3,110 results match your criteria Lower Limb Orthotics


Using mechanical testing to assess texturing of prosthetic sockets to improve suspension in the transverse plane and reduce rotation.

PLoS One 2020 11;15(6):e0233148. Epub 2020 Jun 11.

Northwestern University Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.

Creating a secure and comfortable linkage between the residual limb and prosthetic socket in persons with lower limb amputation is a critical factor for successful rehabilitation, including ambulation and other activities of daily living. Unwanted rotation within the socket can be a clinical problem for prosthesis users. One way of addressing issues experienced with transverse plane control of the socket may be through increased friction interface forces. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233148PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289418PMC

Syme Amputation: Function, Satisfaction, and Prostheses.

J Pediatr Orthop 2020 Jul;40(6):e532-e536

Departments of Orthopaedics.

Background: Syme amputation (SA) is a term used to describe an amputation at the level of the ankle joint in which the heel pad is preserved. It is performed for a number of indications in a pediatric population. SA is purported to hold the advantage of allowing weight bearing without a prosthesis. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001430DOI Listing

Immediate changes in post-stroke gait using a shoe lift on the nonaffected lower limb: A preliminary study.

Physiother Theory Pract 2020 Jun 1:1-6. Epub 2020 Jun 1.

Department of Physical Therapy and Graduate Program in Rehabilitation Sciences, Faculty of Ceilândia, University of Brasília , Brasília, Brazil.

Introduction: Gait impairment is one of the most important post-stroke complications and is associated with reduced mobility, limitations in activities of daily living and decreased quality of life. Gait recovery is an important goal in post-stroke rehabilitation and shoe lifts have been used on the nonaffected lower limb (NLL) to reduce compensatory strategies such as vaulting, pelvic hiking and hip circumduction during the swing phase of the affected lower limb. Moreover, in clinical practice shoe lifts seem to reduce tripping and the risk of falls. Read More

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http://dx.doi.org/10.1080/09593985.2020.1771798DOI Listing

Are consumers satisfied with the use of prosthetic sports feet and the provision process? A mixed-methods study.

Med Hypotheses 2020 May 23;143:109869. Epub 2020 May 23.

University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.

Background: Special feet connected to a prosthesis, prosthetic sports feet, enable athletes with a lower limb amputation to run. The selection of a prosthetic sports feet is usually based on body weight and preferred sports performance. The selection of a prosthetic sport feet is also based on clinicians who likely have limited experience due to a small number of athletes with a lower limb amputation. Read More

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http://dx.doi.org/10.1016/j.mehy.2020.109869DOI Listing

Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees.

Clin Orthop Relat Res 2020 May 20. Epub 2020 May 20.

L. M. Mioton, G. A. Dumanian, N. Shah, C. S. Qiu, J. H. Ko, S. W. Jordan, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA W. J. Ertl, The Department of Orthopedic Surgery, The University of Oklahoma, Oklahoma City, OK, USA B. K. Potter, J. M. Souza, Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of Health Sciences, Bethesda, MD, USA I. L. Valerio, The Department of Plastic Surgery, The Ohio State University, Columbus, OH, USA.

Background: Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.

Questions/purposes: (1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?

Methods: Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Read More

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http://dx.doi.org/10.1097/CORR.0000000000001323DOI Listing

Physical activity guidelines and promotion: An online survey of United Kingdom's prosthetic rehabilitation healthcare professionals.

Prosthet Orthot Int 2020 May 24:309364620920109. Epub 2020 May 24.

Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.

Background: Healthcare professionals play a key role in supporting physical activity participation for people with lower limb absence.

Objectives: The objectives of this study were to survey healthcare professionals' views of people with lower limb absence in the United Kingdom, explore their awareness and knowledge of physical activity recommendations and investigate their current and desirable practice towards physical activity promotion.

Study Design: Cross-sectional study. Read More

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http://dx.doi.org/10.1177/0309364620920109DOI Listing

A patient-specific lower extremity biomechanical analysis of a knee orthotic during a deep squat movement.

