Mapping the challenges and facilitators faced by orthotists, physiotherapists and prosthetists to integrating non-3D gait evaluation into routine practice: A scoping review of key concepts and knowledge gaps.

Abstract

Objective: To systematically map the existing literature on the challenges and facilitators associated with integrating non-3D gait evaluation into routine clinical practice by orthotists, physiotherapists and prosthetists across diverse settings and contexts, while identifying gaps in the evidence base related to these challenges and facilitators.

Data sources: Following PRISMA-ScR guidelines, we searched databases from 1980 to December 2024 (CINAHL, OVID [including APA PSYCH], PEDRO and WEB OF SCIENCE - ALL DATABASES [including MEDLINE]). We also carried out secondary searching through reference lists and Google Scholar.

Study selection: Two authors separately screened 100 sources for calibration. One author screened the remaining sources and referred ambiguous sources to two others. Included sources studied challenges and facilitators to non-3D gait evaluation.

Data extraction: Two authors developed and piloted an Excel^TM data extraction form using 20 sources. Thereafter, one author extracted data, spot-checked by a second author.

Data synthesis: We screened 11,641 sources, selecting 11 for inclusion. Ten focused solely on physiotherapy, one examined physiotherapy and prosthetics, none addressed orthotics.

Conclusions: This scoping review examines challenges and facilitators to the adoption of non-3D gait evaluation methods in orthotics, physiotherapy and prosthetics. Despite benefits, these methods are underused due to clinician awareness, confidence, experience, motivation, environmental constraints, resource limitations (e.g., cost) and time pressures. Gait evaluation methods may also be difficult to use, unrealistic, or lack meaningful data. Clearer guidelines, targeted education and healthcare provider support are essential. Improving the usability of gait evaluation methods and their integration into clinical practice is critical. Research gaps in prosthetics, orthotics and specific gait evaluation methods highlight the need for further investigation to enhance training and inform policy adjustments, improving patient outcomes. Future research should investigate clinician perspectives on specific gait evaluation methods, such as video vector and standardised observational gait assessments, across specialties and their different specialisms.