Orthotic care needs in a cohort of neurological rehabilitation inpatients

Orthotic management is frequently part of the rehabilitation of various neurological conditions in adults such as stroke, peripheral neuropathies, spinal cord injuries and multiple sclerosis. Despite this, there are limited data available on the implementation of orthotic care in practice. The primary aim of this study is to establish the proportion of inpatients in a mixed neurorehabilitation cohort which receive orthotic assessment and treatment. The secondary aim was to document the overall care pathway. Existing data were reviewed retrospectively. Data gathered included patient demographics such as age, gender and diagnosis, type of orthoses prescribed, number of orthotic treatment sessions required and outcome measures used. The paper was prepared in accordance with the STROBE statement for observational studies. During a 6 month period, 54 patients were admitted as inpatients. Of these, 25 (46%) were referred to the orthotic service for assessment, with 23 (43%) receiving a lower limb orthosis and 19 (35%) subsequently being discharged using either an ankle-foot orthosis or knee-ankle-foot orthosis. The conditions most commonly seen were stroke (40%), incomplete spinal cord injuries (28%) and peripheral neuropathies (16%). Significant improvements were recorded at discharge using the Functional Independence Measure (FIM) and Functional Assessment Measure (FAM). Various aspects of the orthotic care process are described. This study suggests that orthotic treatment is needed with high frequency in a mixed inpatient neurorehabilitation cohort. In terms of service planning, these data support existing the recommendation that neurological rehabilitation centres should have good access to orthotic services.Implications for rehabilitationCustom orthoses such as AFOs and KAFOs are frequently needed by neurological rehabilitation inpatients.Orthoses may facilitate standing and walking at an earlier stage during rehabilitation.Those responsible for neurological rehabilitation services should ensure appropriate access to orthotic services. Custom orthoses such as AFOs and KAFOs are frequently needed by neurological rehabilitation inpatients. Orthoses may facilitate standing and walking at an earlier stage during rehabilitation. Those responsible for neurological rehabilitation services should ensure appropriate access to orthotic services.

矫形器管理（orthotic management）常作为成人各类神经系统疾病康复的组成部分，涵盖脑卒中、周围神经病、脊髓损伤及多发性硬化等病症。尽管如此，目前临床中关于矫形护理实施的公开数据仍较为匮乏。本研究的首要目标为明确混合神经康复队列中接受矫形器评估与治疗的住院患者占比；次要目标则为梳理整体护理路径。本研究采用回顾性审查现有数据的方法，收集的资料包括患者人口统计学信息（如年龄、性别、诊断结果）、所开具的矫形器类型、所需矫形治疗次数以及所采用的疗效评估指标。本论文严格遵循观察性研究的STROBE声明（STROBE statement）撰写。

在为期6个月的研究周期内，共计收治54名住院患者。其中25名（46%）被转诊至矫形服务中心接受评估，23名（43%）患者获配下肢矫形器，19名（35%）患者最终在出院时使用踝足矫形器（ankle-foot orthosis, AFO）或膝踝足矫形器（knee-ankle-foot orthosis, KAFO）。本队列中最常见的病症依次为脑卒中（40%）、不完全性脊髓损伤（28%）以及周围神经病（16%）。采用功能独立性评定量表（Functional Independence Measure, FIM）与功能评定量表（Functional Assessment Measure, FAM）评估结果显示，患者出院时的功能状态较入院时有显著改善。

本研究阐述了矫形护理流程的多个维度。结果表明，在混合住院神经康复队列中，矫形治疗的需求占比颇高。从服务规划角度而言，本研究数据支持现有建议，即神经康复中心应确保患者可便捷获取矫形服务。

康复启示：
定制矫形器（如踝足矫形器AFO与膝踝足矫形器KAFO）是神经康复住院患者的常见需求。矫形器可帮助患者在康复早期阶段即可开展站立与行走训练。神经康复服务的负责方应确保患者能够获得充足的矫形服务资源。
定制矫形器（如踝足矫形器AFO与膝踝足矫形器KAFO）是神经康复住院患者的常见需求。矫形器可帮助患者在康复早期阶段即可开展站立与行走训练。神经康复服务的负责方应确保患者能够获得充足的矫形服务资源。