Med Eng Phys 2020 Jun 13;80:1-7. Epub 2020 May 13.

Department of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, Florida, USA.

Although knee orthotics have become the preferred treatment method for rehabilitation and injury prevention, their biomechanical influence has not yet been quantified. A new type of knee joint orthosis (KJO) using a non-linear spring-loaded (NLSL) component was recently introduced to help prevent the growing number of knee injuries and aid during rehabilitation. The purpose of this case study is to quantify the lower extremity biomechanical effects and evaluate functional benefits of a new KJO as a precision treatment option. Read More

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http://dx.doi.org/10.1016/j.medengphy.2020.04.007DOI Listing

The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation.

Phys Ther 2020 May 13. Epub 2020 May 13.

Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables, FL 33146 (USA).

Objective: The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed "Up and Go" (cTUG) Test. Read More

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http://dx.doi.org/10.1093/ptj/pzaa091DOI Listing

Increased prefrontal cortical activation during challenging walking conditions in persons with lower limb amputation - an fNIRS observational study.

Physiother Theory Pract 2020 May 5:1-11. Epub 2020 May 5.

Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.

: Lower limb amputation (LLA) alters the sensorimotor control systems. Despite the self-reports of increased attention during mobility, the interaction between mobility and cognitive control mechanisms is not fully understood.: Concurrently evaluate walking performance and prefrontal cortical (PFC) activity in persons with and without LLA during different walking conditions. Read More

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http://dx.doi.org/10.1080/09593985.2020.1758979DOI Listing

Asymmetry of mass and motion affects the regulation of whole-body angular momentum in individuals with upper limb absence.

Clin Biomech (Bristol, Avon) 2020 Jun 23;76:105015. Epub 2020 Apr 23.

Northwestern University Prosthetics-Orthotics Center, Dept. of Physical Medicine & Rehabilitation, Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1100, Chicago, IL 60611, USA; Jesse Brown VA Medical Center, 820 S Damen Ave, Chicago, IL 60612, USA. Electronic address:

Background: There is a high fall prevalence in individuals with upper limb absence, which may be related to a momentum imbalance resulting from the loss of all or part of one arm. The purpose of this study was to characterise whole-body angular momentum in individuals with upper limb absence during walking, and determine the effect of restoring the mass and inertial properties of the impaired side with a mock prosthesis.

Methods: Ten individuals with unilateral upper limb absence walked at self-selected speeds, with and without a mock prosthesis. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.105015DOI Listing

[A new type of adjustable weight bearing rehabilitation brace for lower limbs in postoperative rehabilitation of proximal femoral nail anti-rotation].

Zhongguo Gu Shang 2020 Apr;33(4):306-11

Department of Orthopaedics, the 909th Hospital of PLA, Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou 363000, Fujian, China.

Objective: To study and analyze the clinical effect of the self-developed new adjustable weight-bearing rehabilitation brace in the rehabilitation of the femoral intertrochanteric fracture after the operation of PFNA.

Methods: From July 2015 to June 2017, 62 patients with typeⅡ (Evans-Jensen classification) intertrochanteric fracture of femur were treated with PFNA internal fixation. There were 11 males and 19 females in the routine rehabilitation group, with an average age of (70. Read More

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http://dx.doi.org/10.12200/j.issn.1003-0034.2020.04.004DOI Listing

SwedeAmp-the Swedish Amputation and Prosthetics Registry: 8-year data on 5762 patients with lower limb amputation show sex differences in amputation level and in patient-reported outcome.

Acta Orthop 2020 Apr 22:1-7. Epub 2020 Apr 22.

Centre for Advanced Reconstruction of Extremities and Department for Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, and Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, Gothenburg, Sweden.

Background and purpose - For want of national guidelines for lower limb amputation (LLA) the quality registry SwedeAmp was started in 2011 to increase knowledge around LLA and prosthetic rehabilitation. We now present data from the first 8 years of registration.Patients and methods - We present descriptive data from the first 8 years (2011-2018) of registration. Read More

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http://dx.doi.org/10.1080/17453674.2020.1756101DOI Listing

The functional effect of 3D-printing individualized orthosis for patients with peripheral nerve injuries: Three case reports.

