Measuring the functional and clinical effectiveness of a passive dynamic ankle foot orthosis when used to rehabilitate complex limb salvage post lower limb blast trauma

Bennett, N

Abstract

Summary: Studies suggest passive dynamic ankle foot orthoses (PD AFO) are effective at improving gait and patient reported outcomes measures (PROM) in personnel who have undergone limb salvage due to blast trauma. Studies using PD AFOs have included able bodied and personnel with variable clinical presentations. This study examines if PD AFO use improves gait and PROMs in personnel injured by the same blast mechanism with similar unilateral deck slap blast injuries.

Introduction: Rehabilitation outcomes following limb salvage are reported as substandard, with personnel frequently demonstrating poor functional and psychosocial outcomes. There has been a call for advancements in orthotics to support limb salvage patients eager to preserve their lower limb, yet function at high levels of mobility. PD AFOs are used to improve clinical outcomes. Studies have shown that when combined with exercise rehabilitation PD AFOs can decrease biomechanical pain, improve physical activity and enable return to work in high functioning adults.

Method: The study consisted of 12 individuals who had sustained “deck slap” injuries caused by high energy blast trauma. Kinematic, kinetic and temporal spatial parameters were measured walking with and without their PD AFO at a self-selected speed. Participants completed the Lower Extremity Functional Scale (LEFS) and the Foot and Ankle Outcome Score (FAOS) pre and post PD AFO provision. The mean and standard deviation was calculated for each test measure and statistical analysis was conducted using R version 3.5.3.

Results: Use of a PD AFO significantly improved each participant’s mean PROM score and user’s propulsive capability. Participant’s gait profile score (GPS) also improved when using the PD AFO.

Conclusion: This study suggests that unilateral PD AFO use can improve gait parameters and PROMs in injured personnel who have sustained unilateral blast trauma.

Citation

Bennett, N. Measuring the functional and clinical effectiveness of a passive dynamic ankle foot orthosis when used to rehabilitate complex limb salvage post lower limb blast trauma. (Dissertation). University of Salford

• Thesis Type: Dissertation
• Deposit Date: Jun 15, 2020
• Publicly Available Date: Jun 15, 2020
• Award Date: Jan 1, 2020