Functional electrical stimulation and ankle foot orthoses have an equally positive therapeutic effect on walking speed in non-progressive central nervous system diagnoses. The current randomized controlled trial evidence base does not show whether this improvement translates into the user's own environment or reveal the mechanisms that achieve that change. Future studies should focus on measuring activity, muscle activity and gait kinematics. They should also report specific device details, capture sustained therapeutic effects and involve a variety of central nervous system diagnoses.

Studies tended to be commentaries on or descriptions of guideline development, testing or implementation of standards. The literature is not sufficiently well developed to warrant the cost and effort of a systematic review. Future primary research should seek to demonstrate whether and how guidelines and standards improve the outcomes for people that require prostheses, orthoses and other assistive devices. Implications for Rehabilitation International Standards and Clinical Guidelines are now an integral part of clinical service provision in prosthetics and orthotics in the developed world. Complying with standards and guidelines has a cost and, particularly in resource-limited environments, it should be possible to justify this in terms of the resulting benefits. This scoping review concludes that there have been no previous studies designed to directly quantify the effects of implementing standards and guidelines on service delivery.

1 Study Design: Scoping review 2Background: Education and training in prosthetics and orthotics typically complies with International 3

This research aims to study the effect of varus malalignment to knee adduction moment (KAM) during walking using 3D gait simulation. KAM is the product of frontal ground reaction force and frontal lever arm; it is a major cause of pain at the lateral knee that is the general symptom of osteoarthritis (OA). For treatment, lateral fixed wedge insole and variable-stiffness shoes were used to treat OA patient for many years. The device helps reduce KAM while walking by shifting the center of pressure (CoP) from medial side to lateral side. Therefore, shifting CoP to lateral side for reducing frontal lever arm was incorporated into the design of the treatment devices for OA patient. In this paper, program simulation "Adams life module" was used to create 3D human model and simulate 3D gait to observe changes of KAM while vary the adduction angle between thigh and tibia. The simulation model was created based on normal gait profile data during the movement of the model. The result obtained from the simulation showed that the varus malalignment plays important roles on KAM. Increasing of the adduction angle leads to the higher value of peak KAM during walking.

No abstract