids that are often used to treat pain and diseases affecting the spine, such as lumbago, whiplash, and disc herniation. In this review, we assess the effectiveness and complications of orthotic treatment for typical spinal conditions and after spinal surgery. The orthotic treatment of fractures and postural abnormalities are beyond the scope of this article.
METHOD
This review is based on a selective search in the Medline database with consideration of controlled trials, systematic reviews, and the recommendations of the relevant medical societies.
RESULTS
Three relevant systematic reviews and four controlled trials were found. Very few controlled trials to date have studied the efficacy of orthotic treatment compared to other conservative treatments and surgery. No definitive evidence was found to support the use of orthoses after surgery, in lumbar radiculopathy, or after whiplash injuries of the cervical spine. In a single trial, short-term immobilization was an effective treatment of cervical radiculopathy. Orthoses are not recommended for nonspecific low back pain. The potential complications of cervical orthoses include pressure-related skin injuries and dysphagia.
CONCLUSION
No definitive evidence as yet supports the use of orthoses after spinal interventions or in painful conditions of the cervical or lumbar spine. They should, therefore, be used only after individual consideration of the indications in each case.
Topics: Acute Disease; Cervical Vertebrae; Humans; Low Back Pain; Lumbar Vertebrae; Neck Pain; Orthotic Devices; Prosthesis Design; Treatment Outcome; Whiplash Injuries
PubMed: 24280429
DOI: 10.3238/arztebl.2013.0737 -
The Cochrane Database of Systematic... 2001Lateral epicondylitis (tennis elbow) is a frequently reported condition. A wide variety of treatment strategies has been described. As of yet, no optimal strategy has... (Review)
Review
BACKGROUND
Lateral epicondylitis (tennis elbow) is a frequently reported condition. A wide variety of treatment strategies has been described. As of yet, no optimal strategy has been identified.
OBJECTIVES
The objective of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow.
SEARCH STRATEGY
An electronic database search was conducted using Medline, Embase, Cinahl, the Cochrane Controlled Trial Register, Current Contents and reference lists from all retrieved articles. Experts on the subjects were approached for additional trials.
SELECTION CRITERIA
All randomised clinical trials (RCT) describing individuals with diagnosed lateral epicondylitis and comparing the use of an orthotic device as a treatment strategy were evaluated for inclusion.
DATA COLLECTION AND ANALYSIS
Two reviewers independently assessed the validity of the included trials and extracted data on relevant outcome measures. Dichotomous outcomes were expressed as Relative Risks (RRs) and continuous outcomes as Standardised Mean Differences (SMD), both with corresponding 95% confidence intervals (95% CI). Statistical pooling and subgroup analyses were intended
MAIN RESULTS
Five small-size RCTs (N per group 7-49) were included. Validity score ranged from 3-9 positive items out of 11. Subgroup analyses were not performed due to the small number of trials. The limited number of included trials present few outcome measures and limited long-term results. Pooling was not possible due to large heterogeneity amongst trials.
REVIEWER'S CONCLUSIONS
No definitive conclusions can be drawn concerning effectiveness of orthotic devices for lateral epicondylitis. More well-designed and well-conducted RCTs of sufficient power are warranted.
Topics: Humans; Orthotic Devices; Randomized Controlled Trials as Topic; Tennis Elbow
PubMed: 11406011
DOI: 10.1002/14651858.CD001821 -
Journal of Neuroengineering and... Dec 2018Movement Disorders (MD) are a class of disease that impair the daily activities of patients, conditioning their sensorimotor, cognitive and behavioural capabilities.... (Review)
Review
BACKGROUND
Movement Disorders (MD) are a class of disease that impair the daily activities of patients, conditioning their sensorimotor, cognitive and behavioural capabilities. Nowadays, the general management of patients with MD is based on rehabilitation, pharmacological treatments, surgery, and traditional splints. Although some attempts have been made to devise specific orthoses for the rehabilitation of patients affected by MD, especially the younger ones, those devices have received limited attention.
MAIN BODY
This paper will principally discuss the case of upper limb rehabilitation in Childhood Dyskinesia (CD), a complex motor disease that affects paediatric patients. Through a critical review of the present solutions and a discussion about the neurophysiological characteristics of the disease, the study will lead to the formulation of desirable features of a possible new upper-limb orthosis.
