Prosthetics and Orthotics International最新文献

{"title":"Longevity and effectiveness of 3D-printed transtibial prosthetic sockets in rural Sierra Leone: A pilot study with 2.5-year follow-up.","authors":"Merel van der Stelt, Lars Brouwers, Sallieu Jalloh, Osman Kamara, Martin Grobusch, Thomas Maal, Ruud Leijendekkers","doi":"10.1097/PXR.0000000000000465","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000465","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic care is limited in low- and middle-income countries. Finding solutions to improve prosthetic accessibility is commendable, and 3D printing presents a potential solution.</p><p><strong>Objectives: </strong>To evaluate the durability and usage of 3D-printed transtibial prosthetic sockets, as well as to assess the impact of these prostheses on participants' functioning and health-related quality of life (HRQoL).</p><p><strong>Study design: </strong>A longitudinal cohort study with 2.5 year follow-up.</p><p><strong>Methods: </strong>Participants received a locally manufactured transtibial prosthesis with a 3D-printed prosthetic socket at the 3D Lab at Masanga Teaching Hospital in Sierra Leone. Baseline, 10-week, 9-month, 1.5-year, and 2.5-year follow-up assessments included (1) quantifying prosthetic longevity, (2) prosthetic use using activity sensors, (3) lower extremity functional status using the adopted Orthotics and Prosthetics User's Survey (OPUS) (range: 0-60), (4) disease-specific health-related quality of life using the adapted OPUS survey (range: 0-36), and (5) generic health-related quality of life using EQ-5D-3L (range: -0.145 to 0.9) and visual analog scale score (range: 0-10).</p><p><strong>Results: </strong>Nine participants participated in the study. Six prosthetic sockets exhibited damage after 361, 398, 399, 553, 641, and 756 days. One participant used the prosthesis for 2.5 years, another had their socket replaced due to socket size problems, and one was lost to follow-up. At 2.5 years, the median wear time was 12.4 (11.4-13.5) hours daily, with 6906 steps (4277-9792), 65% (51%-82%) while wearing the prosthesis. Median scores at follow-up compared with baseline were as follows: OPUS Function (47-55 points), OPUS disease-specific health-related quality of life (17-34 points), EQ-5D-3L (0.741-0.744), and visual analog scale (6-10 points).</p><p><strong>Conclusions: </strong>Most prostheses were extensively used. The study underscores the need for research on enhancing the durability of 3D-printed sockets.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative methods and criteria for modifying and defining transtibial prosthetic alignment: A systematic review.","authors":"Nahid Tafti, Reza Safari, Fatemeh Hemmati, Mohammad Javad Nouri, Mohammad Taghi Karimi","doi":"10.1097/PXR.0000000000000466","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000466","url":null,"abstract":"<p><p>This study aimed to better understand the various objective techniques employed for evaluating and correcting prosthetic alignment and examine proposed methods to define a predefined (a priori) alignment criterion grounded in clinically accepted alignment. A comprehensive search of 5 online databases and a hand search of reference lists of the included papers were conducted. The American Academy of Orthotics and Prosthetics checklists were used to assess the quality of included studies. A total of 247 adults with transtibial amputations participated in the 20 studies included in this study. These studies vary in methodology, approach, instrumentation, and alignment steps. The results indicate that none of the tested methods can replace the current clinical approach. Nevertheless, some techniques can assist the prosthetist in quantifying and adjusting alignment, such as using instruments to measure the moments at the base of the socket or visualizing the ground reaction force. Based on current evidence, it is not possible to define a universal priori alignment because of individual differences and the complexity and multifactorial nature of alignment. However, each prosthetic user appears to have a specific alignment configuration that they find acceptable. Combining various techniques, such as anatomical-based alignment and biomechanical measurement tools, may help to objectively quantify a priori alignment for an individual.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does the content of the 20th I.S.P.O. World Congress align with the United Nations Sustainable Development Goals?","authors":"David F Rusaw, Alix Chadwell, Liselotte Hermansson, Han Houdijk, Anton G Johannesson, Peter Kyberd, Rune Nilsen, Pia Nolstedt, Dick Plettenburg, Erik Prinsen, Stephen Seccombe, Saeed Zahedi","doi":"10.1097/PXR.0000000000000468","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000468","url":null,"abstract":"","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative population data for the Orthotics and Prosthetics User's Survey (OPUS) Client Satisfaction with Services (CSS) module in Australia: A pilot study.","authors":"Emily Ridgewell, Anastasia Haloulos, Jessica Landers, Michael P Dillon","doi":"10.1097/PXR.0000000000000456","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000456","url":null,"abstract":"<p><strong>Background: </strong>Many funding and accreditation bodies require orthotic and prosthetic (O&P) services to measure consumer satisfaction. While the Orthotics and Prosthetics User's Survey Client Satisfaction with Services (OPUS-CSS) module is a valid and reliable instrument to measure consumer satisfaction with O&P services, there are no normative population data to facilitate benchmarking.