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Flexion Deformity of the Knee
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
Active knee extension was restored, and deformities of the knees and feet were adequately corrected (Figure 11.6a, 11.6b). The girl began walking on her feet initially with ankle-foot orthoses and the support of a walker (Figure 11.7). The orthosis was discarded after a year. She gradually began walking independently and was walking well without the walker when last seen four years after the surgery, by which time she was skeletally mature.
Musculoskeletal health in the community
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Rehabilitation after osteoporotic fractures is very essential for patients to return to their normal life. Spinal orthoses have been used in the management of thoracolumbar injuries. Women with established osteoporosis-wearing spinal orthoses for at least 2 hours/day for 6 months showed significantly reduced back pain and increased personal isometric trunk muscle strength (Dionyssiotis et al., 2014). Wearing the orthosis can even give rise to a 73% increase in back extensor strength, 58% increase in abdominal flexor strength, 11% increase in angle of kyphosis, a 23% decrease in body sway, 38% decrease in average pain, 15% increase in wellbeing and 27% decrease in limitations of daily living (Dionyssiotis et al., 2014).
Principles of foot and ankle orthoses
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
An orthosis (orthoses – plural) is a medical device that is applied to an external part of the body with the aim of reducing load upon pathological soft tissue, preventing deformity, reducing pain and improving mobility. Every orthosis applies force with the aim of influencing a limb segment. These forces must be applied over a large surface area, where possible, to improve comfort and to minimise any pressure being exerted on the skin. If the forces are too high and not distributed well enough, this is likely to result in discomfort and rejection by the patient. The name of the orthosis is usually derived from the joints that it spans, e.g., functional foot orthosis (FFO), ankle foot orthosis (AFO), knee ankle foot orthosis (KAFO), etc.
Effect of a semi-rigid backpack type thoracolumbar orthosis on thoracic kyphosis angle and muscle performance in older adults with hyperkyphosis: a randomized controlled trial
Published in Disability and Rehabilitation, 2023
Fatemeh Keshavarzi, Fatemeh Azadinia, Saeed Talebian, Minoo Khalkhali Zavieh, Omid Rasouli
The participants in the experimental group received a semi-rigid TLO, which consisted of two posterior aluminum bars, an abdominal pad, and shoulder straps (Figure 1). The posterior bars are shaped according to the patients’ vertebral column. The abdominal pad helps to reduce the load on the spine by increasing abdominal pressure. The shoulder straps provide posterior forces for counteracting kyphotic posture. The same certified orthotist fit the orthoses for all participants and taught them how to wear and remove orthoses. The participants were asked to wear orthosis for 12 weeks, they received no other treatment, and no change was applied in their usual physical activity. In the first week, the orthosis was worn for 30 min daily, and throughout the second week, this period gradually increased to 2 h per day. From the beginning of the third week to the end of week 12, the participants were asked to wear orthoses for at least 2 h a day and allowed to wear orthoses for a maximum of 4 h per day based on their level of physical activity. The participants were asked to record orthosis’s donning and doffing hours in a daily log to monitor their adherence to our recommendations about the hours of orthosis use during the day. During the intervention period, the participants visited the orthotist each month to reset the orthosis.
Effect of knee braces and insoles on clinical outcomes of individuals with medial knee osteoarthritis: A systematic review and meta-analysis
Published in Assistive Technology, 2022
Mobina Khosravi, Taher Babaee, Aliyeh Daryabor, Maryam Jalali
Our results show that most studies evaluate the short-term effects of these orthoses on clinical outcomes. The methodological quality of almost two-thirds of the studies was moderate. Most of the studies did not achieve the score 1 in power and external validity items. All studies have described the hypothesis, main outcome, inclusion and exclusion criteria, and outcomes. These studies have evaluated different types of braces (e.g., pneumatic and unloader) and insoles (e.g., lateral wedge insole with/without arch support or subtalar strap). Our results show that both orthotic interventions improve the mentioned outcomes in knee osteoarthritis patients. However, there were some controversies among the studies regarding the advantage of using one compared to the other. This may be because of different orthosis designs and methodologies.
Ankle-foot orthoses improve walking but do not reduce dual-task costs after stroke
Published in Topics in Stroke Rehabilitation, 2021
Richard Drake, Kim Parker, Kerry-Lee Clifton, Stefan Allen, James Adderson, Anita Mountain, Gail A. Eskes
Individuals with hemiplegia due to stroke are known to perform poorly on objective measures of gait, and as a result, an ankle-foot orthosis (AFO) is typically prescribed to help reduce foot drop during the swing phase of gait and subsequently improve gait outcomes. A relatively recent assessment of the top ten research priorities for stroke (based on a consensus of clinicians, patients, and caregivers as per the model of the James Lind Alliance) identified improving cognition as a top priority, fatigue prevention as the sixth highest priority, and treatments to improve balance, gait, and mobility as the seventh.1 A sub-item of the balance, gait, and mobility priority1 is the need to investigate the ability of AFOs to improve balance and walking. Consensus conferences have highlighted the need for more research on orthoses and their clinical applications.2–4