Medicine (Baltimore) 2020 Apr;99(16):e19791

Department of Physical Medicine and Rehabilitation, Catholic Kwandong University International St Mary's Hospital, Incheon.

Rationale: In the medical field, the use of 3-dimensional (3D) printing is increasing explosively and it is especially widespread in the clinical application of fabricating orthosis. Advantages of 3D-printed orthosis compared to conventional ones include its lower cost, easier modification, and faster fabrication. The 3D-printing technique makes it possible for physicians to easily create individual-tailored products. Read More

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http://dx.doi.org/10.1097/MD.0000000000019791DOI Listing

The effect of a lateral wedge insole and a subtalar strap on gait parameters in knee osteoarthritis.

Med J Islam Repub Iran 2019 30;33:157. Epub 2019 Dec 30.

Biomedical Engineering School, Amir Kabir University of Technology, Tehran, Iran.

Lateral wedge insole (LWI) aims to reduce loading on medial compartment of tibiofemoral joint in mild knee osteoarthritis (KOA). This effect may be augmented by concomitant use of subtalar strap to fix the ankle joint. Moreover, longitudinal arch support embedded in insoles can cause foot comfort and may be beneficial for people with KOA. Read More

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http://dx.doi.org/10.34171/mjiri.33.157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137820PMC
December 2019

Walking kinematics in young children with limb loss using early versus traditional prosthetic knee prescription protocols.

PLoS One 2020 10;15(4):e0231401. Epub 2020 Apr 10.

Division of Prosthetics and Orthotics, Department of Orthopedics, Children's Healthcare of Atlanta, Atlanta, Georgia, United States of America.

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an "Early Knee" (EK) protocol, which prescribes an articulating prosthetic knee in the child's first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to the knee using TK and EK protocols. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231401PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147787PMC
April 2020
3.234 Impact Factor

Effectiveness of elevated vacuum and suction prosthetic suspension systems in managing daily residual limb fluid volume change in people with transtibial amputation.

Prosthet Orthot Int 2020 Jun 18;44(3):155-163. Epub 2020 Mar 18.

Department of Bioengineering, University of Washington, Seattle, WA, USA.

Background: Previous studies investigating limb volume change with elevated vacuum have shown inconsistent results and have been limited by out-of-socket volume measurements and short, single-activity protocols.

Objectives: To evaluate the effectiveness of elevated vacuum for managing limb fluid volume compared to suction suspension with an in-socket measurement modality during many hours of activity.

Study Design: Fixed-order crossover design with a standardized out-of-laboratory activity protocol. Read More

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http://dx.doi.org/10.1177/0309364620909044DOI Listing

Functional Evaluation of a Shock Absorbing Insole During Military Training in a Group of Soldiers: A Pilot Study.

Mil Med 2020 Jun;185(5-6):e643-e648

Motion Analysis Laboratory, IRCCS-Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40100 Bologna Italy.

Objective: Soldiers' lower limbs and feet are frequently affected by overload- and overuse-related injuries. In order to prevent or limit the incidence of these injuries, the use of foot orthoses is often recommended. The aim of this study is to assess the effects of shock-absorbing insoles on in-shoe plantar pressure magnitude and distribution in a group of professional infantry soldiers wearing military boots during standard indoor military training. Read More

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http://dx.doi.org/10.1093/milmed/usaa032DOI Listing

Design and Evaluation of an Articulated Ankle Foot Orthosis with Plantarflexion Resistance on the Gait: a Case Series of 2 Patients with Hemiplegia.

J Biomed Phys Eng 2020 Feb 1;10(1):119-128. Epub 2020 Feb 1.

PhD, International University of Health and Welfare, Tokyo, Japan.

