Energy Storing Orthosis Improves Functionality After Lower Limb Injury

The Intrepid Dynamic Exoskeletal Orthosis (IDEO), a custom energy-storing ankle-foot orthosis designed for lower limb extremities that have been salvaged after a high-energy trauma, was proven to significantly improve performance on validated tests of agility, power and speed, according to a study published in the Journal of Bone & Joint Surgery.

The researchers evaluated 18 participants with unilateral dorsiflexion and/or plantarflexion weakness on six functional tests. The participants wore the IDEO, the BlueRocker non-custom carbon fiber orthosis, a posterior leg spring brace or no brace at all. The brace order was randomized, and five trials were completed for each of the functional measures, including a four-square step test, a sit-to-stand five times test, tests of self-selected walking velocity over level and rocky terrain and a timed stair ascent. The participants also completed a timed 40-yard dash.

The researchers found that performance was significantly better with the IDEO with respect to all functional measures compared with all other bracing conditions with the exception of the sit-to-stand five times test, in which there was significant improvement only as compared with the BlueRocker. No significant difference was found among the posterior leaf spring, BlueRocker and no-brace conditions.

The participants also completed a satisfaction questionnaire and indicated whether they had ever considered having an amputation, and if so, whether they still intended to proceed with it. Thirteen patients initially considered amputation, but after completion of the trial, eight desired limb salvage, two were undecided and three still wanted an amputation.

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