Improving the Evidence Base for the Orthotic Management of Lower Limb in Neurological Conditions’

Ross, Karyn (2014) Improving the Evidence Base for the Orthotic Management of Lower Limb in Neurological Conditions’. In: UK Scientific Meeting of the International Society for Prosthetics and Orthotics, 2014-10-03 - 2014-10-04.

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As healthcare professionals working in the area of management of the lower limb in neurological conditions, it is encouraging to note that there is growing interest and an expanding body of research investigating orthotic interventions, particularly the use of ankle-foot orthoses (AFOs) for cerebral palsy (CP) and stroke. There is an increasing need for Evidence Based Practice (EBP) to inform clinical decision making. EBP is reliant on a clinician’s training and experience combined with an understanding and use of the evidence established through scientific research [1]. The expanding body of knowledge on the efficacy of orthotic interventions has the potential to both impact on further research and, importantly, clinical practice. However this can only happen if studies are well designed with robust testing protocols and appropriate outcomes measures, and if they report on homogeneous patient groups, providing explicit details on participants and interventions. While there is some evidence to support the use of lower limb orthoses following stroke and in the management of children with CP, literature reviews carried out in the areas of cerebral palsy [2-5] and stroke [6, 7] have identified a lack of important detail in previously published research. If an enhanced level of detail can be considered and reported in future studies, synthesis of results across studies will contribute to an improved evidence base. This will improve the generation of prescription and clinical guidelines which will facilitate enhanced service provision, clinical decision making and the prescription of more appropriate orthoses. Many clinicians face barriers to becoming more active in research, however there are a numbers of ways in which the National Health Service and industry can engage with Higher Education Institutions to expedite the research process. Effective partnerships and collaborations will facilitate the process of establishing quality research and an evidence base to inform clinical practice.


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