The efficacy of lower limb orthoses on quality of life, well-being, and participation following stroke: A systematic review

Stroke is the main cause of acquired adult disability globally, with motor impairment affecting 80% of people after stroke. To regain mobility, diminish falls, and improve quality of life (QoL), after a stroke, orthoses are recommended. Most studies, to date, have focused on the positive impact of ankle-foot orthoses on spatial-temporal, kinematic, and kinetic outcomes. The objective of this review is to assess the evidence of the effects of lower-extremity orthoses on perceptions of QoL, psychological well-being, and social participation after stroke. The following databases were used to search the literature: CINAHL, EMBASE, Scopus, and PubMed, between 1990 and 2022. Previous reviews and reference lists were also screened. Information on the trial design, sample characteristics, information of orthoses used, outcome measures, and results were extracted. Critical appraisal was conducted using SIGN guidelines. Ten articles were identified as meeting the inclusion criteria. The effect of orthoses on QoL was inconsistent: 4 articles reported a positive relationship, one found a negative relationship, and 3 did not find any relationship. Six of 7 articles reported a positive relationship between the use of orthoses and psychological well-being and participation, although the level of evidence was low. This literature review has identified a small number of articles addressing the research question. Furthermore, varied study designs, low levels of evidence seen, the variation in follow-up times, and the limited information about the fitting and appropriateness of the orthoses in the studies highlight that more research is needed.