PEG Ankle Braces

Transcription

PEG Ankle Braces

Product Evaluation
Ankle Braces
Contents
Product Evaluation Introduction
• Ankle Brace Document Guide
Executive Summary
• Clinical Research
• Key Observations and Recommendations
Product Evaluation Contents
*For Internal purpose only, for further details about the Product Evaluation Group please contact
Marketing. All information was correct at time of print, for current pricing and recomendations please
contact Customer Services.
E: [email protected]
T: +44 (0) 113 270 4841
Product Evaluation Introduction
Executive Summary
The Product Evaluation Group is a national team of Steeper employed Orthotists that meet
every 6-8 weeks to discuss a range of specified orthotic products.
Whilst researching ankle bracing the Product Evaluation Group found an almost infinite number
of devices available for this area of intervention. To narrow the field we selected 26 braces
based on the ordering habits of our 60+ Orthotists. We then went on to split the remaining
braces into sections in an attempt to compare like for like braces.
The aim of the evaluation is to inform and educate whilst assisting the reader in the comparison
of products, highlighting the features, benefits and disadvantages of each product. The
views and opinions expressed in this document are those of a small number of experienced
practitioners and may not represent the views of Steeper, therefore this report is for internal
guidance only.
In order to ascertain the products to be evaluated within each category, the order history for
the category was analysed. The most popular products and the newest products on the market
were selected to be analysed.
The evaluation process consists of
•
•
•
•
•
Direct Evaluation
Expert Opinion
Online Survey
Clinical Evidence
Patient Perspective (taken from patient feedback received from the group of
Orthotists)
The group’s initial thoughts on stock ankle bracing were that we would be able to assign a
description of ‘low’, ‘medium’ or ‘high’ level of support. After the initial trials however it became
clear that none of these braces provided what the group considered to be a ‘high’ level of
support. For this reason the group recommends that if a high level of support is required then a
custom device such as an AFO or DAFO should be considered.
Throughout the course of the document you will see the PEG PICKS icon.
This is to highlight the top rated product as recommended by the Product
Evaluation Group.
PEG PICKS
Top Rated
Product
Best Brace for...
Poor Dexterity
Darko Web
(Beagle)
Lace up/Figure 8
Good All Rounder
Easy Sport
(Steeper)
Increased Support
Bioskin with Fig 8
(Ossur)
Ankle Brace Document Guide
Document Code – SPEG0005V1
Product Evaluation Group –
Adam Horrocks – Orthotist
Andrew Nicol – Clinical Director
Hayley Eaton - Marketing
Rachel Summers - Orthotist
Richard Thomas - Head of Business Development
Zoe Wright - Orthotist
Ankle
Instability
Maximum Support
Stirrup Brace
4
Rebound Ankle
Brace
(Ossur)
AirSport
(Donjoy)
Good All Rounder
AirGel Ankle
Brace (Steeper)
Low Profile
A60 Ankle
Support (Donjoy)
5
Clinical Research
Key Observations and Recomendations
Research shows that the most commonly seen sporting injury in A&E is the sprained
ankle, although it is not exclusively sports enthusiasts who suffer this type of injury.
Whilst the research in this area is plentiful, none of the braces the group evaluated
come with any specific evidence aside from one study. This study (Campbell et al 2005)
compared the Aircast stirrup brace to a Tubigrip in two different A&E departments. The
results indicated that the Aircast brace was significantly better than the Tubigrip on
patients with acute ankle lateral ankle sprains after 10 and 30 days. However, no long
term follow up was reported.
Section 1 – Additional Support Braces
The remaining evidence is limited, however, the common theme for further study is
the comparison of taping to braces. Studies of this theme raise the issue of orthotic
relevance, which must be taken into consideration. Eils et al (Comprehensive Testing
of 10 Different Ankle Braces, 2002) found some improvement in maximum inversion
angles whilst testing 10 different styles of braces. However, the study was carried out
in laboratory conditions using a custom made machine, with the inability to accurately
replicate gait.
Section 2 – Stirrup Style Braces
The Sharpe et al (1997) study into female soccer players in America found that athletes
who have previously been prone to ankle injury do benefit from wearing braces whilst
competing, thus reducing the likelihood of inversion injuries. Conversely, this study
looked at relatively high level athletes and this factor should be considered when
prescribing.
In a more recent article in the Scandinavian Journal of Medicine & Science in Sports,
Genthon et al concluded, ‘Following lateral ankle sprain, wearing an orthosis allows
patients to improve postural function a few hours after the injury to 1 month later. Only
cutaneous pressure intervening without mechanical maintenance induced mild effects,
indicating that orthosis effects on postural control could partly result from its sensorial
stimulation.’ It, therefore, seems relevant to prescribe orthosis wear for at least 1 month.