</p><p><strong>Objectives: </strong>Describe normative population data for the OPUS-CSS in Australia and identify demographic and service-related factors for the most and least satisfied quartiles.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Participants were adult O&P consumers, or parents/guardians of pediatric O&P consumers. Consumers were convenience sampled from O&P services enrolled in the Australian Orthotic Prosthetic Association Consumer Experience Program. As part of the Consumer Experience Program, an electronic survey was administered when a new orthosis/prosthesis was provided. The survey included demographics, service-related factors, and the OPUS-CSS module.</p><p><strong>Results: </strong>Consumers (n = 180) were highly satisfied with the O&P service they received (OPUS-CSS median score 78.7, interquartile range 55.1-100); acknowledging the distribution of scores was positively skewed with a ceiling effect. The factors that varied most between the upper and lower quartiles included age, education, income, work status, number of comorbidities, identifying as Aboriginal or Torres Strait Islander, and speaking a language other than English at home.</p><p><strong>Conclusions: </strong>On average, consumers were highly satisfied with the O&P services received. Given the ceiling effect, the OPUS-CSS may not adequately distinguish between consumers who were highly satisfied. These pilot data can help inform future research to identify the factors that most influence consumer satisfaction with O&P services.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the rationale for prescribing ankle-foot orthoses and supramalleolar orthoses to children with cerebral palsy among pediatric orthotists in Australia.","authors":"Asumi H Dailey, Sarah Anderson, Michael P Dillon","doi":"10.1097/PXR.0000000000000457","DOIUrl":"10.1097/PXR.0000000000000457","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the rationale for prescribing ankle-foot orthoses and supramalleolar orthoses in children with cerebral palsy among pediatric orthotists in Australia.</p><p><strong>Methods: </strong>Purposive, convenience, and snowballing sampling were used to recruit pediatric orthotists across Australia. Semistructured interviews were recorded and transcribed. The data were independently coded to derive themes and subthemes with illustrative first-person quotes.</p><p><strong>Results: </strong>Participants (n = 16) in the sample were diverse in their age, years of clinical experience, and state of residence reflecting the breadth of pediatric orthotists in Australia. Two themes were generated: rationale for orthotic prescription and alignment of prescription rationale with child/family goals. Experienced clinicians could clearly articulate the key factors that influence their orthotic prescription aligned to the reasons why children/families sought orthotic intervention. Early to mid-career clinicians found this more challenging.</p><p><strong>Conclusions: </strong>The rationale for the orthotic prescription should be aligned with the child/family's treatment goals. With a clear focus on treatment goals, the rationale for prescribing either ankle-foot orthoses or supramalleolar orthoses could be clearer if clinicians focused on key primary factors (eg, presence of crouch gait) and then optimized the prescription using a range of secondary factors (eg, body mass).</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Custom-made foot orthoses with and without heel plugs and their effect on treatment outcomes and plantar pressures in patients with plantar fasciitis: A crossover study.","authors":"Megan E R Balsdon, Colin E Dombroski","doi":"10.1097/PXR.0000000000000450","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000450","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis (PF) is considered to be the most common cause of plantar heel pain in adults. Various types of foot orthoses (FOs) have been used to treat plantar heel pain, between flat ethylene-vinyl acetate (EVA) devices, to prefabricated orthoses, to completely custom FOs. The objective of this crossover study was to quantify both objective plantar pressures, and subjective foot function and comfort ratings for two custom foot orthoses (CFOs), one with a heel plug (HP) and one without.