An important part of the orthotic treatment process includes performing adjustments to the shape or design of the orthosis to improve its fit and function. However, the ability to adjust 3D printed (3DP) materials is not well understood.

Charcot-Marie-Tooth (CMT) is a progressive disease resulting in distal sensory deficit and muscular weakness. As the disease progresses, most children develop a cavovarus foot deformity. Foot orthoses (FO) are widely prescribed in CMT to support the foot and improve gait, but there is a lack of guidelines for their conception. The aim of this pilot study was to report the methodology used for the design of FO (FOmax) based on an evaluation of foot deformities and to assess its effects on gait in children with CMT.

The abandonment rates of upper-limb (UL) prostheses are concerning and are related to limitations in the functional and kinematic aspects of the UL prosthesis. Evaluating the usability of prostheses is essential to make improvements in relation to these aspects and develop effective equipment and inform clinical results relevant to rehabilitation. The purpose of this scoping review is to explore the current state of the literature, the characteristics of studies on the topic, and the main parameters and instruments used to evaluate UL prosthesis, regarding kinematic and functional aspects. The search was performed in 7 databases using descriptors related to "Prosthesis," "Outcome Measures," and "Upper Limb." Specific data were extracted from full-text articles included in the final sample. A literature search identified 1122 articles. After analyzing the articles using predetermined inclusion and exclusion criteria, 121 relevant articles were included in the final review. Most of the studies found originated from the United States and United Kingdom, predominating quasi-experimental studies and case studies. The predominant level of disability was transradial, and the most cited type of prosthesis was electric/myoelectric. The studies predominated in the clinical context and focused on the use of functional assessments. About 101 assessment instruments in total were found, 82 (81.2%) of which were related to functionality and 19 (18.8%) related to kinematic aspects. Kinematic focus is still scarce on the evaluation of users of UL prostheses. Combining kinematic and functional assessments expands the approach and data collection with the target population. There is a need to develop instruments specifically aimed at this audience.

Preferred walking speed (PWS), maximal walking speed (MWS), and walking speed reserve (WSR)-the difference between MWS and PWS-can be easily obtained from the 10-m walk test (10MWT) to assess walking ability and function. However, their test-retest reliability has not been determined in persons with unilateral lower-limb amputation (LLA).

Walking speed is a measure of functional mobility that is relatively easy to quantify. In people with lower limb amputation, reduced walking speed has been linked with specific atypical spatiotemporal gait parameters. However, the influence of atypical spatiotemporal gait parameters on the walking speed of people with unilateral transtibial amputation (TTA) and transfemoral amputation (TFA) remains unclear.

A boy with bilateral congenital anomalies of the upper extremities with transverse absence of the left arm (agenesis) and absence of right thumb (disgenesis), fixed elbow in extension due to humeroradial synostosis thought that the humerus was intact. His wrist could move passively with 50° flexion, 0° extension, and 70° radial deviation. The other 4 fingers were intact, 4-5 metatarsal bones were in synostosis, and the fifth finger was clinodactyly. He was born by normal delivery. The physiotherapist started sensorimotor training to achieve functional movements of the right upper extremity. The exercises for the trunk muscles were emphasized to prevent the future possible thoracolumbar curve due to the absence of loading of the left arm on trunk muscles. Serial splinting was performed to position the wrist and fingers for functional purposes and abduction and internal rotation of the index finger to perform the opposition position until the pollicization surgery. At 1 and a half, his trunk was straight, and the wrist was partially corrected (15° extension; 35° radial deviation). He was able to play with toys and eat food. The mother rated his performance as 8/10 and 10/10, respectively. Both mother and father were satisfied with his performance in activities of daily living according to his age compared with his peers (9/10; 10/10, respectively). Thus, the physiotherapist's sensorimotor training and the positioning splints may be considered as feasible interventions in this case.