Whilst there is some current research that supports the use of ankle braces, the
assessment skill and the brace selection of the Orthotist ultimately dictates the
prescription. Furthermore, the long term effects of bracing should also be considered.
References
Comprehensive testing of 10 different ankle braces Eils, Eric et al.
Clinical Biomechanics, Volume 17 , Issue 7 , 526 – 535
Ankle Braces Effectively Reduce Recurrence of Ankle Sprains in Female Soccer Players. Sharpe SR,
Knapik J, Jones B. Journal of Athletic Training. 1997;32(1):21-24.
Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an
elastic support bandage or an Aircast ankle brace. S H Boyce, M A Quigley, S Campbell. Br J Sports Med
2005;39:91-96doi:10.1136/bjsm.2003.009233
Of the 4 braces in this section the Ossur Rebound Ankle Brace came out on top in
terms of support in our evaluation. However it does seem to cover a wide range of
sizes so optimum fit may not always be possible. The Air Sport offered marginally less
support than the Rebound Ankle Brace but conformed well to a variety of ankles. The
CaligaLoc and the Malleoloc performed similarly and are not recommended by the
group because of the difficulties gaining optimum fit.
The key observation with stirrup style braces is to gain optimum support you must
obtain optimum fit. Due to the various ways these braces fasten via Velcro at the
bottom of each strut some are easier to adjust than others. The group found that the
most effective way of gaining an intimate and supportive fit to the hind foot is to have
the Velcro fastening up the outside of the side struts such as the Air-Stirrup, M.Step,
Steeper Inflatable Ankle Brace and AirGel Ankle brace.
Added to this section was the A60 Aircast which is a slightly different design to the
traditional stirrup brace but essentially works off the same principle. This brace offers
good cosmetics and is also relatively low profile too.
Section 3 – Lace up and Figure 8 Style Braces
It was noted that a fairly good level of manual dexterity is needed to fit the lace and
figure of 8 style braces as some of the strapping and lacing combinations can be a little
challenging. The Ossur Form Fit Fig 8 offers a good level of support, conforming to
the ankle well. The Steeper Easy Sport ankle brace offered a similar level of support in
this area too. Whilst the Darco Ankle Web offered improved appearance and a slightly
easier method of fastening, however, with elastic laces, support is sacrificed. Ossur’s
Bioskin range offers good compression and support, however as with the Bioskin range
you need to consider sizing up as the braces tend to come up small.
Section 4 - Specialist Braces
It is difficult to accurately compare these braces, as to our knowledge they are the only
braces of their kind. The group did not find the air heel particularly comfortable to wear,
however it provides some short term temporary relief of heel pain. The Aircast PTTD
brace seems to be popular for the immediate relief of PTTD symptoms. Although fairly
effective, it is quite bulky and is not a long term solution for PTTD. The Ottobock Dyna
Ankle has previously been reviewed as a foot drop splint but was added to this section
as it does offer some support in terms of combined instability. It is lightweight, fairly
flexible and gives mild support to inversion as well as plantarflexion.
Lateral ankle sprain alters postural control in bipedal stance: Part 2 sensorial and mechanical effects
induced by wearing an ankle orthosis N. Genthon, E. Bouvat, J. J. Banihachemi, J. Bergeau, A. Abdellaoui,
P. R. Rougier Scandinavian Journal of Medicine & Science in Sports Volume 20, Issue 2, pages 255–261,
April 2010
6
7
Product Evaluation Contents
Ankle Braces
Product
Page
AirSport (Donjoy)
10
Rebound Ankle Brace (Ossur)
11
CaligaLoc (Bauerfind)
12
MalleoLoc (Bauerfind)
13
A60 Ankle Support (Donjoy)
14
AirGel Ankle Brace (Steeper)
15
Inflatable Ankle Brace (Steeper)
16
Air-Stirrup Ankle Brace (Donjoy)
17
Air/Gel Ankle Stirrup (Beagle)
18
Foam Stirrup Ankle (Beagle)
19
M-Step Medi (Medi)
20
Form Fit Foam Ankle Brace (Ossur)
21
Ankle Air-Form Universal (Ossur)
22
Easy Sport Ankle Brace (Steeper)
23
Darco Web Ankle Support (Beagle)
24
Bioskin with Front Closure (Ossur)
25
Bioskin TriLok (Ossur)
26
Ankle Stabiliser (Steeper)
27
Form Fit Figure 8 (Ossur)
28
Form Fit Standard (Ossur)
29
Swede-O-Ankle Lok (Beagle)
30
BioSkin Standard Ankle (Ossur)
31
Air Heel (Aircast) (Donjoy)
32
AirLift (PTTD) (Donjoy)
33
Ankle Sleeve (Steeper)
34
Dyna Ankle (Ottobock)
35
Additional Support Brace
AirSport
Supplier
Donjoy
Application
•
•
•
Expert Opinion
‘Good adjustable brace, that fits well.’