</p><p><strong>Methods: </strong>Twenty-one patients with diagnosed PF participated in this study and were casted using a semi-weight-bearing foam box cast. Both CFOs were made with the same materials and specifications, but the HP orthosis had a softer blue PORON® plug under the heel for added cushioning. The foot function index (FFI) was given at weeks 0, 4, and 8, as well as a subjective comfort rating at 4 and 8 weeks. Plantar pressures were recorded during treadmill walking for both devices in a running shoe after 8 weeks, after having worn each pair for 4 weeks. Average pressure, peak pressure, and pressure contact area were determined for 3 regions of the foot: hindfoot, midfoot, and forefoot. A paired samples t test determined differences in each region.</p><p><strong>Results: </strong>Average pressure, peak pressure, and pressure contact area were significantly reduced at the hindfoot in the HP orthosis (P < 0.001), and peak pressure was significantly reduced at the midfoot with the HP orthosis (P < 0.05). Total FFI scores were significantly reduced with both orthosis types compared to baseline (P < 0.01), but there was no difference in FFI scores or comfort scores between CFO conditions.</p><p><strong>Conclusions: </strong>CFOs with heel plugs are more effective at reducing plantar pressure at the heel in patients with PF compared to CFOs without heel plugs. Both CFOs were effective at reducing FFI scores, showing an improvement in pain, and an increase in function and activity after both 4 and 8 weeks of treatment.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee biomechanics during walking in individuals with anterior cruciate ligament repair: The role of a custom 3D-printed knee brace.","authors":"Florian Mougin, Mickaël Begon, Gauthier Desmyttere, Jacinte Bleau, Marie-Lyne Nault, Yosra Cherni","doi":"10.1097/PXR.0000000000000452","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000452","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injuries frequently lead to altered gait biomechanics and muscle activation patterns, increasing the risk of osteoarthritis. Knee braces are commonly used to address these issues although a lack of consensus remains regarding their clinical benefits. The most recent 3D-printed braces, lighter and personalized, could improve rehabilitation.</p><p><strong>Objectives: </strong>To evaluate the effect of a novel custom-made 3D-printed knee brace (Provoke™) in individuals after unilateral ACL reconstruction during walking. The brace incorporates an asymmetrical hinge system aimed at stabilizing the knee joint while minimizing compensatory movements.</p><p><strong>Methods: </strong>Fourteen participants with unilateral ACL reconstruction wore the Provoke™ brace while walking at comfortable and fast paces. Knee kinematics and kinetics and muscular activity (rectus femoris, vastus medialis, and semitendinosus) were assessed with and without the brace. Nonparametric paired t tests were used to assess the biomechanical effect of the brace.</p><p><strong>Results and conclusions: </strong>The Provoke™ brace improved knee kinematics, facilitating a more neutral knee position by reducing valgus angles (-1.95°) and increasing flexion angles (+1.14°). In addition, it enhanced muscle activation, particularly of the rectus femoris, suggesting improved quadriceps function. Overall, the Provoke™ brace effectively improves knee function and reduces muscle imbalances in individuals undergoing ACL reconstruction. It may help prevent further injury and reduce the risk of post-traumatic osteoarthritis development. The long-term effects of brace use in ACL rehabilitation must be investigated.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dual-task training with ankle-foot orthosis on stroke gait.","authors":"Negin Mizangir, Aliyeh Daryabor, Maryam Samadian, Seyyed Payam Shariatpanahi, Sedigheh Sadat Naimi","doi":"10.1097/PXR.0000000000000451","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000451","url":null,"abstract":"<p><strong>Background and objective: </strong>There is limited research on the use of ankle-foot orthosis (AFO) with dual-task training. The aim of the study was to assess impact of orthotic use during dual-task training in patients who have had a stroke during walking.</p><p><strong>Study design: </strong>The quasi-experimental study.</p><p><strong>Methods: </strong>Eleven hemiplegic people after stroke, aged 35-65 years, underwent gait training with dual task for 10 daily sessions over 4 weeks, guided by a physiotherapist while wearing an AFO. Gait was measured under 2 conditions-only dual-task walking and dual-task walking with the AFO-at baseline and after 4 weeks of training using a motion capture system. The gait parameters were compared before and after intervention in each condition and between 2 walking conditions after intervention using paired t test.