The Effect of Ankle-Foot Orthoses on Self-Reported Balance Confidence in Persons With Chronic Poststroke Hemiplegia.

The effect of ankle-foot orthoses on self-reported balance confidence in persons with chronic poststroke hemiplegia.

Prosthet Orthot Int. 2013 Jun 24;
Zissimopoulos A, Fatone S, Gard S

Background:One intervention often used to address physical impairments post stroke is an ankle-foot orthosis. Ankle-foot orthoses may improve walking speed, stride length, and gait pattern. However, effects on balance, crucial for safe ambulation, are thus far inconclusive. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one’s ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation (as defined by the International Classification of Functioning, Disability, and Health) than physical performance measures of gait or balance.Objectives:We investigated whether self-efficacy, or balance confidence when referred to in the context of balance capabilities, is improved with ankle-foot orthosis use.Study design:Repeated measures study design.Methods:Balance confidence was measured using the Activities-specific Balance Confidence Scale in 15 persons with chronic poststroke hemiplegia, with and without their regular ankle-foot orthosis.Results:Activities-specific Balance Confidence Scale scores were significantly higher (p ? 0.01) for the ankle-foot orthosis condition compared to no ankle-foot orthosis.Conclusions:One mechanism by which ankle-foot orthosis use may influence balance is improved balance confidence. Future work should explore the specific mechanisms underlying this improvement in self-efficacy.Clinical relevanceSelf-efficacy may be an important factor to consider when evaluating functioning post stroke. Rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations, particularly in the fall-prone poststroke population. Study results provide evidence for improvements in balance confidence with ankle-foot orthosis use. HubMed – rehab


The Araz medial linkage orthosis–a new orthosis for walking in patients with spinal cord injury: A single patient study.

Prosthet Orthot Int. 2013 Jun 24;
Arazpour M, Bani MA, Hutchins SW, Sayyadfar M

Background:This article describes the development and evaluation of a new medial linkage orthosis to potentially assist paraplegic patients to ambulate.Case description and methods:The orthosis was initially designed using the solid works program and was subsequently evaluated when used by a spinal cord injury subject to test the structure during standing and walking. Gait analysis was used to compare the medial linkage orthosis to a standard hip-knee-ankle-foot orthosis.Findings and outcomes:The results demonstrated improvements in gait velocity, step length, and decreased compensatory motions in the new orthosis compared to the hip-knee-ankle-foot orthosis.Conclusions:The results propose that this new Araz medial linkage orthosis could be used to assist paraplegic subjects who have adequate ranges of motion and also with weakness or reduced tone to stand and walk.Clinical relevanceThe Araz medial linkage orthosis can potentially provide standing and walking assistance for spinal cord injury patients. HubMed – rehab


Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome.

Prosthet Orthot Int. 2013 Jun 24;
Mlakar M, Ramstrand N, Burger H, Vidmar G

Background:Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position.Objectives:We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses.Study design:Experimental.Methods:Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20° of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side.Results:Orthosis type did not significantly affect grip strength (p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips (p < 0.050). The grips of the affected side were weaker than those of the nonaffected side (p = 0.002).Conclusions:In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20° wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker.Clinical relevanceThe findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome. HubMed – rehab