3,277 results match your criteria Lower Limb Orthotics


Orthotic treatment of idiopathic toe walking with a lower leg orthosis with circular subtalar blocking.

BMC Musculoskelet Disord 2021 Jun 7;22(1):520. Epub 2021 Jun 7.

Orthopaedics, Krankenhaus Agatharied, Agatharied, Germany.

Background: There is no universally accepted treatment standard for idiopathic toe walking patients (ITW) in the current literature. None of the established methods provide homogenous satisfying results. In our department we treat ITW patients with lower leg orthoses with a circular foot unit for a total of 16 weeks. Read More

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Has the Threshold for Epiphysiodesis Versus Lengthening Changed in the Era of Magnetically Controlled Nails?

J Pediatr Orthop 2021 Jul;41(Suppl 1):S24-S32

Department of Orthopaedic Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Introduction: Limb length discrepancy (LLD) is common in both the pediatric and adult population. Length inequalities can be due to a multitude of etiologies including congenital, developmental, and acquired causes. There has been little consensus on the morbidity of LLD and, as a result, the threshold necessary for treatment of LLD to prevent morbidity. Read More

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IMU-Based Effects Assessment of the Use of Foot Orthoses in the Stance Phase during Running and Asymmetry between Extremities.

Sensors (Basel) 2021 May 10;21(9). Epub 2021 May 10.

Sport Performance Analysis Research Group, University of Vic-Central University of Catalonia, 08500 Vic, Spain.

The objectives of this study were to determine the amplitude of movement differences and asymmetries between feet during the stance phase and to evaluate the effects of foot orthoses (FOs) on foot kinematics in the stance phase during running. In total, 40 males were recruited (age: 43.0 ± 13. Read More

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Anti-pronator components are essential to effectively alter lower-limb kinematics and kinetics in individuals with flexible flatfeet.

Clin Biomech (Bristol, Avon) 2021 May 23;86:105390. Epub 2021 May 23.

École de Kinésiologie et des Sciences de l'Activité Physique, Université de Montréal, Campus Laval, 1700 rue Jacques Tétreault, Laval, QC H7N 0B6, Canada; Laboratoire Orthopédique Médicus, 2520 Boul. St-Joseph, Montréal, QC H1Y 2A2, Canada.

Background: Foot orthoses are commonly used to correct for foot alterations and especially address excessive foot pronation in individuals with flatfeet. In recent years, 3D printing has taken a key place in orthotic manufacturing processes as it offers more options and can be patient specific. Hence, the purpose of this study was to evaluate whether stiffness of 3D printed foot orthoses and a newly designed rearfoot posting have an effect on lower limb kinematics and kinetics in individuals with flatfeet. Read More

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Different types of foot orthoses effect on gait mechanics in patients with rheumatoid arthritis.

J Biomech 2021 Apr 30:110496. Epub 2021 Apr 30.

Department of Materials and Production, Aalborg University, DK-9220 Aalborg East, Denmark. Electronic address:

Foot orthoses are a first line conservative treatment for foot impairments in patients with rheumatoid arthritis (RA), however their effect on gait mechanics is poorly understood. We aimed to compare changes in lower limb and foot mechanics between two types of commonly used foot orthoses (FO) with a control. Twenty-seven patients with rheumatoid arthritis participated in this crossover study. Read More

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A Scoping Review of Physical Activity in People With Lower-Limb Loss: 10,000 Steps Per Day?

Phys Ther 2021 Apr 28. Epub 2021 Apr 28.

Program in Physical Therapy, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032.

Objective: After amputation, people with lower-limb loss (PLL) face challenges to regain their previous physical activity level. Assessing the scope of evidence regarding physical activity in PLL can identify sources of evidence and gaps within the literature that can influence amputation-related research, outcome assessment choices, and wellness activities. The purpose of this scoping review was to map the evidence regarding steps per day as a physical activity measure for PLL. Read More

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The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation.

Health Qual Life Outcomes 2021 Apr 27;19(1):134. Epub 2021 Apr 27.

Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy.

Background: The Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users' Survey is an extensively used questionnaire that measures patients' satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users.

Objectives: The aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users. Read More

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Paediatric flat foot and foot dimension in Central Anatolia.

BMC Pediatr 2021 04 27;21(1):200. Epub 2021 Apr 27.

Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara University, Ankara, Turkey.

Background: Information on the foot structures of Central Anatolian children is limited. Foot structures of children aged 6-10 years were shown to be different according to sex and increasing age.

Objective: This study aimed to compare the foot anthropometric values by age and sex and collect the foot anthropometric data to reveal the relationship between pes planus and pes cavus in the arches of children according to age. Read More

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Current Evidence Does Support the Use of KT to Treat Chronic Knee Pain in Short Term: A Systematic Review and Meta-Analysis.

