Journal of Prosthetics and Orthotics最新文献

{"title":"A Scoping Review on Bone Mass Status in Individuals with Transfemoral Amputation.","authors":"Jose L Zavaleta-Ruiz, Matthew J Major, Pankaj Pankaj","doi":"10.1097/JPO.0000000000000635","DOIUrl":"10.1097/JPO.0000000000000635","url":null,"abstract":"<p><strong>Background: </strong>Deterioration of bone mineral density (BMD) in the residual femur after a transfemoral amputation (TFA) has been reported over the past five decades, with various potential explanations described in the literature. BMD loss is a critical risk factor of fracture and hence an important clinical concern for prosthesis users.</p><p><strong>Objectives: </strong>This scoping review audited in vivo imaging studies that focused on BMD in individuals with TFA, with the aim to synthesize the status of knowledge on this topic, report on the mechanisms related to BMD status as hypothesized in the reviewed literature, and review BMD outcomes separately for prosthetic socket and bone-anchored suspension.</p><p><strong>Methods: </strong>Three databases (Scopus, PubMed, and Web of Science) were searched on December 1, 2024. Search keywords covered terms that reference bone mineralization (BMD, osteopenia, and osteoporosis) and TFA. Data were extracted for analysis and grouped according to reported prosthesis suspension for analysis.</p><p><strong>Results: </strong>In total, 244 articles were screened, with 20 ultimately reviewed. Articles were published between 1969 and 2024. Fourteen articles reported the use of socket prosthesis and six used bone-anchored devices. The former group consistently reported BMD loss, while the latter presented maintenance or improvements. The socket prosthesis cohort was younger in age compared to bone anchored (range 24-73 vs. 47-58 years). Proposed reasons for BMD loss included disuse atrophy, bedrest post-surgery, gait asymmetry, and prosthesis influence.</p><p><strong>Conclusions: </strong>Articles reporting BMD status using socket prosthesis consistently reported demineralization despite interventions, with no consensus on the mechanical cause of BMD loss. Further, the bone-anchored group tended to demonstrate improvements in limb loading symmetry during ambulation and higher levels of bone loading compared to prosthetic socket use.</p><p><strong>Clinical relevance: </strong>The residual femur in persons with TFA has demonstrated bone demineralization, which appears to be less prevalent in bone-anchored devices compared to socket use. These findings warrant further analysis of the effects of prosthetic socket use on bone demineralization in persons with TFA.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"38 4","pages":"e123-e132"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Conservative Strategies for Ankle Osteoarthritis Treatment: Understanding Footwear Preference-Rocker Bottom Shoes and Ankle Foot Orthotics.","authors":"Brittney C Muir, Christina Carranza, Jing-Sheng Li, Bruce Sangeorzan, Patrick M Aubin","doi":"10.1097/jpo.0000000000000608","DOIUrl":"10.1097/jpo.0000000000000608","url":null,"abstract":"<p><strong>Background: </strong>Ankle osteoarthritis (AOA) is a progressive condition that impairs mobility and reduces quality of life. Conservative treatments like rocker bottom (RB) shoes and ankle-foot orthoses (AFOs) are commonly prescribed, but their effectiveness in managing AOA is not well understood, and patient preferences are underexplored.</p><p><strong>Objectives: </strong>This is a pilot study aimed to evaluate the effect of RB shoes and AFOs in managing AOA and to identify factors influencing patient preferences for these conservative treatments.</p><p><strong>Study design: </strong>This was a cross-over telehealth study involving 10 participants with doctor-diagnosed AOA. Each participant wore three footwear conditions: control shoes, RB shoes, and AFOs, each for 3 weeks.</p><p><strong>Methods: </strong>Participants completed baseline pain ratings and functional assessments using PROMIS and FAAM questionnaires. After each 3-week footwear session, participants reported pain levels and provided feedback on their preferred footwear.</p><p><strong>Results: </strong>Younger participants (aged 56-63) preferred AFOs for pain relief and improved mobility, while older (aged 66-75) and taller participants preferred RB shoes for their comfort. No significant differences were found in pain or function across footwear conditions, but AFO-preferred participants experienced significant reductions in maximum pain compared to the RB group.