Rehabilitation is often complex for persons with transfemoral amputation, and poor socket fit is one of the main factors affecting gait re-education, rehabilitation, and quality of life. The present study systematically reviewed the literature to test whether the subischial socket provides better outcomes in comfort, quality of life, and mobility than other transfemoral sockets. Systematic review and meta-analysis. We searched MEDLINE, Physical Therapy Evidence Database Scale, Epistemonikos, Cochrane, BIREME, Web of Science, and Scopus from inception to January 2024 to identify randomized and controlled trials. Two authors independently screened records and assessed the risk of bias. We performed a narrative synthesis of the evidence and used the standardized mean difference and mean difference for meta-analyses and the Grading of Recommendations, Assessment, Development, and Evaluation approach for recommendations. We identified 7 randomized and controlled clinical trials. Five studies compared the subischial socket with the ischial containment socket (IC), 1 study compared the IC with the Marlo anatomical socket, and 1 study compared the IC with the quadrilateral. Very low certainty showed a difference in comfort (1 study: mean difference = 1.4 [95% CI 0.61, 2.19]), but no in quality of life (2 studies: standardized mean difference = 1.28 (95% CI -1.04, 3.59), and mobility (2 studies: mean difference = 0.11 (95% CI -1.08, 1.29). We observed differences between the subischial socket and the IC in comfort but not in quality of life, mobility, and stability. Furthermore, we found a very low certainty that the subischial socket provides better outcomes than the IC in comfort, quality of life, and mobility.

Knee bracing is commonly used for rehabilitation after ligament surgery. However, the effectiveness of knee bracing in preventing ligament injuries is not widely studied. This study aimed to develop a computational methodology to investigate the effectiveness of a novel type of cable-stabilized knee brace on anterior cruciate ligament (ACL) strain during single-leg jump landing. The brace features a compliant design with nonextensible pretensioned cables integrated within a compression tight garment. A combined in vivo/in silico method was developed for this purpose. A computational model of the cable-stabilized knee brace was developed with linked truss elements used to simulate the cable. The cables were integrated into an existing computational model of the knee. Subsequently, single-leg jump landing simulations were conducted on the model, using muscle forces and joint kinematic/kinetic profiles from 10 participants. Anterior cruciate ligament strain behaviors were then compared between the braced and unbraced configurations. The computational methodology was successful in simulating the differences in ACL strain because of the brace. The average peak ACL strain in the braced configuration was 4.99% ± 2.36% and in the unbraced configuration was 3.23% ± 2.31% (p = 0.091). The methodology developed lays the groundwork for future advancements in optimizing the cable-stabilized knee brace design and refining its potential in preventing ligament injuries.

The history of a profession is valuable literature as it recognizes the noteworthy contributions of its forerunners and the scientific evolution from its earliest state. The purpose of this paper is to recount the historical developments in the profession of Prosthetics and Orthotics (P & O) in South Africa. An electronic literature search identified 54 Sabinet and 17,400 Google Scholar records. Key search words were "medical orthotics and prosthetics," "South Africa," and "history." The selection criteria of literature were accomplished in the subsequent 3 phases: (1) the title review, (2) the abstract review, and (3) the full-text review. The records were screened by all 3 authors. Records were excluded if they were unrelated to the history and/or development of P & O in South Africa, the history and development of other medical professions in South Africa, the historical development of P & O in other countries, the historical development of other medical professions of other countries, and records that were non-English. No peer-reviewed record was found describing the history of P & O in South Africa. Faced with the paucity of peer-reviewed evidence, the authors browsed Tshwane University of Technology, Durban University of Technology, and Walter Sisulu University websites to secure historical context. The analyses of these P & O training institutions websites provide a glimpse of the history of P & O in South Africa. The authors had identified the following areas noteworthy to be reported on (1) the historical account of the profession in South Africa, (2) the recognized tertiary training institutions, (3) the minimum admission criteria to South Africa P & O training institutions, and (4) regulatory and statutory bodies of the profession of P & O in South Africa.

Prosthetic silicone liners improve comfort and skin protection and allow the use of total surface bearing (TSB) sockets, which provide enhanced proprioception and comfort. Unfortunately, silicone liners are cost-prohibitive in resource-limited environments (RLEs) where patellar tendon bearing (PTB) sockets with PE-lite liners remain standard, leading to patient discomfort and skin issues.

Numerous factors can affect mobility of individuals with lower limb amputation, including prosthesis-dependent, physical and psychological determinants.Objective:This study aimed to investigate the prosthesis and health-related factors of mobility in people with nontraumatic unilateral transtibial amputation.Study Design:Cross-sectional observational study.

The dynamic elastomeric fabric orthoses (DEFOs) are made of neoprene material, providing the right biomechanical alignment and afferent input in the trunk, pelvis, and extremities, potentially allowing individuals to actively participate in daily life.

