A Pilot Study to Assess the Immediate Effect of Dynamic Carbon Ground Reaction Ankle Foot Orthoses on Balance in Individuals with Charcot-Marie-Tooth in a Clinical Setting

Charcot-Marie-Tooth (CMT) causes muscle weakness and atrophy generally in distal extremities, with or without sensory changes. These impairments contribute to impaired balance and gait and increase risk for falls and secondary injuries. Dynamic Carbon Ground Reaction Ankle Foot Orthoses (DCGR-AFOs) are one type of lower extremity orthosis that can be prescribed to help improve gait and balance in this patient population. To our knowledge, no studies have evaluated the immediate impact of DCGR-AFOs on gait and balance in this population. In this pilot study, 9 individuals with CMT and gait impairment were seen in clinical setting by a physical therapist and orthotist. Participants were asked to complete the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and tasks on the 4-Item Dynamic Gait Index (DGI) with and without bilateral DCGR-AFOs to assess static and dynamic balance. The average DGI scores were 6/12 without the DCGR-AFOs and 10/12 with the DCGR-AFOs. Improvements on the mCTSIB varied. The findings in this study suggest an immediate improvement in dynamic balance during ambulation with the use of DCGR-AFOs, as assessed by the 4-Item DGI. Data on static balance did not reach significance suggesting the need for future studies to further assess the effects of DCGR-AFOs on static standing balance, as well as the impact of training with physical therapists. This pilot study demonstrates that it is possible to demonstrate potential benefits of DCGR-AFOs with a gross fitting in a clinical setting, prior to referral to an orthotist for custom fitting.

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A pilot study of a cross trial with randomised use of ankle foot orthoses and Ligaflex for People with Charcot Marie Tooth disease

http://isrctn.org/> ◽

10.1186/isrctn61814249 ◽

2013 ◽

Author(s):

Margaret Phillips

Keyword(s):

Pilot Study ◽

Foot Orthoses ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Ankle Foot Orthoses ◽

Tooth Disease

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A pilot study of a crossover trial with randomized use of ankle-foot orthoses for people with Charcot–Marie–Tooth disease

Clinical Rehabilitation ◽

10.1177/0269215511426802 ◽

2011 ◽

Vol 26 (6) ◽

pp. 534-544 ◽

Cited By ~ 15

Author(s):

Margaret F Phillips ◽

Zoe Robertson ◽

Brian Killen ◽

Barney White

Keyword(s):

Pilot Study ◽

Crossover Trial ◽

Foot Orthoses ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Ankle Foot Orthoses ◽

Tooth Disease

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Development of a Best Practice Statement on the Use of Ankle-Foot Orthoses Following Stroke in Scotland

Prosthetics and Orthotics International ◽

10.3109/03093646.2010.486392 ◽

2010 ◽

Vol 34 (3) ◽

pp. 245-253 ◽

Cited By ~ 17

Author(s):

Roy Bowers ◽

Karyn Ross

Keyword(s):

Health Service ◽

Working Group ◽

Best Practice ◽

Foot Orthoses ◽

Ankle Foot Orthoses ◽

Expert Working Group ◽

Health Service Quality ◽

The Impact ◽

Successes And Challenges

A National Health Service Quality Improvement Scotland (NHS QIS) scoping exercise in 2007 identified the use of ankle-foot orthoses (AFOs) following stroke as a clinical improvement priority, leading to the development of a best practice statement (BPS) on AFO use after stroke. This paper outlines the development process of the BPS which is available from NHS QIS. The authors were involved as part of a working group that included practitioners from the fields of orthotics, physiotherapy, stroke nursing and bioengineering, staff of NHS QIS and a patient representative. In consultation with an NHS QIS health services researcher, the authors undertook a systematic literature review to evidence where possible the recommendations made in the BPS. Where evidence was unavailable, consensus was reached by the expert working group. As the BPS was designed for the non-specialist and non-orthotic practitioner the authors also developed educational resources which were included within the BPS to aid the understanding of the principles underpinning orthotic design and prescription. The BPS has been widely distributed throughout the health service in Scotland and is available electronically at no cost via the NHS QIS website. As part of an ongoing evaluation of the impact of the BPS on the quality of orthotic provision, NHS QIS has invited feedback regarding successes and challenges to implementation.