PEG PICKS
Top Rated
Product
Ankle sprain
Chronic instability
Prophylaxis
Rebound Ankle Brace
Supplier
Ossur
Application
•
•
•
•
•
Expert Opinion
Evaluation
Ankle injury rehabilitation (grade I, II, III)
High ankle sprains and strains
Transition from Walker Boot to daily
activities
Prophylactic use
Posterior tibialis dysfunction
‘The brace did not feel supportive at first,
however, numerous different strapping
configurations are available to give the level of
support needed.’
Evaluation
Features
Incorporates clinically-proven semi-rigid shell and aircells to provide comfort and
support. Additional compression and stabilization is provided by anterior talofibular
cross strap and integral forefoot and shin wraps. This unique “step-in” design (toes
first inserted into the back of the brace) and automatic heel adjustment make the
AirSport™ extremely fast and easy to put on.
Cost
£32.50
Evidence
There is no evidence to support this brace.
PEG Observations
Good adjustable strapping configuration leads to the feeling of stability and
compression. The brace fits well into footwear offering mild to moderate resistance
to medial but more so lateral moments. Measurements span 3 shoe sizes so a fairly
good fit is achievable if the foot can reach a fairly neutral position. The medial and
lateral stays cannot be removed for shaping if fit is not as desired.
Expert User Comments
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Solid supportive brace.
This is effective but bulky and can cause footwear fitting problems.
Good, basic ankle brace. Stiffeners can cause rubbing in anything but perfectly
shaped ankles.
Very useful discreet supportive ankle brace.
Can tend to be a little short in the length of the final wrap around strap
unfortunately, but otherwise a really easy to put on, effective ankle support, that
tends to be well liked by patients.
Well-liked by most patients, slim fitting so easier for wearing with shoes than
most.
•
•
•
Orthotist Perspective
PEG PICKS
Top Rated
Product
Perspective
Number of Orthotist
Orthotist that
have used DJ
thisOrtho
23/38.
Airsport
Features
The Rebound hinged ankle brace offers more stability than soft ankle supports,
and is perfect for transitioning out of a walker boot. Application is simple and
reduces plantar flexion, making it ideal for patients with limited range of motion.
The low-profile design is comfortable and fits easily in most shoes. Available as
Standard or With Stability Strap which provides extra support & numerous strapping
configuration for a range of stability levels.
Cost
£30
Evidence
PEG Observations
Sizing for this brace is based on shoe size which may lead to a poor fit. The small size
covers shoe sizes 2-7.5 and medium 8-10.5 which seems a large size range to cover
with two braces. The brace did not feel as supportive as first anticipated however
there are numerous strapping configurations available for this brace to give more or
less support as required.
•
Number of Orthotist that have used this 9/38.
Can be quite hard and unforgiving.
Orthotist Perspective Ossur Rebound
3.5
3.4
3.3
3.2
3.1
3
2.9
2.8
2.7
2.6
Ease of Adjustment
4
3
Quality of
instructions
Ease of Fitting
Ossur Rebound Ankle Brace
Range of sizes
Average
2
1
0
Ease of Adjustment
10
Quality of
instructions
DJ Ortho Airsport
Ease of Fitting
Average
Range of sizes
11
CaligaLoc
MalleoLoc
Supplier
Bauerfind
Supplier
Bauerfind
Application
•
•
Application
•
•
•
Expert Opinion
Torn ankle ligaments
Temporary stabilisation for post-traumatic
tarsal sinus syndrome and decompensated
instability of the subtalar joint
Permanent stabilisation for chronic
instability of the upper and/or lower ankle
where surgery is contraindicated
Post-operative ligament suturing/
reconstruction
•
•
•
Expert Opinion
Early functional treatment for injuries of the
lateral malleolar ligaments
Capsular ligament strains
Post-operative rehabilitation
Chronic ligament insufficiency
‘The brace does not conform to the foot/ankle
easily and some user’s reported pressure at
proximal ankle and the base of 5th Met.’
‘The brace does not conform to the foot/ankle
easily and some user’s reported pressure at
proximal ankle and the base of 5th Met.’
