Effect Of Orthotic Intervention Research Articles

Combined effect of orthotic intervention and conventional exercise training on balance and gait performance in cerebral palsy: a randomized controlled trial

BackgroundThis study aimed to examine the combined effect of orthotic intervention and conventional therapeutic exercise training on balance and gait performance in children with cerebral palsy. This study was a randomized control trial. Forty children with dyskinetic cerebral palsy of both genders with ages ranged from 12 to 16 years were included. Participants in the control and study groups received a conventional therapeutic exercise training program for two 2 h ours per session. The treatment program was conducted three sessions per week, for twelve 12 successive weeks. Children in the study group additionally wore TheraTogs orthotic undergarment with the strapping system. Pediatric Balance Scale score and postural stability indices (overall, anteroposterior , and mediolateral) evaluated by the Biodex Balance System were assessed (in both groups) at baseline and after 12 weeks of treatment. The changes of step length, gait cycle time, cadence, and velocity were also measured by an electronic walkway.ResultsChildren in the study group showed significant improvements in the scores of all the measured variables post-treatment compared to the control group (P < 0.05). The P -values for overall, anteroposterior and mediolateral postural stability indices were 0.011, 0.014, and 0.021, respectively. The P -values for Pediatric Balance Scale score, step length, gait cycle time, cadence, and velocity were 0.001, 0.023, 0.041, 0.011, and 0.013 respectively.ConclusionsConventional therapeutic exercise training combined with orthotic intervention were more effective in improving balance and gait performance in children with dyskinetic cerebral palsy.Trial registrationThe ClinicalTrial.gov PRS (NCT04990193).Registered 4 August 2021 - Retrospectively registered.

Prescribing upper limb orthoses for children with cerebral palsy: a Q methodology study of occupational therapists’ decision making

Purpose: This study identified occupational therapists’ viewpoints that guide their practice of upper limb orthosis prescription for children with cerebral palsy (CP).Methods: A qualitative study utilising Q methodology explored participants’ viewpoints. Thirty-nine occupational therapists (38 females) were purposively recruited to rank statements generated from interviews of experienced clinicians and peer reviewed and published literature. Statements about reasons for orthoses prescription, were ranked according to what guides decision making the most to least. Data from ranked statements were analysed using by-person factor analysis to reveal the different ways statements were grouped. The resultant factors, based on the average arrangement of statements associated with each factor, were interpreted and named as viewpoints.Results: Viewpoints identified: 1. Potential effect of the orthosis (n = 12 sorts); 2. Biomechanical presentation (n = 12 sorts); and 3. Client/therapist relationship (n = 10 sorts). The “Client’s goals” statement was ranked highest across all viewpoints.Conclusions: Viewpoints identified may inform development of clinical guidelines. Further research is required to (i) identify valid and reliable classification and assessment tools to guide decision making; and (ii) establish the mechanism of the effect of orthotic intervention by considering the link between the biomechanical purpose of the orthosis (e.g., mobilise tissue) and aim of intervention (prevent contracture).Implications for rehabilitationQ methodology provided an opportunity to identify viewpoints of occupational therapists that guide their upper extremity orthosis prescription decision making.Consistent with best-practice, clients’ goals were the primary focus of decision making in each viewpoint.It is recommended that clinicians consider the identified viewpoints; 1) the potential effects of the orthosis, 2) the biomechanical presentation of the child, within 3) an established client/therapist relationship when prescribing upper extremity orthoses.Practice guidelines to inform upper limb orthotic intervention may be developed using the identified viewpoints.

The effects of orthotic intervention on nerve conduction and functional outcome in Carpal Tunnel Syndrome: A prospective follow-up study

AimTo evaluate the effects of using night orthosis for 6 weeks in patients with mild to moderate carpal tunnel syndrome (CTS), including a follow up after 3 months using electrophysiological and functional outcome measurements. Study design12 week follow-up prospective study. MethodsTwenty-two patients with a total of 36 hands diagnosed as CTS were included. Subjects were informed about using a night orthosis for 6 weeks and were evaluated at the baseline, 6th and 12th week. ResultsMedian motor distal latency was significantly decreased and median motor compound muscle action potential was significantly increased at the 6th week. Median sensory velocity was significantly increased at the 12th week. No significant difference was found in terms of functional outcome measurements. ConclusionElectrophysiological follow-up findings support the positive effects of using a wrist orthosis on median nerve conduction for CTS patients.

Orthotic intervention in forefoot and rearfoot strike running patterns

Objective. To compare the differential effect of custom orthoses on the lower extremity mechanics of a forefoot and rearfoot strike pattern. Design. Fifteen subjects ran with both a forefoot and a rearfoot strike pattern with and without orthoses. Lower extremity kinematic and kinetic variables were compared between strike pattern and orthotic conditions. Background. Foot orthoses have been shown to be effective in controlling excessive rearfoot motion in rearfoot strikers. The effect of orthotic intervention on rearfoot motion in forefoot strikers has not been previously reported. Methods. Five trials were collected for each condition. Peak rearfoot eversion, eversion excursion, eversion velocity, peak inversion moment, and inversion work were compared between conditions. Kinematic variables in the sagittal plane of the rearfoot and in the frontal and sagittal plane of the knee were also determined. Results. Increased rearfoot excursions and velocities and decreased peak eversion were noted in the forefoot strike pattern compared to the rearfoot strike pattern. Orthotic intervention, however,did not significantly change rearfoot motion in either strike pattern. Reductions in internal rotation and abduction of the knee were noted with orthotic intervention. Conclusions. Foot orthoses do not differentially effect rearfoot motion of a rearfoot strike and a forefoot strike running pattern. Orthotic intervention has a larger and more systematic effect on rearfoot kinetics compared to rearfoot kinematics. Relevance Due to the similarity in response to orthotic intervention, foot strike pattern should not be a factor when prescribing a foot orthoses for controlling rearfoot motion.

Characteristics of Gait in Hemiplegia

The following review examines the walking patterns of patients who have hemiplegia, primarily as a result of a stroke. Attention is given to the changes in the distance and temporal factors of walking, phasic patterns and joint ranges of motion throughout the walking cycle, the ground reaction forces, joint moments of force, joint powers, energy expenditure, and muscle activation patterns. The effect of orthotic intervention on these walking parameters is also addressed. A frequently cited issue regarding the gait patterns of these patients was that their walking patterns exhibit significant deviations from normal healthy individuals. Although hemiplegia is primarily associated with unilateral motor involvement, changes in almost all of the parameters used to assess walking were evident on both the involved and uninvolved sides of the body. Last, although hemiplegia appears to reflect a single diagnostic category, there is large interindividual variability in the patterns of gait deviations, which suggests that the management and treatment of these patients need to address the unique deficits of the individual.

The effect of orthotic intervention in patients with hemiparesis

The effect of orthotic intervention in patients with hemiparesis