Investigating the effects of ankle foot orthoses on electromyography in impaired populations: a systematic review.

PURPOSE: Despite ample evidence supporting ankle foot orthoses (AFOs) for enhancing ambulation in those with neuromuscular impairment, a prevalent belief among rehabilitation professionals is that AFO use may lead to disuse and reduced muscle activity of the lower leg. To determine the effects of AFO intervention on electromyography (EMG) activity during walking in individuals with neuromuscular impairment. MATERIALS AND METHODS: Five databases were searched for studies that met the predefined inclusion criteria and were published any time through April 2024. AFO design characteristics, muscle groups measured, study design, experimental comparisons, and EMG parameters were extracted from each study. Methodological quality of the included studies was assessed using the modified PEDro scale. RESULTS: Twenty studies met the inclusion criteria. AFO interventions utilized, EMG outcomes utilized, and result interpretations varied widely. In situations of hypertonicity, reduced EMG activity was deemed a positive outcome, while other studies viewed it negatively. Seven longitudinal studies found no adverse long-term impact on EMG activity. CONCLUSION: The results of this review challenge the clinical belief that AFOs cause muscle disuse over time; however, the heterogeneity of AFO designs prevents broad statements related to which orthoses optimize muscle activity.

Ankle foot Orthosis (AFO) intervention demonstrates diverse effects on the timing and amplitude of electromyography (EMG) measures, with significant variability in direction, magnitude, and interpretation across studies, necessitating personalized approaches.Longitudinal studies refute concerns about adverse effects on EMG activity with prolonged AFO use, challenging the notion of decreased muscle activation and supporting the safety of extended AFO utilization.Clinicians are advised to differentiate between peripheral and central nervous system disorders when considering AFO intervention, emphasizing the need to align AFO goals with the patient's clinical presentation and carefully weigh the known advantages associated with AFO utilization.

A disparity in prosthetic access for Ecuadorians with lower-limb amputation.

BACKGROUND: Individuals with disabilities in low- and middle-income countries face barriers to rehabilitation services, including prosthetic care. Many countries, such as Ecuador, have adapted policies toward achieving universal health care coverage. For optimal functional outcomes, understanding the physical potential of prosthetic users is critical for appropriate prosthetic services. OBJECTIVE: To determine the association between the functional level of Ecuadorians with lower-limb amputations and the functional level of their prosthetic componentry. STUDY DESIGN: Retrospective study. METHODS: A data set containing functional level (K-Level) of Ecuadorians with lower-limb amputations and the K-Level of their prosthesis was analyzed. RESULTS: A diverse cohort of 164 participants with unilateral lower-limb amputation was recruited. Most participants were male (76.8%) with transfemoral amputations (56.1%) due to traumatic causes (51.2%). There was a small, positive, and statistically significant correlation between participants' functional levels and prosthetic componentry. Participants's functional levels were typically superior (median = 3) to their prostheses' functional abilities (median = 1), and 37.2% of participants did not have a prosthesis at the time of assessment. CONCLUSIONS: These data indicated that participants whose physical ability exceeded basic ambulation lacked access to prostheses to match their functional abilities. The detailed disparity between physical potential and prosthetic access derived from the study's analysis supports investment into high functioning prosthetic componentry and further investigation into where gaps in care exist.

Tipping the Scales of the Admissions Process: Interview Weighting in an Orthotics and Prosthetics Education Program.

AIMS: Orthotics and prosthetics is a healthcare profession which is currently exploring opportunities to increase student diversity. There are limited publications on the admissions process in orthotics and prosthetics. The purpose of this study was to evaluate the impact of the admissions interview weighting on the diversity of the top-ranked applicants at one education program. METHODS: Researchers gathered retrospective data from 3 years of admissions interviews (n=144). The proportions of the screening scores and interview scores were systematically adjusted to determine various ranking scores. At each adjustment point, descriptive statistics of racial demographics, age, gender, and military status of the top-ranking applicants were evaluated. RESULTS: Adjustments in the weights of the screening and interview scores had an impact on cohort diversity within, but not across, admissions cycles. Increasing the weight of the interview score decreased the mean age of a cohort for all admissions cycles. CONCLUSION: This study is the first to present an evaluation of the admissions process in an orthotics and prosthetics education program. The methodology can be used by health professions education programs which incorporate interview scoring into admissions decisions.