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Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

Children ◽

10.3390/children8100903 ◽

2021 ◽

Vol 8 (10) ◽

pp. 903

Author(s):

Diogo Ricardo ◽

Maria Raposo ◽

Eduardo Cruz ◽

Raul Oliveira ◽

Filomena Carnide ◽

...

Keyword(s):

Cerebral Palsy ◽

Scientific Data ◽

Cochrane Library ◽

Leaf Spring ◽

Foot Orthoses ◽

Gait Patterns ◽

Functional Scores ◽

Ankle Foot Orthoses ◽

Pathological Gait ◽

The Impact

Background: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. Methods: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. Results: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. Conclusions: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.

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Contributions of Non-professional Local Physical Therapist In the Promotion of Community Health Activities in the Arsi Zone, Southeast Ethiopia (Preprint)

10.2196/preprints.27789 ◽

2021 ◽

Author(s):

Leta Melaku

Keyword(s):

Health Promotion ◽

Physical Therapy ◽

Physical Therapists ◽

Physical Therapist ◽

Sampling Technique ◽

Cross Sectional Study ◽

Cross Sectional ◽

Arsi Zone ◽

Southeast Ethiopia ◽

The Impact

BACKGROUND Physical activity is a first-line therapy and secures against persistent illnesses. Essential medical care professionals are obviously situated to advance actual action. Active recuperation mediations focused on advancement and upkeep of wellbeing, personal satisfaction, and wellness. There is, notwithstanding, a deficiency of such examination proof in Ethiopia. OBJECTIVE We planned to assess the degree of KAP of nonprofessional local physical therapists' towards wellbeing advancement in Arsi zone of Oromia, Southeast Ethiopia. METHODS Community based cross sectional study was conducted in April 2018 among 45 physical therapists. Data were collected using pre-tested, structured and self-administrative questionnaires. Participants were selected by quota sampling technique. The questionnaire was drafted specifically to test the KAP. Data were double entered and analyzed by SPSS Version 20.0 program. Descriptive statistics were used. The KAP were estimated using proportion. RESULTS In present response rate is 90.0%. Ages of respondents ranged between 24 – 87 years. 57.8% of participants got initial physical therapy knowledge from either of their parents. 53.3% of the respondents hear about health promotion from families and friends. 57.8% of them provided health promotion at their workplace. The overall percentage of all the respondents’ KAP in health promotion was 60.1%. CONCLUSIONS The respondents’ have good KAP towards health promotion. However there is still room for improvement. Also there is a lack of proper guide lines in determining the impact physical therapy.

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BalanCI: Head-Referenced Cochlear Implant Stimulation Improves Balance in Children with Bilateral Cochleovestibular Loss

Audiology and Neurotology ◽

10.1159/000503135 ◽

2019 ◽

Vol 25 (Suppl. 1-2) ◽

pp. 60-71 ◽

Cited By ~ 3

Author(s):

Nikolaus E. Wolter ◽

Karen A. Gordon ◽

Jennifer L. Campos ◽

Luis D. Vilchez Madrigal ◽

David D. Pothier ◽

...

Keyword(s):

Postural Control ◽

Cochlear Implant ◽

Virtual Environment ◽

Clinical Setting ◽

Spatial Information ◽

Center Of Pressure ◽

Effective Means ◽

Sensory Information ◽

Clinical Test ◽

The Impact

Introduction: To determine the impact of a head-referenced cochlear implant (CI) stimulation system, BalanCI, on balance and postural control in children with bilateral cochleovestibular loss (BCVL) who use bilateral CI. Methods: Prospective, blinded case-control study. Balance and postural control testing occurred in two settings: (1) quiet clinical setting and (2) immersive realistic virtual environment (Challenging Environment Assessment Laboratory [CEAL], Toronto Rehabilitation Institute). Postural control was assessed in 16 and balance in 10 children with BCVL who use bilateral CI, along with 10 typically developing children. Children with neuromotor, cognitive, or visual deficits that would prevent them from performing the tests were excluded. Children wore the BalanCI, which is a head-mounted device that couples with their CIs through the audio port and provides head-referenced spatial information delivered via the intracochlear electrode array. Postural control was measured by center of pressure (COP) and time to fall using the WiiTM (Nintendo, WA, USA) Balance Board for feet and the BalanCI for head, during the administration of the Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). The COP of the head and feet were assessed for change by deviation, measured as root mean square around the COP (COP-RMS), rate of deviation (COP-RMS/duration), and rate of path length change from center (COP-velocity). Balance was assessed by the Bruininks-Oseretsky Test of Motor Proficiency 2, balance subtest (BOT-2), specifically, BOT-2 score as well as time to fall/fault. Results: In the virtual environment, children demonstrated more stable balance when using BalanCI as measured by an improvement in BOT-2 scores. In a quiet clinical setting, the use of BalanCI led to improved postural control as demonstrated by significant reductions in COP-RMS and COP-velocity. With the use of BalanCI, the number of falls/faults was significantly reduced and time to fall increased. Conclusions: BalanCI is a simple and effective means of improving postural control and balance in children with BCVL who use bilateral CI. BalanCI could potentially improve the safety of these children, reduce the effort they expend maintaining balance and allow them to take part in more complex balance tasks where sensory information may be limited and/or noisy.

