title: Influence of appropriate lower extremity orthotic management on ambulation, pain, and fatigue in a postpolio population.
abstract: A major functional problem for the postpolio patient is the loss of ambulation ability. A retrospective study of lower extremity orthotic management for ambulation was made of 104 subjects with histories of paralytic poliomyelitis who received treatment and evaluation in a postpolio clinic. Thirty-six patients (35%) had a remote history of a surgical arthrodesis of the ankle. Fifty-six subjects (54%) reported using lower extremity orthoses after the onset of their polio. At initial postpolio clinic evaluation 19 subjects (18%) were using lower extremity orthoses, and all of these patients had a remote history of orthotic use. After clinical evaluation, a new lower extremity orthosis was recommended for 37 subjects (36%). Nine of these patients had never used orthotic devices. New orthoses for a previously braced limb or an additional orthosis for a previously unbraced limb were prescribed more frequently in previously braced patients (28 of 56 vs 9 of 48, p less than 0.02). Seventy-two percent of subjects with ankle fusion required new orthoses; 19% of those without fusion required one (p less than 0.001). A questionnaire returned by 81 subjects (78%) indicated that appropriate orthotic prescription significantly improved the ability to walk, increased perceived walking safety, and reduced knee and overall pain (p = 0.04 to 0.008).
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor.
authors.forename: W P
authors.initials: WP
authors.lastname: Waring
authors.forename: F
authors.initials: F
authors.lastname: Maynard
authors.forename: W
authors.initials: W
authors.lastname: Grady
authors.forename: R
authors.initials: R
authors.lastname: Grady
authors.forename: C
authors.initials: C
authors.lastname: Boyles
mesh_terms: D000328:Adult; D000368:Aged; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007866:Leg; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000209:etiology; D011051:Poliomyelitis / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D012189:Retrospective Studies