Specialized orthotic care to improve functioning in adults with neuromuscular disorders: results of an open-label blinded end-point randomized controlled trial.
Elza VAN Duijnhoven, Fieke S Koopman, Jana Tuijtelaars and 5 others
PMID 40856378WHAT IT FOUND
Specialized orthotic care helped adults with neuromuscular disorders reach personal walking goals and improved perceived physical functioning more than usual care.
However, it did not significantly reduce the energy cost of walking compared to usual care, though the specialized group did improve on their own.
Key findings
01Specialized orthotic care resulted in significantly higher attainment of personal goals at 24 weeks compared to usual orthotic care.
02There was no significant difference between groups in the reduction of energy cost of walking, although the specialized care group showed a significant internal reduction.
03Participants receiving specialized care reported greater improvements in perceived physical functioning and higher satisfaction with their orthosis and services.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was underpowered for the energy cost of walking outcome, meaning a true difference between groups might have been missed. The population was heterogeneous, including various neuromuscular conditions, which may make it hard to apply findings to a specific diagnosis. Most participants required ankle-foot orthoses (AFOs); there were too few knee-ankle-foot orthosis (KAFO) users to draw conclusions for that group. Recruitment and participant movement were affected by the COVID-19 pandemic during the study period. Usual care varied across 15 different centers without a standardized protocol, making it difficult to define exactly what 'standard' looked like.
Declared interests
The authors declared no conflicts of interest. The study was funded by ZonMw, a public health research organization in the Netherlands.
The easy way to misread this
Do not conclude that specialized orthotic care is superior for reducing the metabolic cost of walking. While the specialized group improved on their own, the difference between the specialized and usual care groups was not statistically significant for this primary outcome.