Authors:
Wen-Hao Luo Ye Li

Pain Res Manag 2021 23;2021:5516389. Epub 2021 Mar 23.

Department of Orthopedics Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Objective: To demonstrate whether KT is better than placebo taping, nonelastic taping, or no taping in reducing pain.

Methods: PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 20 October 2020 for randomized controlled studies that used KT to treat chronic knee pain according to PRISMA guidelines. Read More

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Design and development of a novel 3D-printed non-metallic self-locking prosthetic arm for a forequarter amputation.

Prosthet Orthot Int 2021 Feb;45(1):94-99

1Prosthetics & Orthotics Service, Foot Care & Limb Design Centre, Tan Tock Seng Hospital, Singapore 2Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design, Singapore.

Background: Upper limb, in particular forequarter amputations, require highly customised devices that are often expensive and underutilised.

Objectives: The objective of this study was to design and develop a comfortable 3D-printed cosmetic forequarter prosthetic device, which was lightweight, cool to wear, had an elbow that could lock, matched the appearance of the contralateral arm and was completely free of metal for a specific user's needs.

Study Design: Device design. Read More

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February 2021

Quantifying Step Count and Oxygen Consumption with Portable Technology during the 2-Min Walk Test in People with Lower Limb Amputation.

Sensors (Basel) 2021 Mar 16;21(6). Epub 2021 Mar 16.

Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. Read More

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Design and Preliminary Validation of Individual Customized Insole for Adults with Flexible Flatfeet Based on the Plantar Pressure Redistribution.

Sensors (Basel) 2021 Mar 4;21(5). Epub 2021 Mar 4.

Academy for Engineering & Technology, Fudan University, Handan Rd. 220, Shanghai 200433, China.

Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. Read More

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Intramedullary nail for the surgical treatment of unstable fractures of the femur in previously amputated patients

Rev Fac Cien Med Univ Nac Cordoba 2021 03 12;78(1):57-63. Epub 2021 Mar 12.

Hospital Italiano de Buenos Aires.

Introduction: Femoral fractures in previously amputated patients (PAP) have been poorly reported in international literature, however it is worth mentioning that advances in the manufacture of orthotics for lower limbs have allowed these patients to remain functionally active. Surgery is then an option but difficulties may appear in positioning the patient for surgery due to the absence of the foot or ankle from where to pull and optimize the fracture reduction.

Objective: We report 3 cases of PAP with ipsilateral unstable femur fractures, treated surgically with cervicodiaphyseal endomedular nail. Read More

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Selecting, Administering, and Interpreting Outcome Measures among Adults with Lower-Limb Loss: An Update for Clinicians.

Curr Phys Med Rehabil Rep 2020 Sep 3;8(3):92-109. Epub 2020 Aug 3.

Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.

Purpose Of Review: To summarize outcome measurement research among adults with lower-limb loss (LLL) for clinicians.

Recent Findings: Houghton Scale, Prosthetic Evaluation Questionnaire-mobility subscale (PEQ-m), Prosthetic Limb Users Survey of Mobility (PLUS-M™), Activities-Specific Balance Confidence Scale (ABC), Amputee Mobility Predictor (AMP), Comprehensive High-Level Activity Mobility Predictor, Four Square Step Test (FSST), Narrowing Beam Walking Test (NBWT), L Test, 10 Meter Walk Test (10MWT), and 6 Minute Walk Test (6MWT) are appropriate for evaluating individual patient changes post-LLL. Post-LLL, Socket Comfort Score, Patient-Specific Functional Scale, Patient-Reported Outcomes Measurement Information System 29-Item Profile, Timed Up and Go, and 2 Minute Walk Test may be more appropriate for evaluating groups. Read More

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September 2020

The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial.

J Neuroeng Rehabil 2021 03 16;18(1):49. Epub 2021 Mar 16.

School of Kinesiology, University of Michigan, 401 Washtenaw Avenue, Ann Arbor, MI, 48109-2214, USA.

Background: Powered prosthetic ankles provide battery-powered mechanical push-off, with the aim of reducing the metabolic demands of walking for people with transtibial amputations. The efficacy of powered ankles has been shown in active, high functioning individuals with transtibial amputation, but is less clear in other populations. Additionally, it is unclear how use of a powered prosthesis influences everyday physical activity and mobility. Read More

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Should weight-bearing activity be reduced during healing of plantar diabetic foot ulcers, even when using appropriate offloading devices?

Diabetes Res Clin Pract 2021 Mar 10;175:108733. Epub 2021 Mar 10.

