Ankle-foot orthotic management in neuromuscular disorders: recommendations for future research
Bibliographic record
Abstract
Purpose: To describe research evidence supporting clinical recommendations for ankle-foot orthotic (AFO) prescription and examine common limitations in current research among individuals with stroke and cerebral palsy. Method: Three databases and one journal website were searched for articles reporting AFO interventions on gait and functional mobility outcome measures in participants with stroke or cerebral palsy. The International Society for Prosthetics and Orthotics (ISPO) best practice recommendations from consensus conferences were reviewed. Data extracted from the articles include participant characteristics, AFO intervention details, evaluation methods, and outcome measures. Results: Sixty articles were included; twenty-seven on stroke and thirty-three on cerebral palsy participants. Many articles reported insufficient detail on severity of lower limb impairment. Type of interventions included nineteen nonarticulating AFO studies, twelve articulating AFO studies and twenty-three studies testing both. Confounding factors, such as compliance, activity level and footwear, need to be considered in longitudinal studies. Conclusions: Most studies demonstrated improvement in walking speed and ankle dorsiflexion, whereas the indirect effect on knee stability remains unclear. Future research needs to provide detailed information on type and severity of lower limb impairment of participants and design features of the AFO intervention.Implications for RehabilitationResearch reports need to provide clinical measures of impairment and function to facilitate understanding the AFO’s mechanical effect during gait.Standardized outcome measures related to the prescription goals and patient’s functional mobility is essential to determine whehter the orthotic effect is beneficial.ISPO recommendations should be consulted for reporting orthotic design characteristics.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.072 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.007 | 0.011 |
| Open science | 0.006 | 0.003 |
| Research integrity | 0.012 | 0.007 |
| Insufficient payload (model declined to judge) | 0.015 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".