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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?

There are four phases to the PhD programme of research. Firstly a systematic review will be completed to collate the existing evidence on lower limb orthotic involvement following stroke; secondly we will conduct a national survey to gather real world experiences and perspectives from orthotists practicing within stroke rehabilitation in the UK. Further to this, focus groups will be conducted with orthotists, physiotherapists, bioengineers, stroke survivors and their carers to refine the findings from the survey. Finally an International eDelphi is to be completed seeking to agree expert consensus on what the optimum timing and methods of orthotic intervention following stroke is. 

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 (MDT) 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 role of the orthotist as a member of the wider stroke MDT and seek to determine best practice statements for how and when they are best involved in a stroke survivors care. 

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 The British Association of Prosthetists and Orthotists. 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. 


Miriam Golding-Day, Centre of Rehabilitation and Ageing Research, The University of Nottingham,