Evaluation
Evaluation
Features
The CaligaLoc is used as a conservative treatment for torn ankle ligaments, after
operations on the ligaments or in cases of chronic instability of the upper and/or
lower ankle. It offers round-the-clock protection against unexpected or excessive
strain and prevents the ankle from twisting outwards.
Cost
£60
Evidence
PEG Observations
This could be uncomfortable if the foot isn’t a standard shape as it doesn’t conform
very well to the shape of the foot and ankle easily. The brace does however feel like
it resists lateral moments via the lateral wedge and stay however this may be at the
cost of comfort if anatomy is altered. Some users reported pressure at proximal
ankle and the base of 5th Met.
•
•
•
Patients have always found this brace to be too uncomfortable to tolerate, and I
have never used it satisfactorily.
Don’t use them very often at all. Not well tolerated by most patients.
Very rarely used as once brace is fitted footwear is very difficult to find to fit over
the brace, there are better braces for this function.
Features
MalleoLoc is an anatomically self-shaping stabilizing orthosis that can be used in the
immediate care and treatment of ankle injuries. After serious twisting injuries, torn
ligaments and capsular ligament strains, it stabilizes the ankle and protects it from
lateral twisting. The normal heel-to-toe movement of the foot is still possible and the
support can be worn therapeutically without a shoe.
Cost
£54
Evidence
PEG Observations
As with the CaligaLoc the foot has to be a fairly standard shape to allow a
comfortable fit. Slightly less support than the CaligaLoc as expected but comfort
level was similar. Only available in 2 sizes so these must cover a quite a large range of
different size ankles, this could possibly lead to an ill-fitting orthosis.
•
•
•
•
Orthotist Perspective Bauerfiend
Caligaloc
3.5
3
2.5
2
1.5
1
0.5
0
•
Only used once, very poor fit. Didn’t even look like it was on the correct leg (and
it was, I promise!) Dug into lateral side of heel badly.
Poor fit.
Nice low profile brace that misses most pressure points. Not tolerated by all
patients deemed to be a suitable candidate.
This has always proved comfortable and effective. It is low profile and
inconspicuous. I like it a lot.
Only fits a fairly average size ankle.
Orthotist Perspective Bauerfiend
Caligaloc
3.4
3.2
3
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Bauerfiend Caligaloc
Average
Range of sizes
2.8
2.6
2.4
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Bauerfiend Malleoloc
12
Range of sizes
Average
13
Stirrup Style Brace
A60 Ankle Support
PEG PICKS
Top Rated
Product
Supplier
Donjoy
Application
•
•
Expert Opinion
‘This is a sporty, lightweight brace that offers
mild support for an active patient.’
Chronic mild instability
Prophylaxis
Evaluation
Features
Prophylactic support, protection and comfort with simplified application. The design
incorporates a stabilizer molded at a 60 degree angle to help guard against ankle
sprains and prevent rollover. Manufactured with breathable material, for cool comfort.
Lightweight anatomic design easily fits in athletic footwear. Easily adjustable
application. Single strap replaces time-consuming lacing.
£35
Evidence
PEG Observations
A lightweight comfortable brace offering mild support for a more active patient.
Sporty looks with flexibility in the stays to help with contouring. The brace doesn’t
fit too well to the narrower foot however with the Lycra lining bunching slightly. This
fits well into footwear and supported without limiting range of movement enough to
impair activity.
•
•
Does not fit narrow feet well.
Low profile and easy to don brace. Not as supportive as Airsport, but ok for mild
instability or young active patients.
Good all round brace and less issues than the Airsports version I find.
Single wraparound strut rarely fits well around plantar surface of foot on first
application but does tend to mold in time.
•
•
Chart Title
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
2.8
Supplier
Steeper
Application
•
•
•
•
•
Expert Opinion
‘This brace gives excellent contour to the ankle
and fits well into footwear.’
Acute soft tissue injury
Lateral ligament injury/instability
Medio lateral ankle instability
Rheumatoid arthritis
Osteoarthritis
Features
Two shaped plastic medial and lateral ankle supports attached by a supporting
stirrup, air/gel liner bags can be used for hot/cold therapy fitting. Universal left/right
application. Universal sizing to reduce stock.
Cost
£22
Evidence
PEG Observations
Combined air and gel pads line this brace giving excellent contour to the ankle.
Slightly more padding round the malious maybe a requirement for the slimmer leg.
Strap configuration is fairly standard aside from the heel adjustment strap which
is in a much easier position to adjust in comparison to similar alternatives. Fits into
footwear well offering a mild level of support.
•
Straps on lateral stays are easily adjustable and easy to use.
