A Comparison of Ankle-Foot Orthoses for Individuals with Multiple Sclerosis
Individuals with multiple sclerosis (MS) experience gait and balance deficits, even early in the disease. Fatigue is also a common complaint. We have previously shown that fatigue makes these deficits in gait and balance even worse. Newer carbon composite ankle-foot orthoses (AFOs) may reduce fatigue through energy storage and return properties, in turn preserving function. In collaboration with Dr. Kurt Jackson, PhD, PT in this study-in-progress, our teams are examining the effectiveness of two different types of off-the-shelf AFOs worn by individuals with multiple sclerosis who are currently non-AFO users. We are examining trade-offs that may exist between the no-AFO condition and each of the two AFO types relative to balance, gait, strength, endurance, self-perceived fatigue, and self-reported comfort and preferences. We anticipate that the findings of this study will inform AFO prescription, improving mobility outcomes for individuals with MS.
The Use of Laser Biofeedback for Potential Home Rehabilitation
Developing and delivering low-cost, effective interventions to help individuals continue physical therapy exercises after out-patient care has ended is a critical need. One such commercial product to do this is a small, limb-mounted laser pointer that can be used in conjunction with wall-mounted targets. Individuals with movement disorders or those who are recovering from certain injuries use the visual feedback provided by the laser to practice performing movements that are controlled, smooth, and in-line with the targets. It is believed that this will help develop better outcomes relative to desirable movement. In this study-in-progress we work with our long-time collaborator Dr. Kurt Jackson, PhD PT and his team of PT students, as well as Dr. Megan Reissman, to evaluate the effectiveness of the laser. In this case series we have included individuals with various disabilities and conditions affecting lower limb stability. Motion capture data is collected for baseline (no laser) condition, with laser condition, and a final no laser condition (carryover) for various lower limb movement tasks. We expect that this case series will inform us as to which sub-groups may benefit most from this product, leading to a full training study.
Examining the Effectiveness of Vestibular Swing Therapy for Children with Autism Spectrum Disorders
Autism Spectrum Disorders (ASDs) are increasingly common, affecting every 1 in 68 children. Often these children exhibit hypo- and/or hyper-sensitivity to sensory stimulus, as well as deficits in integrating and processing sensory inputs. Vestibular swing therapy seeks to address this. However evidence to document the effectiveness of this therapy is lacking, affecting the likelihood of insurance reimbursement. We proposed that using quiet-standing posturography under various sensory conditions might capture postural control changes related to the therapy. In this feasibility study, completed as part as Senia Smoot’s thesis for her Master’s degree, we examined postural control in children with autism spectrum disorders and typically developing children immediately before and after a 10 minute swing session. We found that all five children with ASD exhibited consistent improvement in the eyes open, flat plate condition which requires a great degree of sensory processing as information comes in from the visual, vestibular, and somatosensory systems. This, along with the other findings of our study, led us to suggest in a recent Physical and Occupational Therapy in Pediatrics article, that posturography may be an appropriate means of capturing and documenting physiological changes related to use of a vestibular swing therapy.
