The application of lower limb orthoses is one of the core areas of neuromuscular rehabilitation expertise (Hsu 2008). However, despite their widespread provision, there is a lack of evidence-based knowledge on the selection of orthoses to best promote patients’ mobility. In the absence of evidence-based knowledge, the choice of orthotic design appears to depend primarily on the preferences and experience of the prescribing rehabilitation physician and/or orthotist. This leads to variation in orthotic practice and differences in the effects of lower limb orthoses, with both positive and negative outcomes being reported (Brehm 2008, Waterval 2019), obviously limiting cost-effectiveness. This situation highlights the need to standardise and optimise the orthotic provision process to guide and inform decision making. Providing lower limb orthoses based on multidisciplinary orthotic expertise and with guidance on how to select the best orthosis for the individual patient using objective gait analyses can lead to an improvement in treatment outcomes and cost-effective lower limb orthotic care in neuromuscular rehabilitation (Duijnhoven 2024). In this symposium, we will:
• Provide insight into the steps of guideline-based orthotic practice for lower limb orthoses in neuromuscular disorders.
• Demonstrate the value of guideline-based orthotic practice in improving the cost-effectiveness of lower limb orthoses in neuromuscular disorders.
• Describe current orthotic practice for children with cerebral palsy in Norway and outline the process of developing the Norwegian National Quality Register for prescribing ankle-foot orthoses in children with cerebral palsy.
Statement of the objective / learning objectives
To provide healthcare professionals with an understanding of guideline-based orthotic practice in patients with neuromuscular disorders and cerebral palsy, and show how this approach can be used for the indication and selection of leg orthoses.