</p><p><strong>Conclusions: </strong>Footwear preferences were influenced by age and activity level. Younger participants preferred AFOs for functional benefits, while older participants prioritized comfort and selected RB shoes. These findings emphasize the need for personalized conservative treatment strategies in managing AOA.</p><p><strong>Clinical relevance statement: </strong>This pilot study highlights the importance of tailoring conservative treatments for AOA based on age and activity level. Understanding patient preferences can help guide clinical decisions and improve patient outcomes.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"38 3","pages":"178-184"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Usability of an Adjustable Prosthesis for Aquatic Therapy.","authors":"Anna Atkins, Shenan Hoppe-Ludwig, Walter Guminiak, Monica Hendricksen, Laura Miller","doi":"10.1097/JPO.0000000000000544","DOIUrl":"10.1097/JPO.0000000000000544","url":null,"abstract":"<p><strong>Introduction: </strong>During aquatic therapy, without a prosthesis, individuals with lower-limb difference are limited in navigating stairs or ladders, performing gait training, balance, and strengthening exercises. A noncustom prosthesis for individuals with transtibial limb difference in aquatic therapy, consisting of interchangeable sockets and pylons, does not exist. Dilatancy has not been applied within a socket to provide an accommodative shape for multiple users.</p><p><strong>Objectives: </strong>This study explores the development and usability of an adjustable prosthesis, utilizing dilatancy, for aquatic therapy.</p><p><strong>Study design: </strong>The design of this study is developmental.</p><p><strong>Methods: </strong>Participants underwent an informed written consent process (IRB STU00219525). Three individuals (1 male, 55 years; and 2 female, 47 and 22 years) with unilateral transtibial amputations were recruited. A set of interchangeable adjustable sockets and pylons were developed. Utilizing dilatant properties, small particles under vacuum were assessed for their ability to provide a rigid, lightweight, and remoldable pouch within the socket. Participants trialed the prosthesis during two fittings and three aquatic therapy sessions. Upon completion, participants and treating therapists completed the System Usability Scale. Survey results were converted to a 100-point scale. Time to don the prosthesis was recorded, and socket comfort scores at the final session were averaged.</p><p><strong>Results: </strong>The System Usability Scale indicated that the prosthesis was usable for aquatic therapy. Participant scores were 97.5, 95, and 87.5, and therapist's scores were 92.5 and 85 of a total possible 100. Average socket comfort scores were 10, 9, and 7.6/10. Times to don the prosthesis were 5:45, 5:32, and 4:10 (minutes:seconds).</p><p><strong>Conclusions: </strong>This system functioned successfully as a noncustom prosthesis for multiple users in aquatic therapy from the participant and therapists' perspective.</p><p><strong>Clinical relevance: </strong>The novelty of this system is utilizing a prosthesis for multiple users, improving the rehabilitation capabilities during aquatic therapy.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"37 3","pages":"186-192"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12189191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Portable Bionic Ankle Prosthesis Under Direct Continuous Electromyography Control for Quiet Standing Tasks.","authors":"Nicole E Stafford, Eddie B Gonzalez, Daniel P Ferris","doi":"10.1097/JPO.0000000000000533","DOIUrl":"10.1097/JPO.0000000000000533","url":null,"abstract":"<p><strong>Introduction: </strong>Postural control and balance are necessary for activities of daily living. Passive prostheses that reduce ankle dorsiflexion/plantarflexion control can require different balance strategies compared with able-bodied individuals. Powered prostheses may restore ankle joint control and improve balance compared with passive prostheses. Muscle activity as the prosthetic control input leverages the human neural control system to directly modulate prosthetic dynamics. This study evaluates continuous myoelectric control during quiet standing tasks with an untethered electromechanically actuated bionic ankle prosthesis.