Caldeira Quaresma Duarte, McMonagle Christine
Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Curran Building, Glasgow, United Kingdom.
Prosthet Orthot Int. 2024 Dec 11;49(4):388-399. doi: 10.1097/PXR.0000000000000389.
Stroke is the main cause of acquired adult disability globally, with motor impairment affecting 80% of people after stroke. To regain mobility, diminish falls, and improve quality of life (QoL), after a stroke, orthoses are recommended. Most studies, to date, have focused on the positive impact of ankle-foot orthoses on spatial-temporal, kinematic, and kinetic outcomes. The objective of this review is to assess the evidence of the effects of lower-extremity orthoses on perceptions of QoL, psychological well-being, and social participation after stroke. The following databases were used to search the literature: CINAHL, EMBASE, Scopus, and PubMed, between 1990 and 2022. Previous reviews and reference lists were also screened. Information on the trial design, sample characteristics, information of orthoses used, outcome measures, and results were extracted. Critical appraisal was conducted using SIGN guidelines. Ten articles were identified as meeting the inclusion criteria. The effect of orthoses on QoL was inconsistent: 4 articles reported a positive relationship, one found a negative relationship, and 3 did not find any relationship. Six of 7 articles reported a positive relationship between the use of orthoses and psychological well-being and participation, although the level of evidence was low. This literature review has identified a small number of articles addressing the research question. Furthermore, varied study designs, low levels of evidence seen, the variation in follow-up times, and the limited information about the fitting and appropriateness of the orthoses in the studies highlight that more research is needed.
中风是全球后天性成人残疾的主要原因,中风后80%的人会出现运动障碍。为了恢复活动能力、减少跌倒并提高生活质量(QoL),中风后建议使用矫形器。迄今为止,大多数研究都集中在踝足矫形器对时空、运动学和动力学结果的积极影响上。本综述的目的是评估下肢矫形器对中风后生活质量感知、心理健康和社会参与影响的证据。使用以下数据库检索文献:1990年至2022年期间的CINAHL、EMBASE、Scopus和PubMed。还筛选了以前的综述和参考文献列表。提取了关于试验设计、样本特征、所用矫形器信息、结局指标和结果的信息。使用SIGN指南进行批判性评价。确定有10篇文章符合纳入标准。矫形器对生活质量的影响并不一致:4篇文章报告了正相关关系,1篇发现了负相关关系,3篇未发现任何关系。7篇文章中有6篇报告了使用矫形器与心理健康和参与之间的正相关关系,尽管证据水平较低。这篇文献综述发现解决该研究问题的文章数量较少。此外,研究设计多样、证据水平低、随访时间不同以及研究中关于矫形器适配性和适用性的信息有限,这表明需要更多的研究。