Program in Physical Therapy and Department of Radiology, Washington University School of Medicine in St Louis, St. Louis, MO 63108, USA. Electronic address:

Physical activity is an essential part of general health and diabetes management. However, recommending weight-bearing physical activity for people with plantar diabetic foot ulcers is controversial, even when gold standard offloading devices are used, as it is commonly thought to delay healing. We aimed to narratively review relevant studies investigating the relationship between plantar diabetic foot ulcer healing and weight-bearing activity, plantar pressure and device adherence. Read More

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Effects of Handrail and Cane Support on Energy Cost of Walking in People With Different Levels and Causes of Lower Limb Amputation.

Arch Phys Med Rehabil 2021 Mar 5. Epub 2021 Mar 5.

Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Objective: The energy cost of walking with a lower limb prosthesis is higher than able-bodied walking and depends on both cause and level of amputation. This increase might partly be related to problems with balance control. In this study we investigated to what extent energy cost can be reduced by providing support through a handrail or cane and how this depends on level and cause of amputation. Read More

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Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions - a systematic review.

Disabil Rehabil 2021 Mar 8:1-11. Epub 2021 Mar 8.

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

Purpose: In persons with a hip or knee flexion contracture ≥25°, fitting a prosthesis is said to be difficult. This systematic review aims to assess the evidence for fitting of a prosthesis in persons with a severe contracture (≥25°) after a lower limb amputation.

Method: PubMed, Embase, Scopus, CINAHL, and Orthotics & Prosthetics Virtual Library databases were searched from inception to December 2019, using database specific search terms related to amputation, prosthesis, and contracture. Read More

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A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke.

J Neurol Phys Ther 2021 04;45(2):112-196

Department of Physical Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania and Ossur, Foothill Ranch, California (T.E.J.); Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, Illinois (S.K.); Kessler Institute for Rehabilitation, Chester, New Jersey (C.D.-W.); and Boston University College of Health and Rehabilitation Sciences: Sargent, Boston, Massachusetts (L.B.).

Background: Level of ambulation following stroke is a long-term predictor of participation and disability. Decreased lower extremity motor control can impact ambulation and overall mobility. The purpose of this clinical practice guideline (CPG) is to provide evidence to guide clinical decision-making for the use of either ankle-foot orthosis (AFO) or functional electrical stimulation (FES) as an intervention to improve body function and structure, activity, and participation as defined by the International Classification of Functioning, Disability and Health (ICF) for individuals with poststroke hemiplegia with decreased lower extremity motor control. Read More

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Effect of biomechanical footwear on upper and lower leg muscle activity in comparison with knee brace and normal walking.

J Electromyogr Kinesiol 2021 Apr 28;57:102528. Epub 2021 Jan 28.

Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland. Electronic address:

Aim: To evaluate the activity of knee stabilizing muscles while using custom-made biomechanical footwear (BF) and to compare it when walking barefoot and with a knee brace (Unloader®).

Methods: Seventeen healthy working-aged (mean age: 29 years; standard deviation: 8 years) individuals participated. The knee brace was worn on the right knee and BF in both legs. Read More

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Incidence of lower limb amputation in Central Australia.

Aust Health Rev 2021 Jun;45(3):361-367

Prosthetics/Orthotics Department, Alice Springs Hospital, 6 Gap Road, Alice Springs, NT 0870, Australia. Email:

Objective The aims of this study were to review the demographic details of those who have undergone lower limb amputation (LLA) surgery in Central Australia and determine the region-specific age-adjusted incidence rate of LLA. Methods A retrospective audit of service users who underwent LLA in a Central Australian hospital from 2012 to 2017 was undertaken. Demographic, operative and postoperative outcomes data were collected. Read More

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[Clinical experience of an offloading orthosis to prevent and heal diabetic foot ulcers of the digits].

Rev Med Suisse 2021 Feb;17(725):315-319

Institut de santé globale, Faculté de médecine, Université de Genève, 9 chemin des Mines, 1202 Genève.

Globally, every 30 seconds a lower limb amputation is carried out due to diabetes, in 85 % of cases preceded by a foot ulcer. One of the main causes of foot ulcer formation is abnormal mechanical pressure and shear, the alleviation of which is therefore a key element in the management of diabetic foot ulcers. The toes, often neglected in routine clinical examinations, are particularly vulnerable because of the thin soft tissue between the bones and the skin and because of trauma due to ill-fitting shoes. Read More

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February 2021

The lived experience of people who require prostheses or orthoses in the Kingdom of Cambodia: A qualitative study.

Disabil Health J 2021 Feb 6:101071. Epub 2021 Feb 6.

Department of Rehabilitation, Jönköping University, Sweden. Electronic address:

Background: There is an assumption that provision of assistive technologies, such as prostheses and orthoses, will improve the life situation of people with disabilities; however, this issue has been poorly addressed in low- and middle-income country settings.

Objective: The objective of this qualitative study was to explore the life experience of people who use lower-limb prosthetic or orthotic devices in Cambodia, with a view to identifying areas in which developments can be made to improve the life experiences for prosthesis and orthosis users.