CONCLUSIONS
Design principles will be derived to provide specialised orthoses for the dynamic control of posture and the stabilisation of voluntary movements: those include using biomechanical actions and enhanced proprioception to support the sensorimotor rehabilitation of the children affected by CD. A similar approach could be advantageously applied in other MD-related conditions, especially with hyperkinetic and/or hypertonic traits.
Topics: Child; Female; Humans; Male; Movement Disorders; Orthotic Devices; Upper Extremity
PubMed: 30547807
DOI: 10.1186/s12984-018-0466-8 -
The Cochrane Database of Systematic... Jul 2009Post-stroke motor impairments cause difficulty controlling the joints of the affected limbs to produce useful movements. One way to manage this to use an orthosis to... (Review)
Review
BACKGROUND
Post-stroke motor impairments cause difficulty controlling the joints of the affected limbs to produce useful movements. One way to manage this to use an orthosis to control the movement of the affected joints but evidence for their benefit is lacking.
OBJECTIVES
To determine the effectiveness of upper or lower limb orthoses on activity and impairment in people with stroke and other non-progressive brain lesions.
SEARCH STRATEGY
In February 2007 we searched the trials registers of the Cochrane Stroke, Movement Disorders and Injuries Groups, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2007), MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1983), AMED (from 1985), PsycINFO (from 1967) and RECAL (from 1990), and other databases and trials registers. We screened reference lists, contacted lead authors and other researchers in the field.
SELECTION CRITERIA
We included randomised controlled trials of orthoses applied to the upper or lower limb in people with stroke and other non-progressive brain lesions.
DATA COLLECTION AND ANALYSIS
Two review authors independently identified trials, extracted data, and assessed trial quality. Results for continuous outcomes were combined and analysed using mean difference or standardised mean difference, both with 95% confidence intervals and fixed-effect model.
MAIN RESULTS
We analysed 14 trials with 429 participants. The overall effect of lower limb orthoses on walking disability (speed), walking impairment (step/stride length) and balance impairment (weight distribution in standing) was significant and beneficial. There was no significant effect on postural sway (balance impairment) or mobility disability but the numbers of studies and participants were low. However, these were all cross-over trials that looked at the immediate effect while wearing the orthosis; they did not assess the effects of wearing an orthosis over the long term. Upper limb orthoses showed no effect on upper limb function, range of movement at the wrist, fingers or thumb, nor pain. However, this was based on only three trials.
AUTHORS' CONCLUSIONS
A lower limb orthosis can improve walking and balance but the included studies have only examined the immediate effects while wearing the orthosis; the effects of long-term use have not been investigated. An upper limb orthosis does not effect on upper limb function, range of movement at the wrist, fingers or thumb, nor pain, but this conclusion is based on only three trials.
Topics: Arm; Brain Diseases; Humans; Leg; Orthotic Devices; Randomized Controlled Trials as Topic; Stroke Rehabilitation; Walking
PubMed: 19588345
DOI: 10.1002/14651858.CD003694.pub3 -
Annals of Physical and Rehabilitation... Apr 2017Orthoses for osteoarthritis represent splints, taping, sleeves, unloading knee braces and insoles. This review of the effectiveness of these orthoses involved a search... (Review)
Review
Orthoses for osteoarthritis represent splints, taping, sleeves, unloading knee braces and insoles. This review of the effectiveness of these orthoses involved a search for articles published up to 2015 in MEDLINE via PubMed, with a focus on Osteoarthritis Research Society International, American College of Rheumatology and European League Against Rheumatology international recommendations. Evidence for splinting effectiveness in patients with thumb-base osteoarthritis is now provided. Splints for thumb-base osteoarthritis decrease pain and functional disability. Weaker evidence was found for knee bracing, including taping, sleeves and unloading braces. Low rate of observance and safety results should be considered before using current unloading knee braces for knee osteoarthritis. For insoles, data remain controversial. Orthoses for interphalangeal or hip osteoarthritis have not been investigated in a randomized trial. Regardless, if indicated in daily clinical practice, bracing must be checked by a healthcare professional to insure the suitability of the device. Patients using bracing must be educated. Patient education should include knowledge of the aims and modalities of the treatment as well as knowledge of potential side effects. Patients should be encouraged to contact the therapist if adjustment is needed, with poor tolerance or with questions about the device.
Topics: Foot; Hand; Hip; Humans; Knee; Orthotic Devices; Osteoarthritis
PubMed: 27939833
DOI: 10.1016/j.rehab.2016.10.005 -
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