Types Of Orthoses Research Articles

DETERMINATION OF THE STRESS-STRAIN STATE OF THE STRUCTURAL ELEMENTS OF THE ELBOW ORTHOSIS PROTOTYPE

Rehabilitation of patients should not be limited only to the time of intensive treatment in the hospital, but also to therapy in the following stages, especially during daily activities, if the patient’s condition requires it. Such devices that help the patient during postoperative or post-traumatic rehabilitation after joint damage are orthoses. This paper provides an overview of various types of orthoses, selects material for structural elements of the orthosis, and determines the stress-strain state of the sample under study. Also, based on the necessary operating conditions, the engine and bevel gear are selected. The model of the orthosis prototype is presented and the stress-strain state of the structural elements of the elbow orthosis prototype is determined.

The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients.

BACKGROUND:The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis.OBJECTIVE:The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients.METHODS:A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined.RESULTS:The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R2 = 0.80).CONCLUSIONS:The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients.

Comparison of Semicustom and Custom UCBL on Lower-Limb Kinematics in Flexible Flatfoot

ABSTRACT Introduction Orthotic devices can be successfully used to treat lower-limb injuries. However, their high cost is a major obstacle. Some orthotic companies have offered the semicustom alternatives at reasonable prices. The purpose of this study was to examine whether semicustom UCBL orthoses can provide similar rearfoot control as custom UCBL orthoses in individuals with flexible flatfoot. Material and Methods Eighteen subjects walked through the motion analysis laboratory under three conditions: no orthosis, custom UCBL orthosis, and semicustom UCBL orthosis. The rearfoot kinematics were assessed for each device. Results Both devices effectively reduced eversion excursion. Compared with the no orthotic condition, the custom and semicustom UCBL orthoses significantly decreased eversion excursion (P < .05), whereas peak eversion angle and velocity were not affected by any type of orthoses (P > .05). Conclusion Regarding the ability of semicustom UCBL orthoses to control rearfoot motion, they can be considered as a feasible alternative to custom UCBL orthoses for individuals with flexible flatfoot. Clinical Relevance This study provides evidence that semicustom UCBL orthoses are as effective as custom UCBL orthoses in controlling the rearfoot motion in flexible flatfoot. Therefore, owing to less fabrication time and lower price, semicustom UCBL orthoses are reasonable alternatives to custom UCBL orthoses.

Conservative treatment of scaphoid fracture: Protocol for a systematic review

The scaphoid is the most commonly fractured carpal bone. Fractures affecting this bone affect young and active patients between 15 and 40 years of age. Stable scaphoid fractures are treated conservatively by plaster cast immobilization or other type of orthosis for an average period of four to 12 weeks. Failure to treat scaphoid fractures may result in avascular necrosis, nonunion, and early secondary osteoarthritis, which may result in significant economic and social impact due to the affected population, formed by young people of productive age. The management of this type of fracture varies significantly between different Institutions and orthopedic surgeons. This article describes a protocol for a systematic review that aims to evaluate the effects (benefits and harms) of conservative interventions in the treatment of scaphoid fractures in adults.

Knee Orthosis for Anterior Cruciate Ligament Injuries - Kinematics and Comfortability Study

Knee orthosis is commonly used in supporting the knee movement and protecting the anterior cruciate ligament (ACL) injuries from worsening. In clinical practices, there are many types of ready-made orthoses that available in the market. However, different types of orthoses may provide different performances for patient’s knee joint. Therefore, this paper attempt to investigate the performance of knee orthoses for ACL-injured knee. Two groups took part in the study; (Group 1) six ACL-injured, (Group 2) four healthy participants, where two types of knee orthoses were adopted; (Brace 1) hinge brace, (Brace 2) sleeve brace with bilateral hinges. The knee joint motions were calculated using kinematics data while comfortability was conducted through surveys. From the findings, Brace 1 produced normal range of motion (ROM) for internal rotation at 5.47° while Brace 2 fall outside of the normal range at 2.165°. Meanwhile, the external rotation for Brace 1 (-13.25°) was lower than Brace 2 (-33.25°). Furthermore, the comfortability analysis suggested that Brace 1 (60%) was more effective than Brace 2 (40%). To conclude, Brace 1 portrayed optimal performance than Brace 2 during dynamic balance activities with reduction in ROM to prevent excessive knee rotation.

