Early specialist orthotic interventions for the lower limb in adult stroke patients: a systematic literature review

Background Stroke is a leading cause of long-term disability worldwide, estimated to affect up to 50% of stroke survivors. Many stroke survivors use orthotic splints and braces to help address difficulties with mobility and gait dysfunction both early after the stroke event and longer-term. Objectives The aim of this systematic review was to identify, synthesise and appraise the evidence on early orthotic involvement for the lower limb following stroke. Study design Systematic literature review Methods We conducted a systematic search of electronic databases including: AMED (1985 to present; CINAHL (1982 to present); EMBASE (1980 to present); MEDLINE (1949 to present); PsycINFO (1967 to present). The search took place on 18/10/2019. Included studies evaluated an early orthotic intervention designed to either promote mobility or reduce secondary complications after stroke. Articles were screened for inclusion by two independent reviewers. Results This review included six articles from one research group in the Netherlands. Methodological quality was considered good in each of the included studies. Limitations include small sample size, restricted descriptions of the intervention and short-term follow-ups. Conclusion This systematic review suggests that earlier lower limb orthotic interventions can result in improved walking speed and balance, and enhanced ability to perform activities of daily living in the early weeks post-stroke. Future research would benefit from considering wider orthotic and orthotist intervention with larger sample sizes and longer-term outcomes.