OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Ankle ; Child* ; Foot Orthoses ; Gait* ; Humans ; Orthotic Devices ; Tibia*

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Ankle ; Child* ; Foot Orthoses ; Gait* ; Humans ; Orthotic Devices ; Tibia*

OBJECTIVE: This study was designed to analyse quantitatively the change in rigidity of plastic ankle foot orthoses (AFOs) corresponding with regulated ankle width and to find the appropriate ankle width for spastic ankles. METHOD: Five different plastic AFOs were fabricated according to the regulated ankle width. The resistance to dorsiflexion and plantar flexion movements was measured by bending the plastic AFOs at intervals of 2 degrees with the measuring device. Plantar flexion moments of hemiplegic spastic ankles were also measured. RESULTS: The rigidity of plastic AFOs increased nearly in proportion to the increase of the ankle width. The plantar flexion moments of hemiplegic spastic ankles increased in proportion to the severity of the spasticity. If the plastic AFOs would be used only for the prevention of toe dragging in swing phase, the ankle width of plastic AFOs could be reduced up to 60% which was enough to support the ankle in swing phase. CONCLUSION: These findings suggested that the degree of rigidity of plastic AFOs could be adjusted by trimming about the ankle to meet the individual patient's requirement. And this study could be helpful to quantify empirical approach of the prescription of plastic AFOs.
Ankle* ; Foot Orthoses ; Muscle Spasticity ; Orthotic Devices* ; Plastics* ; Prescriptions ; Toes

Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
Adolescent* ; Braces ; Humans ; Orthotic Devices ; Scoliosis*

C1-C2 transarticular screw fixation has been a preferred method for the fixation of atlantoaxial subluxation caused by the rheumatoid arthritis or recurrent subluxation caused by postoperative non-union. However, it has required extensive occipitocervical fusion or rigid external orthoses such as halo brace after cable fixation especially when the patient has the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw. The author applied a pair of Halifax interlaminar clamps from C1 to C3 following the C1-C2 cable fixation in one patient with rheumatoid atlantoaxial subluxation and the other with recurrent subluxation after postoperative non-union. The prominent transverse foramen in both patients precluded the safe passage of the C1-C2 transarticular screw. Both patients were maintained in semirigid external orthoses by using philadelphia collar for 3 months after surgery. One has been doing well for 1 year and the other for 5 months following surgery. In conclusion, the application of the Halifax interlaminar clamps from C1 to C3 in addition to the C1-C2 cable fixation can be a useful alternative procedure circumventing extensive occipitocervical fusion for patients with the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw, thereby not sacrificing the motion between occiput and atlas.
Arthritis, Rheumatoid ; Braces ; Humans ; Orthotic Devices

PURPOSE: The purpose of this study was to evaluate pressure distribution on the foot with the use of custom made foot orthosis and evaluate influential factors in young people using custom orthosis. MATERIALS AND METHODS: 22 individuals comprised of young males and females were evaluated by radiograph, pedobarograph, and satisfaction rate and VAS score. The data was analyzed statistically to find influential factors for satisfaction after wearing the foot orthosis. RESULTS: Around 50% of participants were satisfied in wearing the custom made foot orthosis. Initial VAS score of satisfaction of 36.2+/-19.7 improved to 73.1+/-15.6 after application of foot orthosis. There was a statistically significant difference. Talo-second metatarsal angle on AP radiograph after orthosis application was significantly related to satisfaction. On analysis of pedobarograph data, total contact area was increased and weight distribution was transferred medially on ambulation with the orthosis applied. CONCLUSION: Before designing the foot orthosis, individual foot factors such as foot anatomy and foot pressure distribution should be evaluated for foot comfort and better patient satisfaction.
Female ; Foot Orthoses* ; Foot* ; Humans ; Male ; Metatarsal Bones ; Orthotic Devices ; Patient Satisfaction ; Walking

OBJECTIVE: To evaluate the long termeffect of custom-molded foot orthoses on foot pain and balance ability in children with symptomatic flexible flat feet after 1 year.METHOD: A total of 35 children over 6 year-old with flexible flat feet and foot pain for at least 6 months were recruited. Individual custom-molded rigid foot orthoses fabricated with the inverted orthotic technique was prescribed. Pain related parameters (pain sites, degree, and frequency) were obtained through questionnaires. Pain assessment was performed prior to application of the foot orthoses, and 1, 3, 6, 12 months after applying the orthoses. Balance ability was tested by computerized posturography. Such measures were evaluated prior to, 3 months, and 12 months after applying the foot orthoses. Additionally, the difference inbalance ability between barefoot and withfoot orthosesat 12 months was assessed to estimate carryover effect.RESULTS: 17 out of 35 children completed the study. Significant improvements were noted upto 12 months in pain parameters and balance ability. The carry over effect of the orthoses was confirmed.CONCLUSION: There were significant improvements offoot pain and balance ability in children with symptomatic flexible flat foot after wearing foot orthoses fabricated with the inverted orthotic technique over 1year period.
Child ; Flatfoot ; Foot Orthoses ; Foot ; Humans ; Methods ; Orthotic Devices ; Pain Measurement ; Pediatrics ; Postural Balance