The immediate effects of hallux valgus orthoses: A comparison of orthosis designs.

Hallux valgus orthoses are available in a wide range of designs and materials, but the effects of their design on functional performance have not been fully investigated. This present study aims to comprehensively analyze the immediate effects of soft and semi-rigid hallux valgus orthoses on balance, plantar pressure, hallux valgus angle, and subjective sensations. Sixteen female subjects have participated in the study, including 10 subjects with healthy feet and 6 with hallux valgus. Three conditions are tested, including in the barefoot and using two types of commercially available hallux valgus orthoses. The subjects participate in static and dynamic (walking) tests with the use of the Novel Pedar® system. The peak pressure values in the hallux, lateral toes, first metatarsophalangeal joint, 2-4th metatarsal heads, 5th metatarsal head, medial midfoot, lateral midfoot and rearfoot in the various foot conditions are examined and compared. The hallux valgus angle of each subject is measured based on their footprint. Their subjective feelings towards the orthoses are also evaluated. A repeated-measures analysis of variance, and independent-sample t-test are performed. The correction of the hallux valgus angle is statistically significant when the subjects with hallux valgus use the orthoses. In comparing the two types of orthoses, the use of the orthosis made of soft materials results in correction in the hallux valgus angle and higher wear comfort, and lower plantar pressure in hallux area. The results provide insights into the design of hallux valgus orthoses, thus offering practical reference for the selection of hallux valgus orthosis with compromise between functional performance and wear comfort.

The Effect of Spinal Orthoses on Immobilizing the Cervical Spine: A Systematic Review of Research Methodologies

ABSTRACT Introduction The purpose of this article is to review the literature on the effect of immobilization of the cervical spine using orthotic devices. The review focused on the methodologies of the studies to see if this might be a contributing factor to the lack of available clinical guidelines on spinal immobilization using orthoses. Methods This review was conducted using PRISMA guidelines (PLoS Med. 2009;6:e1000097). The search was conducted in August 2019 within all major databases using relevant phrases. No date restrictions were applied, but the search was restricted to full manuscripts published in English. These searches were then supplemented by tracking all key references from the appropriate articles identified. Articles were selected according to a priori–defined criteria. Initially, data were extracted regarding publication details, orthosis name and group, spinal level studied, and whether cervical range of motion was measured. Results A total of 52 articles fulfilled the inclusion criteria. This article discusses the methodology of the included studies. Conclusions There is a clear paucity of well-designed research on immobilization of the cervical spine using orthotic devices. Comparing the results of studies using different types of orthoses is difficult due to the type and age of the participants involved (healthy, pathological, cadaver) and the different techniques of measurement used. This lack of standardization prevents meta-analyses from being performed and may be a contributing factor to the lack of available clinical guidelines. An agreed structured methodology is required to enable meta-analyses and determine clinical guidelines for the prescription of spinal orthoses for cervical spine pathology.

A PROSPECTIVE EVALUATION OF ORTHOTIC DEVICE IMPLICATION ON THE LOWER LIMB IN CHILDREN WITH CEREBRAL PALSY

CP is the foremost cause of motor disability in children and affects two to five children in 1000 live births worldwide. It is been recognized as a global concern medically, socially, and economically due to the increasing financial burden to the states. About half of the children with cerebral palsy suffer a range of motion difficulties. The study aims to understand the role of orthotic devices and its efficacy in the treatment of the patient with cerebral palsy and gait improvement. An online database of Pubmed, Science Direct, Google Scholar, etc. searched to find the articles with the keywords, cerebral palsy, orthotic devices, orthosis, lower limb, and results were synthesized and narrated to explore the effectiveness of the devices on the gait pattern and quality of life of a patient with cerebral palsy. The database search was done without the barrier of dates and regions. Orthoses applied externally appear to be supported and had a diverse effect on gait depending on the type of orthosis. However, the relationship between gait pattern and AFOs and ankle properties is yet to be established. Additional research in this area is needed to complement the development of passive and active AFOs to provide larger improvements in walking capabilities.

