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Early specialist orthotic assessment after stroke: OTIS

Can early specialist orthotic assessment lead to improved rehabilitation outcomes and reduced complications for patients following a stroke? (OTIS) 

What we are doing?

The research project is a 4 phase study exploring orthotic intervention after stroke. Firstly we are conducting a systematic review in order to identify, synthesise and appraise the existing evidence on lower limb orthotic involvement following stroke. Secondly we are convening a Nominal Group Technique focus group to reach an expert consensus on the content of the early orthotic intervention for the lower limb after stroke. We will include clinical, research and patient experts. Thirdly we are conducting a feasibility randomised controlled trial (RCT) to determine if it is possible to evaluate the effectiveness of an early orthotic intervention for stroke survivors. Finally we will be exploring stroke survivor and stroke clinician experiences and perceptions of an earlier orthotic intervention by conducting interviews with them. 

Why we are doing it?

We know that early rehabilitation and mobilisation after stroke is of benefit and critical to the overall recovery of a stroke survivor. Orthotics are external splints and braces which are designed to aid normal bodily movement and function and as such are often used to assist stroke survivors in their rehabilitation and recovery. Currently orthotists are not named members of the stroke rehabilitation Multi-Disciplinary Team and as a result access to orthotic intervention following stroke can often be restricted or delayed. Through this project we would like to explore the impact of embedding an orthotist within the stroke MDT where stroke survivors would be afforded a specialist orthotic assessment early in their rehabilitation to accompany the other specialist assessment they receive. 

What the benefits will be and to whom?

This research will highlight the potential benefits of seeing an orthotist earlier after having a stroke. Stroke survivors have reported that their orthotic splint and their relationship with their orthotist have been critical aspects of successful rehabilitation and more research is needed in this area to better understand how we can best support stroke survivors in their recovery. 

Who we are working with?

The study is funded in partnership with the Stroke Association through a Postgraduate Fellowship. Key collaborators are the Nottingham University Hospital Trusts Orthotic Department and Stroke Unit. Stroke patients and their carers have also had, and will continue to have, a critical role to play in this project. The study has a PPI member who is a stroke survivor and orthotic user herself and we have presented and sought feedback several times from the Nottingham Stroke Research Partnership Group. 

Contact

Miriam Golding-Day, Division of Rehabilitation, Ageing & Wellbeing at The University of Nottingham, miriam.golding-day@nottingham.ac.uk