Ankle-foot orthoses (AFOs) have been described to have positive effects on the gait biomechanics in stroke patients. The plantarflexion resistance of an AFO is considered important for hemiplegic patients, but the evidence is still limited. The purpose of this case series was to design and evaluate the immediate effect of an articulated AFO on kinematics and kinetics of lower-limb joints in stroke patients. Read More

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http://dx.doi.org/10.31661/jbpe.v0i0.1159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036417PMC
February 2020

Load response of an osseointegrated implant used in the treatment of unilateral transfemoral amputation: An early implant loosening case study.

Clin Biomech (Bristol, Avon) 2020 Mar 20;73:201-212. Epub 2020 Jan 20.

Department of Biomedical Engineering, The University of Melbourne, Victoria, Australia. Electronic address:

Background: Osseointegrated implants for transfemoral amputees facilitate direct load transfer between the prosthetic limb and femur; however, implant loosening is a common complication, and the associated implant-bone loads remain poorly understood. This case study aimed to use patient-specific computational modeling to evaluate bone-implant interface loading during standing and walking in a transfemoral amputee with an osseointegrated implant prior to prosthesis loosening and revision surgery.

Methods: One male transfemoral amputee with an osseointegrated implant was recruited (age: 59-yrs, weight: 83 kg) and computed tomography (CT) performed on the residual limb approximately 3 months prior to implant failure. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.01.017DOI Listing

The relationship between body composition and foot posture index in Special Olympics athletes.

Acta Bioeng Biomech 2019 ;21(4):47-52

Faculty of Sports Studies, Masaryk University, Brno, Czech Republic.

Purpose: In Special Olympics, athletes' foot deformities, abnormal postural patterns and overweight and obesity were observed to be more common than in the general population. Therefore, the purpose of this study was to analyze the relationship between body composition and foot posture index. Additionally, the effect of gender and other factors on the body composition and foot posture index in athletes with intellectual disability (ID) were analyzed. Read More

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Acute effects of different orthoses on lower extremity kinetics and kinematics during running; a musculoskeletal simulation analysis.

Acta Bioeng Biomech 2019 ;21(4):13-25

School of Life Science and Education, Staffordshire University.

Purpose: The current investigation aimed to examine the effects of different orthotic conditions on the biomechanical mechanisms linked to the aetiology of chronic pathologies using musculoskeletal simulation.

Methods: 16 male and 20 females ran over an embedded force plate at 4.0 m/s, in five different conditions (medial, lateral, no-orthoses, semi-custom and off the shelf). Read More

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Prosthesis satisfaction in a national sample of Veterans with upper limb amputation.

Prosthet Orthot Int 2020 Apr 21;44(2):81-91. Epub 2020 Jan 21.

Brown University, Providence, RI, USA.

Background: Many persons with upper limb amputation reject prostheses, and many are not satisfied with their devices. Research is needed to understand modifiable factors related to device satisfaction. Myoelectric devices with multiple degrees of freedom are now available; however, no studies have examined whether they lead to greater device satisfaction. Read More

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http://dx.doi.org/10.1177/0309364619895201DOI Listing
April 2020
1.073 Impact Factor

IMU-based Assessment of Ankle Inversion Kinematics and Orthosis Migration.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:6395-6400

Ankle orthoses are used to prevent injuries during very fast inversion motions of the ankle. In order to provide proper protection, they must fit well and migrate as little as possible. Inertial measurement units (IMUs) have become a useful tool for accurate motion analysis and are frequently used for gait analysis. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856661DOI Listing

Optimized Design of a Variable Viscosity Link for Robotic AFO.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:6220-6223

Herein we present the development of a novel Ankle Foot Orthosis for gait support of people with foot-drop symptoms. The developed AFO uses an elastic link mechanism to brake the ankle joint during initial contact, thus mitigating foot-slap, and an integrated energy store-and-release mechanism to support toe lift in the swing phase, thus mitigating toe-drag. This paper presents improvements in the braking-holding power of the elastic link mechanism over its previous version, the torque-angle characteristics of the developed AFO with the renewed elastic link, and a pilot test with one person with foot-drop symptoms to verify the proposed functions of the developed AFO. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856773DOI Listing

IMU Sensor Fusion Algorithm for Monitoring Knee Kinematics in ACL Reconstructed Patients.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:5877-5881