Orthotics lower limbs in children with spastic forms of cerebral palsy: (literature review)

Background. Cerebral palsy (CP) is an important medical and social problem due to the high frequency of childhood disability and a significant prevalence of the disease. One of the features of cerebral palsy is the formation of secondary orthopedic complications, for the correction of which, along with surgery and botulinum therapy, technical rehabilitation devices and orthoses in particular are used.
 Aim: To analyze world experience in orthotics in children with cerebral palsy. World literature review in open electronic databases PubMed and Elibrary for the last 30 years. The most of publications focuses on ankle-foot orthoses as the most commonly used in foreign clinical practice. A minimal number of papers cover the problem of orthopedic footwear, despite on its prevalence in Russia. There are no works analyzing the frequency characteristics of orthoses used, including the likelihood of their reuse and rejection. There is no unified, generally accepted terminology and classification of orthoses. We found no articles covering the effectiveness of combined use of several types of orthoses. To date, no clinical guidelines for orthotics in children with cerebral palsy have been developed; therefore, in many cases, orthoses are prescribed empirically.
 Conclusion. Thus, further research of the role of orthotics in the medical rehabilitation of children with cerebral palsy appears to be an urgent task.

Race and Insurance Status Association With Receiving Orthopedic Surgeon-Prescribed Foot Orthoses.

This study looked at the effect of patient demographics, insurance status, education, and patient opinion on whether various orthotic footwear prescribed for a variety of diagnoses were received by the patient. The study also assessed the effect of the orthoses on relief of symptoms. Chart review documented patient demographics, diagnoses, and medical comorbidities. Eligible patients completed a survey either while in the clinic or by phone after their clinic visit. Of the 382 patients prescribed orthoses, 235 (61.5%) received their orthoses; 186 (48.7%) filled out the survey. Race and whether or not the patient received the orthosis were found to be significant predictors of survey completion. Race, type of insurance, and amount of orthotic cost covered by insurance were significant predictors of whether or not patients received their prescribed orthoses. Type of orthosis, diabetes as a comorbidity, education, income, sex, and diagnosis were not significant predictors of whether the patient received the orthosis. Qualitative results from the survey revealed that among those receiving their orthoses, 87% experienced improvement in symptoms: 21% felt completely relieved, 66% felt better, 10% felt no different, and 3% felt worse. We found that white patients had almost 3 times the odds of receiving prescribed orthoses as black patients, even after controlling for type of insurance, suggesting race to be the primary driver of discrepancies, raising the question of what can be done to address these inequalities. While large, systematic change will be necessary, some strategies can be employed by those working directly in patient care, such as informing primary care practices of their ability to see patients with limited insurance, limiting blanket refusal policies for government insurance, and educating office staff on how to efficiently work with Medicare and Medicaid. Level III, comparative study.

Rehabilitation following surgery for flexor tendon injuries of the hand.

Rehabilitation following surgery for flexor tendon injuries of the hand.

The prescription situation of lower extremity orthoses for hemiplegic patients after stroke in a convalescent rehabilitation ward : Examination of the annual change over 12 years and the relationship between type of orthosis and walking ability

The prescription situation of lower extremity orthoses for hemiplegic patients after stroke in a convalescent rehabilitation ward : Examination of the annual change over 12 years and the relationship between type of orthosis and walking ability

A Soft Pressure Sensor Skin to Predict Contact Pressure Limit Under Hand Orthosis.

