Orthotic Research Initiative for Outcomes aNalysis (ORION I): predictors of PROMIS PF for stroke survivors seeking orthotic intervention.

PURPOSE: Ankle-foot orthoses (AFOs) are used to improve physical performance measures of physical function (PF) post-stroke; however, the perception of improved PF of this population has not been described. The purpose of this study was to identify the predictors of self-reported PF of individuals seeking orthotic intervention post-stroke. MATERIALS AND METHODS: A retrospective analysis of 237 patients at a nationwide orthotic services provider in the United States was conducted to characterize PF using the Patient-Reported Outcome Measures Information System®. A backward stepwise multiple regression was conducted to identify demographic characteristics predictive of self-reported PF. RESULTS: The mean T-score of PF of the sample was 30.8 (±6.5), two standard deviations below the US general population mean, indicating significant impairment. The regression model explained approximately 15% (R = 0.411) of the variance in PF of the sample. Self-reported PF was worse for individuals requiring more supportive assistive devices (ß = 0.270, p = 0.001), those with more recent ankle problems (ß = -0.167, p = 0.035), and those with greater living assistance (ß = -0.139, p = 0.089). CONCLUSIONS: These results improve understanding of the factors that contribute to impaired self-reported PF of stroke survivors in need of AFO intervention.Implications for rehabilitationAnkle-foot orthoses (AFOs) are often used to improve physical performance measures of physical performance (PF) during stroke rehabilitation.Our data indicate that the self-reported PF of AFO users is severely impaired.Level of assistance, time since ankle and foot problems began, and living assistance status are important clinical characteristics to consider when planning AFO intervention for this population.

Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy.

Maintenance of upright posture and gait mobility is frequently a goal in supporting children with cerebral palsy (CP). Ankle-foot orthoses (AFOs) can play an important role in normalizing gait function in this population. Properly designed orthotic interventions consider common ankle and foot deformities, range-of-motion limitations, and natural history of CP. Successful AFO prescription often requires interaction with complementary interventions such as physical therapy, spasticity management, and/or orthopedic management. Recognizing the impact of plantar flexion contractures and the effects of footwear on AFO alignment is key to effective orthotic management of gait dysfunction in children with CP.