In this paper we propose a sensor embedded knee brace to monitor knee flexion and extension and other lower limb joint kinematics after anterior cruciate ligament (ACL) injury. The system can be easily attached to a standard post-surgical brace and uses a novel sensor fusion algorithm that does not require calibration. The wearable system and the sensor fusion algorithm were validated for various physical therapy exercises against a validated motion capture system. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8857431DOI Listing

Using a texture analyser to objectively quantify foot orthoses.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:5348-5351

Background And Aim: Foot orthoses alter the kinematics and kinetics in gait. With the increasing importance of evidence based practice and with the permanent development of subtractive manufacturing and introduction of additive manufacturing, there is a growing need for quantification of orthoses parameters. We describe a measurement method and protocol to quantify different parameters of a foot orthosis. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8857318DOI Listing

Design of the Clutched Variable Parallel Elastic Actuator (CVPEA) for Lower Limb Exoskeletons.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:4436-4439

The paper presents a novel clutched variable parallel elastic actuator (CVPEA) mainly consisting of a motor and a flat spiral spring in parallel to actuate the hip of lower limb exoskeletons in sagittal plane. To minimize the power and torque requirement for motor, we put forward three optimization methods including minimizing the rms motor power, the peak motor torque and the peak motor power to determine the optimal PE (parallel elastic) for CVPEA. It is proved that the mechanical energy reduction in the late stance period can be stored in the PE and can be later recycled in the early swing period in a gait cycle according to simulation results. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8857502DOI Listing

Lower Limb Muscle Activity Control by using Jamming Footwear.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:3302-3305

To change the lower limb muscle activities while walking, we propose a muscle activity controlling system that dynamically changes shoe insoles. We conducted a preliminary experiment on a prototype system to determine the system's validity. In this experiment, we analyzed how tibialis anterior and gastrocnemius muscle might change their activities depending on each insole condition. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856289DOI Listing

Singular value decomposition entropy as a measure of ankle dynamics efficacy in a Y-balance test following supportive lower limb taping.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:2439-2442

Complexity versus regularity is an important component of appropriate joint position to retain balance but has not received much attention. The Singular value decomposition entropy (SvdEn) characterizes information content or regularity of a signal depending on the number of vectors attributed to the process. The current study aimed to investigate the effect of kinesiology tape compared to static strapping tape and no tape on ankle joint dynamics during the Y balance test. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856655DOI Listing

Description of orthotic properties and effect evaluation of ankle-foot orthoses in non-spastic calf muscle weakness.

J Rehabil Med 2020 Mar;52(3):jrm00026

Objective: To describe the orthotic properties and evaluate the effects of ankle-foot orthoses for calf muscle weakness in persons with non-spastic neuromuscular disorders compared with shoes-only.

Design: Cross-sectional study.

Subjects: Thirty-four persons who used ankle-foot orthoses for non-spastic calf muscle weakness. Read More

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http://dx.doi.org/10.2340/16501977-2642DOI Listing

Combining physical therapy and cognitive behavioral therapy techniques to improve balance confidence and community participation in people with unilateral transtibial amputation who use lower limb prostheses: a study protocol for a randomized sham-control clinical trial.

Trials 2019 Dec 30;20(1):812. Epub 2019 Dec 30.

Dr. William M. Scholl College of Podiatric Medicines' Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA.

Background: Low balance confidence is a prevalent yet overlooked issue among people who use lower limb prostheses (LLP) that can diminish community integration and quality of life. There is a critical need to develop rehabilitation programs that specifically target balance confidence in people who use LLP. Previous research has shown that multicomponent interventions including cognitive-behavioral therapy (CBT) techniques and exercise are feasible and effective for improving balance confidence in older adults. Read More

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http://dx.doi.org/10.1186/s13063-019-3929-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937857PMC
December 2019

Kinematic on Ankle and Knee Joint of Post-Stroke Elderly Patients by Wearing Newly Elastic Band-Type Ankle-Foot Orthosis in Gait.

