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Most research in prosthetics and orthotics focuses on the restoration of lost function. Recently, however, some researchers have examined problems caused by increased dependency on unaffected limbs. A study by Burger and Vidmar (2016)published in the August issue of POI examines overuse problems in people with upper limb deficiency. Carpal tunnel syndrome (CTS) was the predominant complaint of the 65 people interviewed by the researchers. Interestingly, the prevalence of CTS was highest in people who did not use a prosthesis and lowest in myoelectric prosthesis users.

Clinicians have available a variety of tools to assess outcomes of rehabilitation interventions but many of these are specific to a particular type of disability and restricted in their validation across languages and cultures. The International Classification of Functioning, Disability and Health (ICF) provides a more general framework for measuring health and disability at individual and population levels and is designed for use around the world. Radhakrishnan et al. (2016)have use the ICF to classify factors influencing mobility in lower limb amputees from Argentina, Austria, Australia, China, Germany and the USA. In this qualitative study published recently in FirstOnline, the researchers analysed interview and focus group data for concepts which could be mapped to the ICF categories. The results emphasise the importance of mobility in the activities and participation domain and the impact of social support systems on function.

Debate continues about the extent to which foot orthoses can alter foot function by modifying neural drive. Sensorimotor orthoses are thought to stimulate reflex excitatory and inhibitory pathways and thereby modify motor drive to musculature. In a study published in the August issue of POI, Wegener, Wegener, Smith, Schott, and Burns (2016)compared pedorthic shoes with shoes plus a custom sensorimotor foot orthosis in a group of patients with Charcot-Marie-Tooth disease. Patients preferred the orthoses and the researchers observed some biomechanical changes. However, based on EMG results, the researchers concluded that orthosis effects were mechanical and not neurological.  

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Tim Bach
Prosthetics and Orthotics International (POI)