</p><p><strong>Methods: </strong>Six individuals with transtibial amputation conducted four 30-second trials of quiet standing for four standing conditions (Eyes Open, Eyes Closed, Eyes Open Foam, and Eyes Closed Foam) using their passive, prescribed prosthesis and a bionic prosthesis under two types of myoelectric control. One strategy solely used residual gastrocnemius muscle as input (GAS), whereas the second used the gastrocnemius and tibialis anterior (GAS+TA). Postural stability was evaluated via Total Excursion, Body Sway Area, and Prediction Ellipse Area center of pressure measures from force plates. We hypothesized that the bionic prosthesis would improve balance control compared with the passive prosthesis. We also quantified weight bearing of prosthetic and sound limbs. Participants completed a preference/sense of stability survey between the prostheses.</p><p><strong>Results: </strong>We found no significant differences in individual prostheses and controllers across our four standing conditions, or between prostheses and controllers for a single standing condition for all center of pressure measures. Participants tended to increase weight on their sound limb from Eyes Open to Eyes Closed Foam conditions. Participants trended toward preferring myoelectric control, but there were no significant differences among prostheses.</p><p><strong>Conclusions: </strong>Compared with a passive transtibial prosthesis, a myoelectrically controlled bionic prosthesis did not alter standing balance performance.</p><p><strong>Clinical relevance: </strong>Our study did not demonstrate differences between the myoelectrically controlled bionic transtibial prosthesis and the prescribed passive prosthesis in balance control. It is possible that other metrics would be necessary to increase sensitivity in comparisons.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"37 3","pages":"153-163"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Design to Clinical Translation: Unraveling Orthotist Perspectives on 3D Printed Accommodative Insoles.","authors":"C Carranza, K A Nickerson, L Gagnon, B C Muir","doi":"10.1097/jpo.0000000000000538","DOIUrl":"10.1097/jpo.0000000000000538","url":null,"abstract":"<p><strong>Background: </strong>Custom accommodative insoles have become the gold standard for managing plantar pressures and reducing ulceration risk in persons with diabetes. With advances in 3D printing technologies, methods of fabricating 3D printed accommodative insoles have emerged. Clinician feedback is imperative to developing a 3D printed accommodative insole that meets clinical needs and is more effective than the current standard of care.</p><p><strong>Objective: </strong>To inform the development of 3D printed accommodative insoles by gaining clinician perspective on insole requirements and application of the digital workflow for seamless translation into the clinical setting.</p><p><strong>Study design: </strong>Qualitative study.</p><p><strong>Methods: </strong>Four focus groups with a total of 16 Orthotists were held, prompting discussions on the current standard of care accommodative insole and other 3D printed insoles we have developed. Sessions were recorded, transcribed, and main themes were derived from transcriptions.</p><p><strong>Results: </strong>Review and analysis of the transcripts resulted in four main themes: 1) Reimbursement, 2) Durability, 3) Effectiveness, and 4) Workflow application in clinic.</p><p><strong>Conclusions: </strong>The responses showed areas to focus improvements on the 3D printed insole design and ways to ease the transition into a clinical setting. Clinician support is crucial in the adoption of a new device to clinical practice. Their feedback is essential to ensuring the item meets the clinical needs and the workflow is not disruptive to the clinical setting.</p><p><strong>Clinical relevance: </strong>Understanding clinician perspective on current SoC disadvantages and shortcomings, areas for improvement in the 3D printed insole fabrication, and what is feasible in clinic appointments will help inform insole design and aid in translating new 3D-printing technology to clinical care for improved patient outcomes.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"2024 ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Electrical Nerve Stimulation at the Wrist as a Method to Restore Sensory Feedback for Individuals with Partial Hand Amputation.","authors":"A R Citterman, A T Harrison, R J Urban, K K Hansen, M A Trout, A T Wang, M M Iversen, J A George","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"36 2 Suppl 1","pages":"69"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Physical Therapy and Orthosis on Clinical Outcomes in Patients with Medial Knee Osteoarthritis","authors":"Zahra Jiryaei, A. Daryabor, Forouzan Rastgar Koutenaei, M. Khosravi","doi":"10.1097/JPO.0000000000000494","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000494","url":null,"abstract":"ABSTRACT INTRODUCTION Orthosis and physical therapy are two conservative managements for knee