Chart Title
4
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Steeper Air Gel Ankle Brace
Ease of Adjustment
Quality of
instructions
Ease of Fitting
DJ Ortho A60 Ankle Brace
14
PEG PICKS
Top Rated
Product
Evaluation
Cost
Stirrup Style Brace
AirGel Ankle Brace
Range of sizes
Average
Range of sizes
Average
15
Stirrup Style Brace
Inflatable Ankle Brace
Stirrup Style Brace
Air-Stirrup Ankle Brace
Supplier
Steeper
Supplier
Donjoy
Application
•
•
•
•
•
Application
•
•
•
•
Expert Opinion
‘This product is easily adjustable and offers
increased stability at the ankle, despite only
being recomended for mild instabilities.’
Expert Opinion
‘Overall a good adjustable and comfortably
fitting brace, offering mild to moderate support.’
Acute soft tissue injury
Lateral ligament injury/instability
Medio lateral ankle instability
Rheumatoid arthritis
Osteoarthritis
Evaluation
Acute injury
Post operative
Ankle sprains grade I, II, III
Chronic instability
Evaluation
Features
Two shaped plastic medial and lateral ankle supports attached by a supporting
stirrup, air liner bags can be inflated using hand pump supplied to increase
compression. Universal left/right application. Universal sizing to reduce stock
holding.
Features
Anatomically designed semi-rigid shells lined with the patented Duplex™ aircell
system for support and graduated compression during ambulation.
The compression promotes efficient edema reduction in addition to helping
accelerate rehabilitation of ankle sprains.
Cost
£19.99
Cost
£32.50
Evidence
Evidence
PEG Observations
Inflatable padded lining on this brace leads to excellent contour to both a slim
and broader foot and ankle. The lower calf straps are standard for this type of
device and as with the AirGel alternative has an easily adjustable ankle stirrup
that accommodates both the narrow and broader leg. Although intended for mild
instabilities this adjustment leads to a feeling of increased stability at the ankle. Fits
into shoe well however the air bladder access point is at the top of the brace which
reduces the aesthetics of this device.
PEG Observations
Sizing based on height of brace required. This seems sensible as this has an
adjustable heel strap to alter the width of the splint. Excellent contour to both
narrow and wider feet. Because of the contour of the stays distally fits into footwear
well. Adjustable air cells covering the plastic stays come pre inflated and can easily
be adjusted with the tube supplied in box. Offers mild to moderate support and is
overall a good adjustable and comfortably fitting brace.
•
•
•
Good fit generally.
Quite a cheap feel to the brace.
Chart Title
Orthotist Perspective DJ Ortho Air
Stirrup
3.4
4
3.5
3
2.5
2
1.5
1
0.5
0
3.3
3.2
3.1
3
2.9
2.8
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Steeper Inflatable Ankle Brace
16
Bulky in footwear, as are all stirrup type ankle supports, but easy to don for
patients who may struggle with multiple straps etc. Would only use for varus
instability.
Average
Range of sizes
Ease of Adjustment
Quality of
instructions
Ease of Fitting
DJ Ortho Air Stirrup Ankle Brace
Range of sizes
Average
17
Stirrup Style Brace
Air/Gel Ankle Stirrup
Stirrup Style Brace
Foam Stirrup Ankle
Supplier
Beagle
Supplier
Beagle
Application
•
Application
•
Expert Opinion
‘This is the better of the two universal braces
from Beagle based on comfort as the support is
similar.’
Expert Opinion
‘Overall, a good fitting brace, however, doesn’t
provide the support for chronic instability that it
claims to.’
Acute ankle sprains, chronic ankle
instabilities and prophylactic use
Evaluation
Chronic ankle instabilities and prophylactic
use
Evaluation
Features
Provides stability to the ankle by minimising ankle rotation.
Air/Gel bladder may be use for cold therapy to treat oedema.
Universal, one size fits all.
Features
Provides stablity to the ankle by minimizing ankle rotation.
Comprises 2 polypropylene outer shells connected with a soft, adjustable foot piece
Unique memory foam pads provde uniform compression and a customised fit
Pads are wider at the bottom to prevent ‘biting’.
Universal, one size fits all.
Cost
£13.50
Evidence
Cost
£12.50
PEG Observations
Marketed as a universal one size fits all brace with gel/air pads. Very similar support
to the foam alternative with increased comfort. The stays are covered well with the
pads however because of this the brace is slightly more bulky. This is the better of
the two universal braces from Beagle based on comfort as the support is similar.
