A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions. METHODS: Literature searches, completed in September 2015, were carried out in fourteen databases between years 1995 and 2015. The search results were independently screened by two reviewers. For the purpose of this manuscript, only randomized controlled trials which examined interventions using orthotic or prosthetic devices were selected for data extraction and synthesis. RESULTS: A total of 342 randomised controlled trials were identified (319 English language and 23 non-English language). Only 4 of these randomised controlled trials examined prosthetic interventions and the rest examined orthotic interventions. These orthotic interventions were categorised based on the medical conditions/injuries of the participants. From these studies, this review focused on the medical condition/injuries with the highest number of randomised controlled trials (osteoarthritis, fracture, stroke, carpal tunnel syndrome, plantar fasciitis, anterior cruciate ligament, diabetic foot, rheumatoid and juvenile idiopathic arthritis, ankle sprain, cerebral palsy, lateral epicondylitis and low back pain). The included articles were assessed for risk of bias using the Cochrane Risk of Bias tool. Details of the clinical population examined, the type of orthotic/prosthetic intervention, the comparator/s and the outcome measures were extracted. Effect sizes and odds ratios were calculated for all outcome measures, where possible. CONCLUSIONS: At present, for prosthetic and orthotic interventions, the scientific literature does not provide sufficient high quality research to allow strong conclusions on their effectiveness and cost-effectiveness

The Effect of Functional Electrical Stimulation on Balance Function and Balance Confidence in Community-Dwelling Individuals with Stroke

Purpose: The purpose of this study was to evaluate the change in balance function and balance confidence in adults with chronic stroke who are starting a gait re-education program with functional electrical stimulation (FES)

Virtual reality for sensorimotor rehabilitation post stroke: design principles and evidence

n the recent years, the use of virtual reality (VR) to enhance motor skills of persons with activity and participation restriction due to disease or injury has been become an important area of research. In this chapter, we describe the design of such VR systems and their underlying principles, such as experience-dependent neuroplasticity and motor learning. Further, psychological constructs related to motivation including salience, goal setting, and rewards are commonly utilized in VR to optimize motivation during rehabilitation activities. Hence, virtually simulated activities are considered to be ideal for (1) the delivery of specifi c feedback, (2) the a bility to perform large volumes of training, and (3) the presentation of precisely calibrated diffi culty levels, which maintain a high level of challenge throughout long training sessions. These underlying principles are contrasted with a growing body of research comparing the effi cacy of VR with traditionally presented rehabilitation activities in persons with stroke that demonstrate comparable or better outcomes for VR. In addition, a small body of literature has utilized direct assays of neuroplasticity to evaluate the effects of virtual rehabilitation interventions in persons with stroke. Promising developments and fi ndings also arise from the use of off-the-s helf video game systems for virtual rehabilitation purposes and the integration of VR with robots and brain-computer interfaces. Several challenges limiting the translation of virtual rehabilitation into routine rehabilitation practice need to be addressed but the fi eld continues to hold promise to answer key issues faced by modern healthcare.info:eu-repo/semantics/publishedVersio