osteoarthritis (OA), but the question is which is better for alleviating pain and improving function? The aim of this study was to compare two interventions of orthosis and physical therapy on pain and function in patients with knee OA. METHODS In this quasi-experimental study, 31 individuals with medial knee OA were recruited into two groups including orthosis group (combination of insole and brace [n = 14]) and physical therapy group (n = 17). Pain severity was measured by visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Also, daily activity was measured by the WOMAC questionnaire at baseline and after 6-week follow-up. Wilcoxon signed rank and Mann-Whitney U tests were used to determine significant difference for intragroup and intergroup comparisons, respectively. RESULTS The orthosis group (using both knee brace and LWLs) had a better result for pain score related to VAS than the physical therapy group immediately after and 6 weeks of using the intervention, with a significant difference between the two groups (P = 0.006). Regarding the WOMAC items including pain and daily activity, both groups had significant differences after the 6-week period of using the intervention, with no significant difference between the groups. CONCLUSIONS Based on the findings, pain and daily activity related to the WOMAC questionnaire were improved in both orthosis and physical therapy groups, with no differences between the two interventions. The orthosis group had better results in pain related to VAS. CLINICAL RELEVANCE The aim of this study was to find whether physical therapy or orthosis best improves pain and function of knee OA patients.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"51 16","pages":"54 - 58"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Regulation in Persons with a Transfemoral Amputation: Effects of Wearing a Prosthesis","authors":"Yasuko Nishioka, Sven Hoekstra, Koshiro Sawada, Takeshi Nakamura, Fumihiro Tajima, Yasuo Mikami","doi":"10.1097/JPO.0000000000000493","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000493","url":null,"abstract":"ABSTRACT INTRODUCTION The purpose of this study was to investigate the effect of wearing a transfemoral prosthesis (FP) on blood pressure regulation in response to postural change. METHODS We enrolled seven persons with a transfemoral amputation who underwent a head-up tilt test while wearing an FP (PROS test) and without wearing an FP (control [CON] test). Systolic blood pressure (SBP), heart rate variability, and muscle blood flow using near-infrared spectroscopy were measured continuously. RESULTS In the CON (no FP) test, SBP decreased from supine to standing positions in all participants (P = 0.001). In contrast, in the PROS (wearing an FP) test, SBP increased (P = 0.001) during the postural change. CONCLUSIONS The findings suggest that a transfemoral prosthesis increases peripheral vascular resistance in the lower limbs and stimulates the baroreflex, helping to stabilize the circulatory dynamics upon postural change. CLINICAL RELEVANCE Because circulatory dynamics may be hampered in persons with a transfemoral amputation, wearing a prosthesis not only assists in ambulation but can also play a significant role in blood pressure regulation during activities of daily living.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"19 10","pages":"49 - 53"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motion Analysis of a Frontal Plane Adaptable Prosthetic Foot","authors":"Murray E. Maitland, Sheri I. Imsdahl, Donald J. Fogelberg, Katheryn J. Allyn, Kevin C. Cain, Andrew T. Humbert, Alexander Albury, Evandro M. Ficanha, James M. Colvin, Matthew M. Wernke","doi":"10.1097/jpo.0000000000000490","DOIUrl":"https://doi.org/10.1097/jpo.0000000000000490","url":null,"abstract":"ABSTRACT Introduction An objective of designing a prosthetic foot is to achieve the natural adaptability of the foot and ankle on various surfaces and different forms of gait. Frontal plane position of the foot relative to the shank changes with many functional aspects of gait, such as turning, stairs, and walking on uneven ground. Prosthetic foot designs have variable frontal plane adaptability. An investigation foot with a linkage with ±10° of frontal plane motion was developed to improve frontal plane response under various conditions. The purpose of this study was to compare the kinematics of locked and unlocked conditions of a frontal plane adaptable prosthetic foot and the person’s usual foot while walking forward on a level surface, on an unstable rock surface, and sidestep, using a crossover design. These different conditions result in changes in frontal plane