</p><p><strong>Results: </strong>After 4-week intervention, there was no significant difference in any gait parameters between 2 walking conditions. In dual-task walking alone, several gait parameters were significantly increased compared to baseline, including peak ankle plantarflexion angle, peak knee flexion angle in loading response, peak knee extension moment in response loading, and peak hip flexion moment in preswing. In dual-task walking with AFO, peak knee flexion angle and peak knee and hip extension moments in loading response phase were significantly increased after intervention compared to baseline.</p><p><strong>Conclusions: </strong>Although the dual-task training has had a positive effect on some aspects of gait kinetics and kinematics in patients who have had a stroke, the AFO had no additional effect on dual-task walking.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized task difficulty promotes balance training outcomes and self-efficacy in individuals with lower limb loss.","authors":"Fu-Lien Wu, Yu-Chen Chung, Szu-Ping Lee","doi":"10.1097/PXR.0000000000000454","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000454","url":null,"abstract":"<p><p>An ideal motor skill learning typically features adaptive task difficulty to facilitate training outcomes and avoid frustration, yet this concept has not been explored in balance training for individuals with diminished postural control including lower limb loss. The purposes of this study were (1) to examine a novel stabilometer-based task with individualized difficulty levels as a balance training protocol and (2) to compare the task performance and self-efficacy between participants receiving the training with and without individualized task difficulty. Ten older adults and 10 individuals with unilateral lower limb amputation were recruited. The experimental group received training with task difficulty individualized based on their pretraining weight-bearing capacities, whereas the control group received standard training without difficulty adjustment. Participants were instructed to maintain the stabilometer in a horizontal position for as long as possible over 20 trials (4 blocks, 30 s per trial). Performance feedback and task-related self-efficacy were assessed after each block. Participants in the 2 groups were comparable in age (62.1 vs. 63.5 years), gender composition (4 females), and amputation levels (3 with transfemoral amputation). Significant interactions between group and trial/block in time in balance (experimental group: 7.8 to 16.9 s, control: 8.5 to 8.2 s, P = 0.002), root-mean-square error (experimental group: 10.9° to 6.8°, control: 10.9° to 10.8°, P = 0.002), and self-efficacy (P = 0.005∼0.012) were detected. The training protocol with individualized difficulty levels promoted greater improvements in balance performance and self-efficacy. Individualizing task difficulty based on participant's capacity is important for improving balance performance and self-efficacy. This training protocol is feasible and can be applied clinically to improve balance and postural confidence in individuals with lower limb loss.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effect of gait plate insole and medial-wedge insole on foot progression angle and balance of children with in-toeing gait.","authors":"Farzaneh Manouchehri, Mohammad Hadadi, Mokhtar Arazpour","doi":"10.1097/PXR.0000000000000447","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000447","url":null,"abstract":"<p><strong>Background: </strong>Rotational deformities, particularly in-toeing gait, are prevalent in children's lower limbs.</p><p><strong>Objectives: </strong>To assess the effects of gait plate insoles (GPI) and medial-wedge insoles (MWI) on foot progression angle (FPA) and balance in children with in-toeing gait.</p><p><strong>Study design: </strong>A randomized controlled trial.</p><p><strong>Methods: </strong>The study involved 30 children aged 3 to 10 years, divided into 2 equal groups: 1 received GPI, and the other received MWI. FPA and balance parameters were measured using motion analysis and force plate devices before and after 1 month of intervention. Children walked a 10-m path, with a force plate placed in the middle that recorded foot data separately to evaluate the balance. The FPA was calculated based on marker data placed on lower limbs as the children walked barefoot at a normal speed.</p><p><strong>Results: </strong>Both insoles significantly increased FPA (6.67 and 4.76 degrees for the right foot and 9.62 and 6.56 degrees for the left foot, respectively). The GPI significantly increased the total standard deviation of the center of pressure (COP) displacement (P < 0.001), COP velocity (P < 0/001), and phase plane portrait of the COP of the right foot (P < 0/001). The MWI decreased COP velocity and phase plane portrait in the left foot (P = 0.01) and increased COP displacement in both feet significantly.</p><p><strong>Conclusions: </strong>Both gait plate and MWI effectively enhance FPA and improve the gait of children with in-toeing gait, with different effects on balance, suggesting that MWI may better reduce fall risk.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}