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Evidence summaries

Orthotic Devices after Stroke and other Non-Progressive Brain Lesions

A lower limb orthosis might possibly improve walking and balance in short-term, although the evidence is insufficient. An upper limb orthosis might possibly have no effect on upper limb function or pain, although the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1[withdrawn from the Cochrane Library] included 14 RCTs with a total of 429 subjects with stroke or other non-progressive brain lesions. The overall effect of ankle foot orthosis (11 trials, n=389) on walking disability (speed), walking impairment (step/stride length) and balance impairment (weight distribution in standing) was significant and beneficial. There was no significant effect on postural sway (balance impairment) or mobility disability but the numbers of studies and participants were low. All were cross-over trials that looked at the immediate effect while wearing the orthosis during single testing session; long-term effects were not assessed. Upper limb orthoses showed no effect on upper limb function, range of movement at the wrist, fingers or thumb, nor pain (3 trials, n=96).

Comment: The quality of evidence is downgraded by imprecise results (few patients, limited study size for each comparison), by inconsistency (heterogeneity in interventions and outcomes) and limitations in study quality (inadequate follow up).

    References

    • Tyson SF, Kent RM. WITHDRAWN: Orthotic devices after stroke and other non-progressive brain lesions. Cochrane Database Syst Rev 2009;(3):CD003694. [PubMed]

Primary/Secondary Keywords