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Ankle foot orthoses for people with Charcot Marie Tooth disease – views of users and orthotists on important aspects of use

Disability and Rehabilitation Assistive Technology ◽

10.3109/17483107.2010.549899 ◽

2011 ◽

Vol 6 (6) ◽

pp. 491-499 ◽

Cited By ~ 12

Author(s):

Margaret Phillips ◽

Kathryn Radford ◽

Adrian Wills

Keyword(s):

Foot Orthoses ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Ankle Foot Orthoses ◽

Tooth Disease

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Physical Therapists' Perceptions of Ease of Care in Patients Receiving 2 Forms of Analgesia After Total Hip Arthroplasty

Physical Therapy ◽

10.2522/ptj.20080323 ◽

2010 ◽

Vol 90 (5) ◽

pp. 707-713 ◽

Cited By ~ 4

Author(s):

Michael H. Bourne ◽

Jacques E. Chelly ◽

C.V. Damaraju ◽

Winnie W. Nelson ◽

Jeff R. Schein ◽

...

Keyword(s):

Physical Therapists ◽

Physical Therapist ◽

Open Label ◽

Time Efficiency ◽

Total Hip ◽

Phase Iiib ◽

Iontophoretic Transdermal System ◽

American Society ◽

The Impact ◽

Satisfaction Subscale

Background Pain management modalities that facilitate patient mobility may contribute to recovery after total hip replacement (THR) surgery. Objective The aim of this study was to evaluate the impact of morphine intravenous (IV) patient-controlled analgesia (PCA) and the fentanyl iontophoretic transdermal system (fentanyl ITS) on physical therapists' ability to complete care tasks for patients after THR. Design The data were from an open-label, randomized, multicenter, active-control phase IIIb clinical trial. Methods The settings were 52 US-based teaching and community hospitals. The patients were ≥18 years of age (mean [SEM]: 62.8 [0.6] years in the fentanyl ITS group and 62.9 [0.6] years in the morphine IV PCA group); had an American Society of Anesthesiologists physical status of I, II, or III; and were scheduled to undergo primary unilateral THR surgery. The patients were randomized to receive analgesia for up to 72 hours via the fentanyl ITS (40 μg of fentanyl over 10 minutes for up to 6 doses per hour for 24 hours or 80 doses per system, whichever occurred first) or morphine IV PCA (1-mg bolus doses [with a 5-minute lockout interval between doses] for up to 10 doses per hour for 24 hours). All patients received the usual treatment administered by physical therapists. After each therapy session, physical therapists completed a validated Physical Therapist Ease-of-Care Questionnaire, which included time efficiency and convenience subscales (lower scores indicated more positive responses) and a satisfaction subscale (a higher score indicated a more positive response). Therapists whose average scores were ≤2 on all items of the time efficiency and convenience subscales or ≥4 on both items of the satisfaction subscale were considered responders. Results Higher percentages of physical therapists were responders for the fentanyl ITS than for morphine IV PCA on the subscales that assessed time efficiency (84.9% and 59.1%, respectively), convenience (86.6% and 71.2%, respectively), and satisfaction (54.3% and 30.5%, respectively). Higher percentages of physical therapists favored the fentanyl ITS than favored morphine IV PCA. Limitations The trial was limited by its open-label design, and physical therapists were more familiar with IV PCA than with the fentanyl ITS. Conclusions The findings demonstrate benefits to physical therapists of using the fentanyl ITS over morphine IV PCA in terms of time efficiency, convenience, and satisfaction.

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