Customized static orthoses in rehabilitation clinics often cause side effects, such as discomfort and skin damage due to excessive local contact pressure. Currently, clinicians adjust orthoses to reduce high contact pressure based on subjective feedback from patients. However, the adjustment is inefficient and prone to variability due to the unknown contact pressure distribution as well as differences in discomfort due to pressure across patients. This paper proposed a new method to predict a threshold of contact pressure (pressure limit) associated with moderate discomfort at each critical spot under hand orthoses. A new pressure sensor skin with 13 sensing units was configured from FEA results of pressure distribution simulated with hand geometry data of six healthy participants. It was used to measure contact pressure under two types of customized orthoses for 40 patients with bone fractures. Their subjective perception of discomfort was also measured using a 6 scores discomfort scale. Based on these data, five critical spots were identified that correspond to high discomfort scores (>1) or high pressure magnitudes (>0.024 MPa). An artificial neural network was trained to predict contact pressure at each critical spot with orthosis type, gender, height, weight, discomfort scores and pressure measurements as input variables. The neural networks show satisfactory prediction accuracy with R2 values over 0.81 of regression between network outputs and measurements. This new method predicts a set of pressure limits at critical locations under the orthosis that the clinicians can use to make orthosis adjustment decisions.

Sensomotoric Orthoses, Ankle-Foot Orthoses, and Children with Cerebral Palsy: The Bigger Picture.

Ankle–foot orthoses (AFOs) and sensomotoric orthoses (SMotOs) are two—clinically relevant, yet under researched—types of lower limb orthoses used in children with cerebral palsy (CP). Quality of life is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Evaluating the effect of these two types of orthoses on quality of life in children with CP has not been reported on. The aim of this case study series was to synthesise and enrich the volume of evidence reported to inform real world applications of SMotO use in children with CP. Participants recruited were children with CP who performed the Berg Balance Scale, Timed Up-and-Go, the Gross Motor Function Measure and/or the Edinburgh Visual Gait Score in AFOs, SMotOs and barefoot where able. Qualitative data included videos of gait, a questionnaire and pedographs. Eight participants completed 39 quantitative and six qualitative measures, with the Edinburgh Visual Gait Score (EVGS) reporting the highest response. A general improvement was seen in gross motor skills and gait when wearing the SMotOs compared to AFOs and some parents reported that SMotOs were preferred. The reader is able to correlate the quantitative results with the qualitative evidence presented.

脳卒中片麻痺者の短下肢装具の装着方法について —装具の種類および身体機能・バランス能力との関係—

脳卒中片麻痺者の短下肢装具の装着方法について —装具の種類および身体機能・バランス能力との関係—

Long-term Stack splint immobilization for closed tendinous Mallet Finger.

Closed tendinous mallet finger can be treated non-operatively by extension splinting of the distal interphalangeal joint (DIPJ) for 6 to 8 weeks. However, method of conservative treatment in detail differs among various reports, especially in type of orthosis, duration of full-time immobilization and additional night orthotic wear after full-time immobilization. In our institution, full-time Stack splint is applied with distal interphalangeal joint (DIPJ) in extension for 12 weeks and night orthosis is worn for 4 weeks. The purpose of this study was to evaluate clinical and functional outcomes of tendinous mallet finger using our treatment protocol. Between March 2007 and December 2017, patients with tendinous mallet finger who were managed conservatively according to our treatment protocol were retrospectively reviewed. A total of 100 patients (101 cases) were enrolled, including 77 males and 23 females. Extension lag was measured before, soon after treatment, and at the final follow-up. Flexion angle of DIP joint was measured at the final follow-up. Patients were clinically evaluated based on the Crawford classification scale and Abouna & Brown criteria. The mean age of patients was 40 years and the mean follow-up was 48 months. The mean extension lag was 28.3 degrees initially and 2.6 degrees at the final follow-up. (p-value < 0.001) Flexion angle at the final follow-up was 68.3 degrees. Based on the Crawford classification scale, 56 % of patients had excellent results, and 25 % of patients had good results. According to Abouna & Brown criteria, 78 % of patients had success results and 7.5 % of patients had improved results. Wearing orthosis for up to 16 weeks (12 weeks full time and 4 weeks night orthosis) in the treatment of tendinous mallet finger injuries can achieve satisfying result.