OBJECTIVE: To compare effectiveness of corticosteroid injection, foot orthoses and oral anti-inflammatory medication for the management of the plantar fasciitis by sequential ultrasonographic follow-up. METHOD: Thirty-three patients with plantar fasciitis were assigned to one of 3 treatment groups. Twelve patients received steroid injection and ten were applied with custom-made foot orthoses and eleven received 4-week course of a non-steroidal anti-inflammatory medication. All patients of each group were instructed to perform self stretching exercise of the Achilles tendon and plantar fascia for the follow-up period. Ultrasonographic evaluation and clinical assessments were performed during 12 weeks; before treatment, every week during the first 8 weeks, and then every 2 weeks during the last 4 weeks. RESULTS: On ultrasonographic examination, fascial thickness decreased significantly in all three groups (p<0.05) but earlier and greater change was noticed in injection group (p<0.05). Hypoechoic lesions were observed less commonly after treatment in injection and orthoses groups (p<0.05). Pain was not significant different among three groups after two or three weeks of treatment. CONCLUSION: Corticosteroid injection showed earlier and greater effect on pain and ultrasonographic feature than other treatments. Although pain aspects of three groups were similar after 12 weeks of follow-up, improved ultrasonographic features were well preserved in injection and orthoses groups. Ultrasonographic feature that was mostly related to the symptom relief was the decrease in fascial thickness other than resolution of hypoechoic lesion.
Achilles Tendon ; Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot Orthoses ; Humans ; Orthotic Devices

OBJECTIVE: To evaluate the effects of heel-opened ankle foot orthosis (HOAFO) on hemiparetic gait after stroke, especially on external foot rotation, and to compare the effects of HOAFO with conventional plastic-AFO (pAFO) and barefoot during gait. METHODS: This cross-over observational study involved 15 hemiparetic patients with external rotation of the affected foot. All subjects were able to walk independently, regardless of their usual use of a single cane, and had a less than fair-grade in ankle dorsiflexion power. Each patient was asked to walk in three conditions with randomized sequences: 1) barefoot, 2) with a pAFO, and 3) with an HOAFO. Their gait patterns were analyzed using a motion analysis system. RESULTS: Fifteen patients consisted of nine males and six females. On gait analysis, hip and foot external rotation were significantly greater in pAFO (-3.35degrees and -23.68degrees) than in barefoot and HOAFO conditions (p<0.05). Wearing an HOAFO resulted in significant decreases in hip (0.78degrees, p=0.04) and foot (-17.99degrees, p<0.01) external rotation compared with pAFO; although there was no significant difference between HOAFO and barefoot walking. Walking speed and percentage of single limb support were significantly greater for HOAFO than in barefoot walking. CONCLUSION: HOAFO was superior to pAFO in reducing hip and foot external rotation during the stance phase in patients with post-stroke hemiparesis. HOAFO may, therefore, be useful in patients with excessive external rotation of the foot during conventional pAFO.
Animals ; Ankle ; Canes ; Extremities ; Female ; Foot ; Foot Orthoses ; Foot Rot ; Gait ; Hip ; Humans ; Male ; Orthotic Devices ; Paresis ; Stroke ; Walking

Brace is one of the most commonly used interventions to manage osteoporotic vertebral fracture. However, its authentic effectiveness remains unclear. The aim of this study was to investigate the efficacy of brace in patients with osteoporotic vertebral fractures. We conducted a literature review and meta-analysis following the guideline and handbook of the Cochrane collaboration. Ten published articles were included in this study and data from 4 randomized controlled trials were analyzed. Low quality evidence proved using Spinomed brace could bring large and significant beneficial effect to patients with sub-acute osteoporotic vertebral fractures. Very low quality evidence proved no significant difference between Spinomed orthosis, rigid brace and soft brace when they were used in patients with acute fractures. Therefore, it might be applicable to recommend middle term use of Spinomed orthosis to patients with subacute fracture. In addition, this study emphasized the need for high quality randomized controlled trials.
Braces* ; Cooperative Behavior ; Humans ; Orthotic Devices ; Osteoporosis ; Spine