Clin Interv Aging 2019 5;14:2097-2104. Epub 2019 Dec 5.

Biomedical System & Technology Group, Korea Institute of Industrial Technology, Cheonan, Chungnam, South Korea.

Purpose: The post-stroke elderly was increased caused by increasing stroke and advanced medical. However, ankle-foot orthoses (AFOs) can be uncomfortable for hemiplegic patients; therefore, the usability is not good. In this study, we analyzed ankle and knee joint angles in post-stroke elderly patients to assess the functional effectiveness (specifically prevention of back knee and drop-foot) of a new elastic band-type AFO (New Product: NP) during gait. Read More

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http://dx.doi.org/10.2147/CIA.S222087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901042PMC

Compliance with prescriptions for wheelchairs, walking aids, orthotics, and pressure-relieving devices in patients with traumatic spinal cord injury.

Eur J Phys Rehabil Med 2020 Apr 3;56(2):160-168. Epub 2019 Dec 3.

Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.

Background: The use of adaptive equipment (AE) is the basic indication for patients with spinal cord injury (SCI). Inappropriate decisions concerning the use of AE imply treatment results, patient confidence, and patient and state costs. The present study is the first analysis of the causes of non-compliance conducted in Europe with the provision of AE in SCI patients using Wielandt and Strong's classification. Read More

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http://dx.doi.org/10.23736/S1973-9087.19.05920-3DOI Listing

The Influence of Orthotics on Lower Limbs Biomechanics in CP.

Ortop Traumatol Rehabil 2019 Oct;21(5):389-398

Wydział Mechatroniki Politechniki Warszawskiej / Warsaw University of Technology, Institute of Micromechanics and Photonics Zakład Techniki Rzeczywistości Wirtualnej, Warszawa, Polska / Division Photonics Engineering, Faculty of Mechatronics, Warsaw, Poland.

The biomechanics of the human body has a direct impact on the quality of gait cycle. Patients with Cerebral Palsy (CP) often present incorrect gait patterns associated with structural deformities which directly influence the locomotor functions. The key to therapeutic success in those patients is the use of lower limb orthotics of the AFO type. Read More

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October 2019

Effectiveness and Duration of Plantar Pressure Off-loading by Two Designs of Felt Padding: A Preliminary Study.

J Am Podiatr Med Assoc 2019 Nov;109(6):431-436

Background: The aim of this study was to observe the pressure changes in the felt padding used to off-load pressure from the first metatarsal head, the effects obtained by different designs, and the loss of effectiveness over time.

Method: With a study population of 17 persons, two types of 5-mm semicompressed felt padding were tested: one was C-shaped, with an aperture cutout at the first metatarsophalangeal joint, and the other was U-shaped. Pressures on the sole of the foot were evaluated with a platform pressure measurement system at three time points: before fitting the felt padding, immediately afterward, and 3 days later. Read More

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http://dx.doi.org/10.7547/17-146DOI Listing
November 2019

A Pilot Study Testing a Novel 3D Printed Amphibious Lower Limb Prosthesis in a Recreational Pool Setting.

PM R 2019 Nov 20. Epub 2019 Nov 20.

The Feinstein Institute for Medical Research, Manhasset, NY.

Introduction: Adults with limb amputation and other physical disabilities are less likely to participate in physical activity than adults in the general population and have elevated risk of heart disease and stroke. Swimming is a physical activity often recommended for persons with limb amputation. However, a standard economical swim prosthesis that facilitates easy transition from land to water does not exist. Read More

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http://dx.doi.org/10.1002/pmrj.12293DOI Listing
November 2019

Orthotic care needs in a cohort of neurological rehabilitation inpatients.

Disabil Rehabil Assist Technol 2019 Nov 20:1-5. Epub 2019 Nov 20.

Wolfson Neurorehabilitation Centre, St George's University Hospitals NHS Foundation Trust, London, UK.

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. Read More

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http://dx.doi.org/10.1080/17483107.2019.1685018DOI Listing
November 2019

Pediatric Considerations.

