Studies examining the efficacy of Ankle Foot Orthoses should report activity level and mechanical evidence
Studies examining the efficacy of Ankle Foot Orthoses should report activity level and mechanical evidence
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DOI：
10.3109/03093646.2010.504977
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发表时间：
2010-09-01
影响因子：
1.5
通讯作者：
Nollet, Frans
中科院分区：
文献类型：
--
作者：
Harlaar, Jaap;Brehm, Merel;Nollet, Frans
踝足矫形器（AFO），以促进步行能力是一种常见的治疗神经或肌肉疾病的患者。然而，目前关于AFO处方的指南是基于关于其疗效的低水平证据。最近的研究旨在证明穿着AFO对步行能力的有效性，但并不总是结论性的。在本文中，它被认为是承认两个级别的证据有关的ICF水平。活动水平证据表示患者步行能力的增加，而机械证据表示AFO的正确功能。为了评估矫正治疗的有效性，两个水平的联合改善加强了所使用的治疗算法。相反，相互矛盾的结果将挑战当前的治疗算法和AFO的假定工作机制。治疗算法必须使用相关信息作为输入，这些信息来自高精度的测量。其结果将是一个特定的AFO，符合患者的需求，由AFO鞋组合的机械特性指定。得出的结论是，关于AFO疗效的研究应使用来自两个证据水平的参数，以证明治疗算法的疗效，即，如何配好合适的AFO
Ankle Foot Orthoses (AFOs) to promote walking ability are a common treatment in patients with neurological or muscular diseases. However, guidelines on the prescription of AFOs are currently based on a low level of evidence regarding their efficacy. Recent studies aiming to demonstrate the efficacy of wearing an AFO in respect to walking ability are not always conclusive. In this paper it is argued to recognize two levels of evidence related to the ICF levels. Activity level evidence expresses the gain in walking ability for the patient, while mechanical evidence expresses the correct functioning of the AFO. Used in combination for the purpose of evaluating the efficacy of orthotic treatment, a conjunct improvement at both levels reinforces the treatment algorithm that is used. Conversely, conflicting outcomes will challenge current treatment algorithms and the supposed working mechanism of the AFO. A treatment algorithm must use relevant information as an input, derived from measurements with a high precision. Its result will be a specific AFO that matches the patient's needs, specified by the mechanical characterization of the AFO footwear combination. It is concluded that research on the efficacy of AFOs should use parameters from two levels of evidence, to prove the efficacy of a treatment algorithm, i.e., how to prescribe a well-matched AFO.