Evidence
PEG Observations
Marketed as a universal one size fits all brace with memory foam inserts. Fits well
into footwear well however doesn’t offer the level of support it claims for chronic
instability of the ankle. Padding on the stirrups is thin and not quite long enough to
cover all of the plastic which tends to lead to the lateral stay rubbing on the narrower
foot.
•
•
Very similar to the foam version – functionally the same.
Orthotist Perspective Beagle Air Gel
Stirrup Ankle Brace
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
2.8
2.7
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Beagle Air Gel Ankle Brace
Average
Range of sizes
Good looking, sporty black brace.
Orthotist Perspective Beagle Foam
Stirrup Ankle Brace
4
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Beagle Foam Stirrup Ankle Brace
18
Range of sizes
Average
19
Stirrup Style Brace
M-Step Medi
Stirrup Style Brace
Form Fit Foam Ankle Brace
Supplier
Medi
Supplier
Ossur
Application
•
Application
•
•
•
•
•
•
•
Expert Opinion
‘A comfortable brace, however, adjustment is
difficult.’
•
•
Expert Opinion
Conservative and post-operative care of
fibular ligament ankle injuries
Chronic instabilities of the ankle
After distorsions
‘A comfortable and sporty looking brace, with
easy adjustment and mild to moderate support.’
Evaluation
Features
Evaluation
Adjustable heel strap.
Universal size.
Three lengths available: standard (long), athletic (short), paediatric (childrens).
Light foam gel padding with soft, skin friendly surface.
Generous padding of the shell edges.
Two straps allow a quick and secure fastening;
Straps can be taken off the shells and individually fixed.
The medi Mstep universal size can be used for the left or right ankle.
Rigid shells provide stabilisation in pronation and supination movements.
The foam-gel of the padding adapts to the varying anatomic.
Conditions and provides a uniform compression.
Cost
£30
Evidence
PEG Observations
Black and sporty looking, the return loop velcro is preferred as allows to tighten
the straps more effectively. The brace gives mild to moderate support with foam
padding. The brace also comes with adjustable heel width, and the strap is on the
outside for easier adjustment. The brace contours well with the foot and is easy to fit
into the shoe.
•
Easy to use, good looking brace. Sometimes stocked by fracture clinic.
Chart Title
4
3.5
3
2.5
2
1.5
1
0.5
0
Features
The Form Fit padding is sculpted from a very light weight foam to selective
thicknesses providing a cushioned environment. The result is low profile comfort.
Also incorporated is our patented Flex-Edge feature, as well as our unique strapping
and adjustment system.
Cost
£23.10
Evidence
PEG Observations
Stirrup brace with foam pads, this brace offers mild support with some width
adjustment at the base of the brace, however this adjustment isn’t as easy as the
Medi M or the Steeper air gel or inflatable. The brace has dual material stays that
offer flexible edges to increase comfort.
•
Adjustment of width is not as easy as comparable ankle braces such as the Medi
M or Steeper Air Gel.
Very good ankle brace, excellent ankle compression and support.
A beige colour option would be good.
Males tend to like the style find it to be trendy and more supportive.
Good for ankle compression.
•
•
•
•
Chart Title
4
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Ossur Form Fit Foam Ankle Brace
Ease of Adjustment
20
Post-Operative stabilisation
Collateral ligament strains
Inversion & eversion injuries
Acute sports injuries
Mild to moderate sprains & strains
Post cast support
Injury prevention
Quality of
instructions
Ease of Fitting
Medi M Step Functional Ankle Brace
Range of sizes
Average
Range of sizes
Average
21
Stirrup Style Brace
Ankle Air-Form Universal
Lace up and Figure 8 Style Braces
Steeper Easy Sport Ankle Brace
Supplier
Ossur
Supplier
Steeper
Application
•
•
•
•
•
•
•
Application
•
•
•
•
•
•
Expert Opinion
‘A mild supporting brace, that is heavy in
comparison to others. However, the brace is
easy to apply.’
Expert Opinion
‘This lightweight brace, conforms well to the
foot and ankle, with lots of adjustment availble
on the straps to enable supportive fit.’
Post cast support
Injury prevention
Evaluation
Acute soft tissue injuries
Lateral ligament injury
Mediolateral ankle instability
Rheumatoid Arthritis
Osteoarthritis
Stage I PTTD
Evaluation
Features
Combines a full-length air bladder with a flexible shell to provide comfort,
compression and support for an ankle sprain.
Inflatable air bladders allow adjustable levels of compression.
Provides medial and lateral control whilst allowing normal dorsi/plantar flexion.