Comparison of the quality of life in individuals with spinal cord injury wearing either reciprocating gait orthosis or hip knee ankle foot orthosis: a cross-sectional study

Background The quality of life (QoL) for patients with spinal cord injuries (SCI) is lower than that for healthy individuals. The main purpose of prescribing orthoses for these individuals is to improve their mobility and QoL. The hip knee ankle foot orthosis (HKAFO) has been the conventional choice for such patients, whilst the reciprocating gait orthosis (RGO) is a more contemporary option. Although the impact of these two types of orthoses on the biomechanics of walking has been previously evaluated in patients with SCI, there has been no specific comparison of their relative effects on QoL. Objectives This study aimed to evaluate the Sickness Impact Profile (SIP-68) QoL questionnaire’s total score and its sub-scores in patients with SCIs wearing either RGOs or HKAFOs. Methods This study was performed on 22 participants (11 participants wearing RGOs and 11 wearing HKAFOs). QoL scores were evaluated in each group of patients using the total and sub-scores from the SIP-68 questionnaire. Results There were no significant differences in the total SIP-68 scores between the RGO and HKAFO groups (p = .57). However, emotional stability and emotional independence sub-scores were significantly lower for the RGO users than for the HKAFO users (p = .03 and p = .01), respectively. Conclusions Based upon this preliminary study, participants wearing RGOs or HKAFOs had similar QoL scores. However, those wearing RGOs may experience better emotional stability, communication, and emotional independence. This preliminary study does not provide definite conclusions since a large randomized control trial is required to compare the effects of these orthoses on the QoL scores in patients with SCIs. Implications for rehabilitation Our main aim in the current investigation was to shed light on the question that does the biomechanical superiority of the RGO to the HKAFO leads to better quality of life in SCI subjects who are using RGO. Regarding the fact that the primary goal of rehabilitation of people with SCI is to improve their quality of life, it seems that the more complicated newer orthosis (RGO) has no difference with the older type (HKAFO) in achieving the rehabilitation goals. More studies will in fact be necessary to find a definitive answer for this important question. According to the findings of our study, it seems to be more appropriate to prescribe RGO for male participants with higher body weight.

Different Types of Orthoses in the Management of Genu-recurvatum, What are the Best Choices?

Different Types of Orthoses in the Management of Genu-recurvatum, What are the Best Choices?

Effect of AMB winding configurations on static and dynamic performances and power consumptions of the AMB-rotor system

Active magnetic bearings (AMBs) bring extraordinary benefits such as free of contact, elimination of lubrication, active control of rotor position, and a built-in monitoring system. In the design of AMBs, the bearing structure is of significance since it has an important impact on bearing performances. However, the effect of winding configurations of AMBs is still obscure. In this paper, the system-level implications of two radial AMB winding configurations termed the Ortho and the Cross types are investigated, including the bearing characteristics, power consumptions and rotor dynamic behaviors. The simulation results demonstrate that the Cross type contributes to larger load capacity in the direction of gravity. In condition of a heavier gravity load (−200 N), the Cross-type winding configuration saves power consumption with a percentage of 17.2% at steady state (20,000 rpm) and 12.7% considering unbalance mass during the run-up process. However, the rotor vibrations of the Cross type in case of external loads and unbalance mass are larger than the Ortho type. The proposed results of this paper provide some useful information for the AMB winding configuration design.

Analysis of the time required to wear ankle foot orthosis by stroke patients—Effects of type of orthosis and physical function on wearing time—

Analysis of the time required to wear ankle foot orthosis by stroke patients—Effects of type of orthosis and physical function on wearing time—