The International Classification of Functioning, Disability, and Health (ICF) provides a universal framework for assessing the functioning of any person. To facilitate the application of the ICF in practice, ICF core sets are being developed. This study is part of a project intended to develop an ICF core set for upper-limb amputation (ULA) and aims to identify relevant concepts included in the outcome measurements used in studies of ULA. Articles involving ULA aged 18 years or older from January 2011 to December 2021 were searched on Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, and Medical Literature Analysis and Retrieval System Online. We included studies with particular designs (randomized controlled trials, before/after studies, cross-sectional studies, and longitudinal observational studies) and published in English. Relevant concepts were extracted from measurements and linked to the ICF using linking rules, and a frequency analysis was conducted. Sixty-one of the 1272 identified publications were included, from which 86 measurements were extracted. Concepts extracted from measurements were linked to 129 ICF categories. Three hundred twenty-six (29.23%) of the 1115 concepts were related to body functions, 643 (57.66%) to activity and participation, 96 (8.60%) to environmental factors, 19 (1.70%) to body structures, and 6 (0.53%) to personal factors. Twenty-five (2.24%) were characterized as "nd-not definable." "Fifty-four" categories identified in at least 5% of the publications will be considered for inclusion in the final ICF core set for ULA during the consensus conference. This review provides information about the content of measures, and the identified ICF categories reveal the research perspective for developing an ICF core set for ULA.

Foot drop is a common condition for patients with upper motor neuron syndrome such as cerebral palsy (CP). This study aimed to investigate the effects of functional electrical stimulation (FES) on gait function, quality of life, and FES satisfaction in adults with CP and foot drop. To analyze effects over time, an observational, longitudinal study was performed.

Rowing requires both the upper and lower body to be active for balance, steering, and propulsion, constituting a real challenge for athletes with disabilities. To our knowledge, adapted setups allowing pararowing for people with bilateral transfemoral amputation have not yet been described. This case report describes the adapted setup for Mr S, 24 years old, who underwent bilateral transfemoral amputation in 2019 after a motorcycle accident. He walks with 2 prostheses and practices high-level para-rowing in the Para-Rowing 2 single sculls category. We designed 2 prostheses consisting of a liner (Iceross Seal-In® X5 TF), an adapted socket, a knee (aqua-knee 3WR95), and a prosthetic foot (RushHiPro). We also designed a seat made of Plastazote and thermoplastic polymer foot rests. This equipment allows Mr S to wear his prostheses, which helps him to stabilize in the boat and to use maximum trunk amplitude during the rowing movement. However, the weight of the current equipment limits Mr S's performance. This case study demonstrates that it is possible to adapt equipment to allow an individual with double transfemoral amputation to perform pararowing at competition level.

Functional capacity assessments have an important role in determining the level of mobility in lower-limb prosthetic users.

Iterative design and modification are used to manufacture lower limb prosthetic sockets that meet users' needs while also fulfilling safety and mobility criteria. Greater understanding of the expectations of prosthesis users regarding prosthetic fit as well as their experiences at the time of socket fitting is needed.

Hallux valgus (HV) is a condition characterized by the lateral deviation of the first phalanx and medial deviation of the first metatarsal, leading to subluxation of the first metatarsophalangeal joint. Various orthotic applications are employed in the treatment of HV deformity. This study aimed to compare the effects of a toe separator (TS) and dynamic orthosis (DO) on hallux valgus angle (HVA), plantar pressure (PP), and quality of life (QoL).

Prosthetic socket is a key component of the prosthesis for clinical application; its performance directly affects the adaptation of the residual limb to the prosthetic socket. There are long-term and short-term volume fluctuation of the residual limb. The volume fluctuation of the residual limb will lead to the pressure mismatch at the interface of the residual limb and the prosthetic socket, which will cause a series of skin and fit problems. The volume fluctuation of the residual limb is considered a key factor for the successful application of the prosthetic socket; its solution is imminent. The purpose of this paper is to design a prosthetic socket with a constant force unit to solve the problem of volume fluctuation of the residual limb.

Recent therapeutic and technological solutions aim to improve the daily living of people with limb amputation by considering various aspects of the phantom limb, in particular painless phantom sensations (PS) and voluntary phantom movements (VPM).