SPECIAL SECTION: Teachings from the East
Researchers and practitioners from across the globe came together in Hyderabad, India, in February for the World Congress of the International Society of Prosthetics & Orthotics (ISPO). LER’s exclusive coverage of the 2013 World Congress, held in India for the first time, explores the evidence-based use of lower extremity devices for conditions ranging from stroke to cerebral palsy to diabetes.
By Jordana Bieze Foster
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Brace wear time, not torque, is key – Dynamic orthoses offer an effective alternative to static devices for management of tip-toe gait and knee flexion contracture in children with cerebral palsy (CP), particularly because the dynamic devices are associated with greater compliance, according to separate studies from Sweden and France.
A Taiwanese study offers more evidence that offloading knee braces and wedged foot orthoses are both associated with significant biomechanical improvements in patients with knee osteoarthritis (OA).
A rocker bar proximally positioned on a running shoe can relieve tension on the Achilles tendon as well as reduce the force required of the calf muscles during walking and slow running, according to research from the Netherlands.
Swedes also find low ulceration rate – Research from Sweden and Egypt provides more evidence that foot orthoses can significantly decrease plantar pressures in patients with diabetes, theoretically reducing the risk of foot ulcers and lower extremity amputation.
Orthotic management of pediatric talipes planovalgus starting at an early age is associated with significant improvement in weightbearing arch structure, according to research from Saga University in Japan.
Tibial inclination appears significant – Orthotic walkers have significant effects on proximal joint mechanics during gait, the extent of which appear to depend on individual device design, according to research from the University of Central Lancashire in the UK.
What appears to be idiopathic scoliosis may actually be functional scoliosis that can be effectively treated with foot orthoses in children who are hyperpronators, according to research from Chungnam National University in Daejeon, South Korea.
Functional balance test scores rise – Use of an ankle foot orthosis (AFO) within six weeks of stroke results in better balance outcomes and earlier independent ambulation than if AFO use is delayed, according to research from the Netherlands.