Authors:
Marc A Benard

Clin Podiatr Med Surg 2020 Jan;37(1):125-150

Baja Project for Crippled Children/Operation Footprint, Westlake Village, CA, USA; American Board of Podiatric Medicine, Hermosa Beach, CA, USA; Western University of Podiatric Medicine, Pomona, CA, USA. Electronic address:

The article discusses the nuances required to effectively perform the biomechanical examination in children and assess the findings. The author covers several factors in children that make the examination different in certain respects than in that of adults, including growth, osseous maturation, gait development, and interpretation of symptoms as conveyed by the child. Further delineation is made for prewalkers, foot-flat to foot-flat walkers, and heel-to-toe walkers. Read More

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http://dx.doi.org/10.1016/j.cpm.2019.08.001DOI Listing
January 2020

Subject- and Environment-Based Sensor Variability for Wearable Lower-Limb Assistive Devices.

Sensors (Basel) 2019 Nov 8;19(22). Epub 2019 Nov 8.

Neural Engineering for Prosthetics and Orthotics Lab (NEPOL), Center of Bionic Medicine, Shirley Ryan AbilityLab (formerly RIC), Chicago, IL 60611, USA.

Significant research effort has gone towards the development of powered lower limb prostheses that control power during gait. These devices use forward prediction based on electromyography (EMG), kinetics and kinematics to command the prosthesis which locomotion activity is desired. Unfortunately these predictions can have substantial errors, which can potentially lead to trips or falls. Read More

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http://dx.doi.org/10.3390/s19224887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891559PMC
November 2019

Effect of cycling and functional electrical stimulation with linear and interval patterns of timing on gait parameters in patients after stroke: a randomized clinical trial.

Disabil Rehabil 2019 Nov 10:1-7. Epub 2019 Nov 10.

Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Patients in the chronic phase after a stroke are an underrepresented group in the literature. Therefore, the aim of this study was to compare the effects of cycling and functional electrical stimulation with linear versus interval patterns of timing on gait parameters in patients after stroke. A double blinded, parallel, randomized clinical trial. Read More

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http://dx.doi.org/10.1080/09638288.2019.1685600DOI Listing
November 2019
1.837 Impact Factor

Conservative treatment of Freiberg's infraction using foot orthoses: A tale of two prescriptions presented as a case study to open debate.

Foot (Edinb) 2019 Dec 27;41:59-62. Epub 2019 Jul 27.

Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, UK. Electronic address:

'Freiberg's infraction or disease' is an osteonecrotic process primarily affecting the 2 & 3 metatarsal heads. Early diagnosis is difficult, and the underlying pathogenesis remains unclear. Surgical options for late disease have been widely reported in the literature, yet details on conservative management for the early stages of Freiberg's are largely absent. Read More

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http://dx.doi.org/10.1016/j.foot.2019.07.002DOI Listing
December 2019

Early mobilization does not reduce the risk of deep venous thrombosis after Achilles tendon rupture: a randomized controlled trial.

Knee Surg Sports Traumatol Arthrosc 2020 Jan 2;28(1):312-319. Epub 2019 Nov 2.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Purpose: The hypothesis was that early functional mobilization would reduce the incidence of deep venous thrombosis (DVT) during leg immobilization after Achilles tendon rupture surgery. A secondary aim was to evaluate if the amount of weightbearing and daily steps influenced the risk of sustaining a DVT.

Methods: One-hundred and fifty patients with Achilles tendon rupture repair were randomized to treatment with early functional mobilization, encouraging full weightbearing and ankle motion in orthosis, or treatment-as-usual, i. Read More

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http://dx.doi.org/10.1007/s00167-019-05767-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971132PMC
January 2020
1 Read

Improvements in strength and functional performance after Kinesio taping in semi-professional male soccer players with and without functional ankle instability.

Foot (Edinb) 2019 Dec 27;41:12-18. Epub 2019 Jun 27.

Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address:

Objective: The objectives of this study were to compare the immediate effects of two methods of Kinesio taping on muscle strength, functional performance, and balance in athletes with and without functional ankle instability (FAI).