motion in the anatomical foot and ankle, and the current study evaluates whether there are similar trends in prosthetic feet. Materials and Methods People were included if they had a unilateral below-knee amputation, intact residual limb skin, were over 16 years old, and were able to walk more than 400 m on level ground without using a walking aid and without an increase in pain. The control group was people without amputations who completed the procedures once. Participants with amputations completed forward walking on level ground, on an unstable rock surface, and sidestep with their usual foot. Then after 2 weeks of accommodation, participants repeated these tests with the investigational foot unlocked and locked. Motion analysis data were collected with a 12-camera optically based system. Primary outcomes were sagittal and frontal plane motions of the foot relative to the shank. In addition, step length, step width, and stride velocity were obtained from the kinematic measures. Paired t -tests were used for statistical inference for individual participant comparisons. Unpaired t -tests were used for comparisons between the controls and people with amputations. Results Twenty-one people with amputations and 10 controls completed the tests. Participants with amputation had 16 different usual feet. There was a wide variation in usual foot motion during forward walking, whereas investigational foot conditions showed less variability. During level walking, control subjects had more frontal plane motion than any of the foot conditions, and the unlocked had more frontal plane motion than the usual foot and locked condition. Walking across an unstable rock surface showed similar trends, with control participants having more sagittal and frontal plane ankle motion compared with any prosthetic foot condition. Also, the unlocked had statistically greater frontal plane motion than the usual foot or locked condition. Sidestep results were also consistent with other gait tests. The control participants’ sagittal plane ankle range of motion was significantly more than the prosthetic sagittal p","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136057925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effect of Soft Lumbosacral Orthosis on Trunk Stability and Upper-Limb Functionality in Children with Cerebral Palsy","authors":"Asiye Uzun, Yavuz Yakut","doi":"10.1097/jpo.0000000000000487","DOIUrl":"https://doi.org/10.1097/jpo.0000000000000487","url":null,"abstract":"ABSTRACT Introduction Lumbar lordosis is important for the spine and pelvis to work in harmony in providing trunk control and maintaining sagittal balance. Children with cerebral palsy (CP) have difficulties in providing trunk postural control and balance, which is critical for independence in daily living activities. This study was planned to examine the immediate effect of a lower-trunk orthosis supporting physiological lumbar lordosis on trunk control and upper-limb functionality in children with CP. Objectives and Methods A total of 30 children with CP, 13 diparetic, 11 hemiparetic, and 6 ataxic, 21 ambulatory (GMFCS I/II), and 9 nonambulatory (GMFCS III/IV) aged 3–16 years were included in the study. The Pediatric Functional Reach Test (PFRT) and the Seated Postural Control Measure (SPCM) were used to assess trunk control; the Pediatric Berg Balance Scale (PBBS) was used to assess balance; and the Box and Block Test (BBT) and the Nine-Hole Peg Test (9HPT) were used to evaluate upper-limb functions. All tests were performed with and without a soft lumbosacral brace. The braces were made of soft, elastic fabric with steel, and were made by the orthotic technician in four different sizes. The angle of lordosis was adjusted with steel underwires according to each child. The existing physiological lordosis of the child is supported by the brace. It is not intended to increase or decrease. Results In the study, the results of all evaluations with a brace were better than those without a brace ( P < 0.05). No significant difference was found only in the functional part of the SPCM test ( P > 0.05). Conclusions Our study revealed that soft lumbosacral orthosis, which supports physiological lordosis, has a positive effect on trunk stability and upper-limb functionality in children with CP. Clinical Relevance In children’s trunk stability and upper-limb functionality studies, the use of soft lumbosacral orthosis that supports physiological lordosis can be added to rehabilitation programs and daily living activities as a support.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135789968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}