Orthotic Prescription Research Articles

Evaluation of abnormal biomechanics of the foot and ankle in athletes.

Athletes often suffer from recurrent or chronic overuse symptoms of the lower extremities. During the office visit it is essential to analyse the patient's shoes, gait cycle, lower extremities and, especially, the talocrural, subtalar and more distal joints of the ankle and foot. The basic (clinical) biomechanical analysis can be supplemented by radiographs, treadmill and video analysis and mirror table (podoscope) examinations. Ideally, successful pain relief by correction of the observed abnormality with an orthotic device completes the diagnostic procedure, especially if symptoms return soon after the removal of the device. In treatment custom-made, expensive orthotics should not be prescribed for overuse symptoms without an obvious malalignment, for asymptomatic athletes with a malalignment, or for symptoms in which the causal relationship between the biomechanical abnormality and symptoms is difficult to see. Strict indications for prescription of orthotics and close cooperation between the attending physician, physical therapist and orthotist are prerequisites for obtaining good, long-lasting results.

Low-Back Orthoses

Spinal orthoses may serve as appropriate adjuncts to both surgical and nonsurgical intervention in the case of thoracolumbar frac-tures or painful conditions. Use of spinal orthoses requires econsideration of normal spinal biomechanics as well as the path-omechanics specific to a given clinical situation. A knowledge of the general principles of bracing, in addition to the indications for and limitations of specific braces, is critical for successful orthotic prescription. This article reviews spinal biomechanics and kinematics, surgical and nonsurgical treatment of thoracolumbar fractures, classification of spinal orthoses, and orthotic management of fracture and surgery of the thoracolumbar spine as well as of low back pain.

Biomechanics of the Spine

This article outlines the static and kinetic aspects of the spine as the basis for orthotic prescription.

Assessment of Gait and Orthotic Prescription

Most survivors of a stroke have the potential for return of significant function and resumption of useful lives. At least 70% of hemiplegic patients recover the ability to walk. This article discusses the most salient factors affecting ambulation and possible orthotic intervention in the stroke population. The use of gait and motion analysis as an evaluation technique to obtain objective and quantifiable data to formulate the optimal treatment program for a gait dysfunction, including the use of invasive and surgical interventions, is discussed.

Abnormal gait of CVA hemiplegics and their orthotic prescription

Abnormal gait of CVA hemiplegics and their orthotic prescription

Influence of appropriate lower extremity orthotic management on ambulation, pain, and fatigue in a postpolio population.

A major functional problem for the postpolio patient is the loss of ambulation ability. A retrospective study of lower extremity orthotic management for ambulation was made of 104 subjects with histories of paralytic poliomyelitis who received treatment and evaluation in a postpolio clinic. Thirty-six patients (35%) had a remote history of a surgical arthrodesis of the ankle. Fifty-six subjects (54%) reported using lower extremity orthoses after the onset of their polio. At initial postpolio clinic evaluation 19 subjects (18%) were using lower extremity orthoses, and all of these patients had a remote history of orthotic use. After clinical evaluation, a new lower extremity orthosis was recommended for 37 subjects (36%). Nine of these patients had never used orthotic devices. New orthoses for a previously braced limb or an additional orthosis for a previously unbraced limb were prescribed more frequently in previously braced patients (28 of 56 vs 9 of 48, p less than 0.02). Seventy-two percent of subjects with ankle fusion required new orthoses; 19% of those without fusion required one (p less than 0.001). A questionnaire returned by 81 subjects (78%) indicated that appropriate orthotic prescription significantly improved the ability to walk, increased perceived walking safety, and reduced knee and overall pain (p = 0.04 to 0.008).

Biomechanical Foot Orthotics: A Retrospective Study

Foot orthotics are becoming recognized as an important consideration in the correction of lower extremity alignment and mechanical dysfunctions. There are many different foot orthotics on the market today claiming to relieve pain and enhance foot function. Unfortunately, minimal research has been conducted investigating the effectiveness of foot orthotics in adult patient populations. The purpose of this study was to determine the degree of pain relief experienced by patients, the ability of patients to return to their previous levels of activity associated with the duration of use of the orthotics, and patient compliance. This study also discusses the specific deformity for which the orthotic was prescribed and the degree of posting necessary to compensate for the deformity. Fifty-three subjects, 20 males and 33 females, responded to a questionnaire survey. The type of foot deformity and the orthotic prescription are also presented for each subject. The responses to the questions were correlated with an individual patient chart review. In addition, chi-square analysis was used to determine the level of significance between the specific deformity and the age and weight of the patients. The level of significance was determined between the patient's ability to adjust to the orthotics and their continued use of the orthotics. Finally, the significance of the orthotic treatment was compared to four other treatment interventions. Ninety-six percent of the patients reported relief from pain with the use of the prescribed foot orthotic. Ninety-four percent of the patients were still wearing the orthotic, and 52% reported that they would not leave home without them in their shoes at the time the survey was conducted. Seventy percent of the patients reported that they were able to return to their previous level of activity with the use of the foot orthotics.J Orthop Sports Phys Ther 1988;10(6):205-212.

Rationale for orthotic prescription in the lower extremity.

Rationale for orthotic prescription in the lower extremity.

Our Orthotic Prescription Form

In order to make an appropriate orthosis to the patient, mutual understanding to the prescribed orthosis between the prescribed doctor and the orthotist are necessary. For this purpose we made the unique orthotic prescription form. The form adopted the check system for complete the prescription and it also included the space for free writing and the illustrations of human body shape for convenience.We usually make three carbon paper copies when prescribe, and deliver them to the doctor in charge, the orthotist, and prescribed doctor.We have been using this prescription sheet since two and a half years ago and had satisfactory results. We found that this prescription form was useful for education of the young doctors and the orthotists.