Methods: The present study investigated the effects of distal taping (muscle application over peroneus longus) and proximal- distal taping (muscle application over gluteus medius and peroneus longus) on the strength of evertor and hip abductor muscles, side hop test, figure of 8 hop test, and star excursion balance test in semi-professional male soccer players with and without FAI (n=15 in each group). A Multifactorial repeated measure ANOVA was used for comparison. Read More

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http://dx.doi.org/10.1016/j.foot.2019.06.006DOI Listing
December 2019

Is Excellence in the Cards?

Authors:
Thomas G McPoil

Phys Ther 2019 10;99(10):1281-1290

Thomas G. McPoil, PT, PhD, FAPTA, is Emeritus Professor of Physical Therapy at Regis University, Denver, Colorado, and Emeritus Regents' Professor of Physical Therapy at Northern Arizona University. He has served as an Adjunct Honorary Professor in the School of Physiotherapy at the University of Queensland, Brisbane, Australia, and currently serves as a consultant to the Physical Therapy Orthotics Clinic at Denver Health Medical Center, Denver, Colorado. Read More

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http://dx.doi.org/10.1093/ptj/pzz104DOI Listing
October 2019

Analysis of Pressure Distribution in Transfemoral Prosthetic Socket for Prefabrication Evaluation via the Finite Element Method.

Bioengineering (Basel) 2019 Oct 24;6(4). Epub 2019 Oct 24.

Department of Science and Engineering, Tokyo Denki University, Tokyo 120-8551, Japan.

In this study, we estimated and validated the pressure distribution profile between the residuum and two types of prosthetic sockets for transfemoral amputees by utilizing a finite element analysis. Correct shaping of the socket for an appropriate load distribution is a critical process in the design of lower-limb prosthesis sockets. The pressure distribution profile provides an understanding of the relationship between the socket design and the level of subject comfortability. Read More

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http://dx.doi.org/10.3390/bioengineering6040098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956391PMC
October 2019

Modifying ankle foot orthosis stiffness in patients with calf muscle weakness: gait responses on group and individual level.

J Neuroeng Rehabil 2019 10 17;16(1):120. Epub 2019 Oct 17.

Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.

Background: To improve gait, persons with calf muscle weakness can be provided with a dorsal leaf spring ankle foot orthosis (DLS-AFO). These AFOs can store energy during stance and return this energy during push-off, which, in turn, reduces walking energy cost. Simulations indicate that the effect of the DLS-AFO on walking energy cost and gait biomechanics depends on its stiffness and on patient characteristics. Read More

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http://dx.doi.org/10.1186/s12984-019-0600-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798503PMC
October 2019
1 Read

Effect of ankle-foot orthosis on level walking in healthy subjects.

Proc Inst Mech Eng H 2019 Dec 18;233(12):1262-1268. Epub 2019 Oct 18.

Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan.

An ankle-foot orthosis is often prescribed in the rehabilitation of patients with neurological motor disorders such as hemiparesis. However, walking with a unilateral ankle-foot orthosis may not be effectively achieved just by trying to reproduce normal intact walking with a symmetrical gait pattern. Understanding skills to facilitate walking gait with a unilateral ankle-foot orthosis has implications for better rehabilitative interventions to help restore walking ability in patients with stroke. Read More

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http://dx.doi.org/10.1177/0954411919880359DOI Listing
December 2019
1 Read

A modified walk-in clinic for shoe insoles: Follow-up of non-attendants.

Prosthet Orthot Int 2019 Dec 17;43(6):597-600. Epub 2019 Oct 17.

Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Background: In a previous study ( = 1286), we found that a modified walk-in system reduced waiting times for prescription of shoe insoles by 40 days compared to scheduled appointments but resulted in a non-attendance rate of 17% compared to 6% for scheduled appointments.

Objectives: To investigate the reasons for non-attendance at the modified walk-in clinic.

Study Design: This is a cross-sectional survey. Read More

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http://dx.doi.org/10.1177/0309364619879285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900566PMC
December 2019
1 Read