Cost
£23.10
Evidence
PEG Observations
The brace is an air bladder type brace that also combines foam cushioning. The
brace is easy to apply but adjustment is more difficult, the area is the heel width
which the brace needs to be removed to adjust. The brace isn’t as light weight
compared to other similar braces. The support is very mild.
•
General easy to fit.
Orthotist Perspective Ossur Airform
Inflatable Ankle Stirrup
4
Features
Lace up design provides an adjustable fit ankle control and an elasticated lining gives
improved comfort. Elasticated figure 8 straps limit excessive levels of ankle inversion
and eversion allowing safe mobilisation and pain reduction.
Cost
£19.99
Evidence
PEG Observations
The brace is a lace fastening with figure 8 stirrup, light weight with mild to moderate
support. The brace comes with flexible removable stays, fits footwear well and ideal
for an active patient with mild to moderate instability. The brace conforms to foot
and ankle well with lots of adjustment on the straps to enable comfortable and
supportive fit.
•
Good level of support and comparable to similar braces, we have this in stock so
use frequently.
Good compliance, contours generally well.
•
Chart Title
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Ossur Airform Inflatable Ankle Stirrup
Range of sizes
Average
4
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Steeper Easy Sport Ankle Brace
22
PEG PICKS
Top Rated
Product
Range of sizes
Average
23
Darco Web Ankle Support
Supplier
Beagle
Application
•
•
•
•
Expert Opinion
‘A lightweight and easy fitting brace, that will
fit the majority of patients, whilst giving mild
support and good compression.’
PEG PICKS
Top Rated
Product
Chronic weak ankles
Post operative ankle recovery
Prophylactic ankle protection
Post ankle trauma
Evaluation
Features
Supplier
Ossur
Application
•
•
•
•
•
•
Expert Opinion
‘This brace, is easy to wear and comfortable,
however only offers very mild support.’
PEG PICKS
Top Rated
Product
Bruising
Arthritis
Tendonitis
Sprains / Strains
Chronic instability
Sprain prevention
Evaluation
Comfortable, open-back ankle splint that provides
comfort and compression.
Unique bungee closure system to provide consistent, even pressure.
Back entry provides extreme ease of application.
Low Profile - can easily be worn with athletic or casual shoes.
Constructed of a durable, vinyl shell lined with high tech spacer padding to help wick
moisture away.
Cost
£15.38
Evidence
PEG Observations
The brace has elastic lace fastening with removable medial and lateral stays, very
light weight and easily fits into the footwear. The brace conforms well to ankle with
mild support whilst giving good compression. The brace will fit the majority of
patients and is suitable for sporting activities
•
•
•
Bioskin with Front Closure & Figure of 8
Good, easy to use, supportive brace.
I’ve used it on 2 patients who have used it and have both been happy.
Usually like Ossur Foam Fit but this brace is very very good and fastening is
much easier.
Chart Title
Features
BioSkin’s Front Closure Ankle Skin™ is an economical way to control swelling and
support ankles with minor instability. The Ankle support is constructed of BioSkin’s
patented, thin, breathable material which makes the support comfortable to wear
and easy to put inside a shoe while providing excellent compression.
Cost
£22.20
Evidence
PEG Observations
The brace is made of soft flexible material, is light weight and easy to don and
doff. The fig 8 strap gives mild support and the compression gives proprioceptive
feedback.
•
•
•
Can come up on the small side of the sizing chart i.e. tight on a particular size.
Small made.
Bioskin are always far too small whatever measures I obtain.
Chart Title
3.4
3.3
3.2
3.1
3.4
3
3.3
2.9
3.2
2.8
Ease of Adjustment
3.1
Quality of
instructions
Ease of Fitting
Ossur Bioskin Std Fig 8 Ankle Brace
3
Range of sizes
Average
2.9
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Beagle Darco Web Ankle Brace
24
Range of sizes
Average
25
Bioskin TriLok
Steeper Ankle Stabiliser
Supplier
Ossur
Supplier
Steeper
Application
•
•
•
•
Application
•
•
•
Expert Opinion
‘This brace is soft and flexible, however only
offers very mild support.’
Expert Opinion
‘An adequate fitting brace, however a perfect
contour can be hard to achieve due to the
material.’
Collateral ligament sprains
Arthritis
Tendonitis
Contusion
Evaluation
Features
Unstable ankle
Ligamentous Laxity
Inversion/eversion injury
Evaluation
The most effective brace for controlling inversion, eversion, and plantar flexion
inversion. The key to the TriLok’s™ outstanding effectiveness is the patented
FootLok™ strap which acts as an external ligament, controlling the motion of the
forefoot, while allowing a full range of motion in plantar and dorsi-flexion. The
FootLok™ strap protects the ankle, while not restricting the ability to walk, run, or
jump.
