A scoping literature review of the provision of orthoses and prostheses in resource-limited environments 2000-2010. Part two: research and outcomes.
BACKGROUND
Despite the activities of many orthotic and prosthetic provision organizations in resource-limited environments, there is still a great need and there are several areas for improvement, as identified in Part One of this series.


OBJECTIVE
Our goal was to examine outcomes and conclusions of research studies to produce an evidence base for determining factors that may lead to successful provision of orthoses and prostheses in resource-limited environments.


METHODS
Literature review.


METHODS
We conducted a scoping literature review of all information related to orthotic and prosthetic provision in resource-limited environments published from 2000 to 2010. We extracted measured outcomes reported in all types of articles and analyzed conclusions from research studies.


RESULTS
Reported outcomes included durability, cost, satisfaction, use/nonuse of device, amount of utilization, walking speed, discomfort, pain, fit, misalignment, capacity for service provision, number of devices produced or delivered, and number of graduates from training programs.


CONCLUSIONS
There are many gaps in the evidence base, notably in measuring inclusion, participation, and quality of life for orthosis and prosthesis users in resource-limited environments. There is a paucity of reported outcomes for orthotics. Valid, reliable, and standard methods of data collection and reporting are needed to advance the field and enhance the evidence base.
Whirlwind Wheelchair International, San Francisco State University, San Francisco, CA, USA andrea@whirlwindwheelchair.org.
Andrea J
AJ
Ikeda
Department of Integrative Physiology University of Colorado Boulder, Boulder, CO, USA Eastern Colorado Healthcare System, U.S. Department of Veterans Affairs, Denver, CO, USA.
Alena M
AM
Grabowski
Whirlwind Wheelchair International, San Francisco State University, San Francisco, CA, USA.
Alida
A
Lindsley
Musculoskeletal Research Center, Orthotics and Prosthetics Department, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran.
Ebrahim
E
Sadeghi-Demneh
Whirlwind Wheelchair International, San Francisco State University, San Francisco, CA, USA.
Kim D
KD
Reisinger
D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D006801:Humans; D009989:Orthotic Devices / Q000600:supply & distribution*; D017063:Outcome Assessment, Health Care; D019736:Prostheses and Implants / Q000600:supply & distribution*; D011474:Prosthesis Design; D011475:Prosthesis Failure
Prosthetics and orthotics in developing countries; developing countries; orthotics; prosthetics; prosthetics and orthotics services in low-income countries