Methods: Participants were recruited from 1/urban and 2/rural prosthetic and orthotic clinics, run by the same non-governmental organisation. Read More

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February 2021

Effects of mechanical interventions in the management of knee osteoarthritis: protocol for an OA Trial Bank systematic review and individual participant data meta-analysis.

BMJ Open 2021 02 5;11(2):e043026. Epub 2021 Feb 5.

Department of Orthopaedics and Sports Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

Introduction: Knee osteoarthritis (OA) is a prevalent and disabling musculoskeletal condition. Biomechanical factors may play a key role in the aetiology of knee OA, therefore, a broad class of interventions involves the application or wear of devices designed to mechanically support knees with OA. These include gait aids, bracing, taping, orthotics and footwear. Read More

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February 2021

Material properties and application of biomechanical principles provide significant motion control performance in experimental ankle foot orthosis-footwear combination.

Clin Biomech (Bristol, Avon) 2021 02 30;82:105285. Epub 2021 Jan 30.

School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.

Background: This study, the first of its kind, originated with the need for a brace (an ankle foot orthosis), to constrain ankle plantarflexion and dorsiflexion within a motion threshold of <5°. A conventional thermoplastic, solid brace failed during a quasi-static loading study, informing the investigation and development of an experimental carbon composite brace, maximizing stiffness and proximity of shank and foot cylindrical shells to provide the required degree of control.

Methods: Two experiments were conducted: a quasi-static loading study, using cadaveric limbs (n = 2), and a gait study with healthy subjects (n = 14). Read More

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February 2021

Assessment of the Shank-to-Vertical Angle While Changing Heel Heights Using a Single Inertial Measurement Unit in Individuals with Incomplete Spinal Cord Injury Wearing an Ankle-Foot-Orthosis.

Sensors (Basel) 2021 Feb 2;21(3). Epub 2021 Feb 2.

Department of Research, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands.

Previous research showed that an Inertial Measurement Unit (IMU) on the anterior side of the shank can accurately measure the Shank-to-Vertical Angle (SVA), which is a clinically-used parameter to guide tuning of ankle-foot orthoses (AFOs). However, in this context it is specifically important that differences in the SVA are detected during the tuning process, i.e. Read More

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February 2021

Health Outcomes Used to Determine Facets of Health-related Quality of Life for Post-9/11 Veterans Using Assistive Technology for A Combat-related Mobility Impairment: A Literature Review.

Mil Med 2021 Feb 4. Epub 2021 Feb 4.

Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.

Introduction: Novel rehabilitation methods, including distribution and adoption of assistive technology for lower extremity impairments, are becoming crucial to ensure positive quality of life in all individuals. The quality of life of post-9/11 combat veterans is not well understood, in comparison to research on other populations. The following essay describes a review on health outcomes used to determine health-related quality of life (HR-QoL) among combat-injured service members who require mobility-related assistive technology. Read More

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February 2021

The feasibility and validity of a wearable sensor system to assess the stability of high-functioning lower-limb prosthesis users.

J Prosthet Orthot 2020 Aug;Online first

Northwestern University Prosthetics-Orthotics Center, Chicago, Illinois.

Introduction: Lower-limb prosthesis users (LLPUs) experience increased fall risk due to gait and balance impairments. Clinical outcome measures are useful for measuring balance impairment and fall risk screening but suffer from limited resolution and ceiling effects. Recent advances in wearable sensors that can measure different components of gait stability may address these limitations. Read More

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A Biomimetic Adapter for Passive Self-alignment of Prosthetic Feet.

Mil Med 2021 01;186(Suppl 1):665-673

Ability Prosthetics & Orthotics, Mechanicsburg, PA 17050, USA.

Introduction: Dynamic alignment of lower limb prostheses is subjective and time-consuming. Compensatory gait strategies caused by prosthesis misalignment can negatively affect lower limb amputees who cannot access a certified prosthetist for alignment adjustments. The objective of this study is to evaluate a novel six-degrees-of-freedom passive transtibial prosthetic adapter that self-aligns during various phases of gait. Read More

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January 2021

Influence of age, gender and obesity on pressure discomfort threshold of the foot: A cross-sectional study.

Clin Biomech (Bristol, Avon) 2021 02 24;82:105252. Epub 2020 Dec 24.

Instituto de Biomécanica de Valencia, Valencia, Spain. Electronic address:

Background: Foot pain is a highly prevalent health problem for which measures such as a pattern of Pressure Discomfort Threshold of the foot plantar surface can provide valuable information for orthosis design. This study aimed to describe such pattern as a tool for the assessment of painful conditions of the feet and to analyse how it modifies according to age, gender and obesity.

Methods: A cross-sectional study was performed with participants allocated in: Group 1 people aged 20 to 35 years, Group 2 aged 50 to 65 years and Group 3 aged over 65. Read More

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February 2021