Features
Strong padded support with a lace up front, two removable plastic malleoli inserts
providing medial/lateral stability and protection against inversion/eversion injuries.
Universal left/right application.
Cost
£17
Cost
£37
Evidence
Evidence
PEG Observations
PEG Observations
The brace is made of soft flexible material, is light weight and easy to don and doff
other than a difficult strap configuration. The figure 8 strap gives mild support and
the compression gives proprioceptive feedback.
A lace fastening brace with removable plastic stays both medially and laterally. The
material this brace is constructed from does not contour perfectly but an adequate
fit can be achieved with a firm pull to the laces. Medial and lateral stays can cause
issues on particularly bony prominences but these are easily removed and can be
contoured with ease.
•
•
•
Fiddly, due to multiple, loose straps. Bulky as well when all straps used. Good
support.
Small made.
Very complicated! Would not use again for this reason.
Straps can be very complicated for the patient.
•
•
•
Chart Title
4
3.5
3
2.5
2
1.5
1
0.5
0
Chart Title
4
3.5
3
2.5
2
1.5
1
0.5
0
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Steeper Ankle Stabiliser
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Ossur Bioskin Trilok Ankle Brace
26
Can be stocked in most sites, ease use is good.
Easy to use and generally good compliance – I usually go for the Easy Sport
though as a little more supportive.
Range of sizes
Average
Range of sizes
Average
27
Form Fit - Figure 8
Form Fit Standard
Supplier
Ossur
Supplier
Ossur
Application
•
•
•
•
•
•
•
Application
•
•
•
•
•
•
•
Expert Opinion
‘A mild supporting brace that is aesthetically
pleasing, easily adjustable and suitable for
sporting activities.’
Expert Opinion
‘A mild supporting brace that is aesthetically
pleasing, easily adjustable and suitable for
sporting activities.’
Post cast support
Injury prevention
Evaluation
Evaluation
Features
The Form Fit Ankle Brace with Exoform® Technology is a hybrid between a rigid
ankle stirrup and a soft ankle support. With a stirrup-shaped, plastic exoskeleton
that conforms to the user’s anatomy, it offers the comfort and compression of a soft
ankle support with 20-35% more support than traditional stirrup supports. Optional
figure-8 heel lock strapping performs consistently. Quick donning/doffing.
Embedded stirrup structure provides excellent inversion/eversion support.
Cost
£29.10
Evidence
PEG Observations
Lace up ankle brace with additional figure 8 strap, the brace gives mild to moderate
medial and lateral support the brace is light weight and contours well, is easy to
fit into the shoe and adjustable by lace up fastening and straps, Contours well on
the narrower and the broader foot with moderate restriction on ROM. Suitable for
sporting activities but offering a high level of support.
•
•
•
Figure of 8 is ok. Not really required, as brace itself I find is pretty solid and
supportive.
We use stock Easy Sport Brace (Steeper) before ordering this one as pretty
much the same.
Unsure the figure 8 strap adds much support-wise in reality.
Chart
Number of Orthotist that
haveTitle
used this 14/38.
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
2.8
Features
The Form Fit Ankle Brace with Exoform® Technology is a hybrid between a rigid
ankle stirrup and a soft ankle support. With a stirrup-shaped, plastic exoskeleton that
conforms to the user’s anatomy, it offers the comfort and compression of a soft ankle
support with 20-35% more support than traditional stirrup supports. Embedded
stirrup structure provides excellent inversion/eversion support.
Cost
£33.60
Evidence
PEG Observations
Lace up ankle brace giving mild support medial and lateral, light weight and contours
well, fits easily into the shoe and easily adjustable with lace fastening. The brace
doesn’t feel quite as supportive on a narrower foot but forms well on a broader
foot. The brace gives good support without restricting ROM, suitable for sporting
activities.
•
Very adjustable, made of soft yet supportive materials that conform to shape of
feet well.
Easy to adjust because of full lace opening.
•
Chart Title
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
Ease of Adjustment
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Ossur Form Fit Fig 8 Ankle Brace
28
Post cast support
Injury prevention
Range of sizes
Quality of
instructions
Ease of Fitting
Ossur Form Fit Ankle Brace
Range of sizes
Average
Average
29
Swede-O-Ankle Lok
BioSkin Std Ankle & Figure of 8
Supplier
Beagle
Supplier
Ossur
Application
•
•
Application
•
•
•
•
•
•
Expert Opinion
‘This brace, is easy to wear and comfortable,
however only offers very mild support.’
•
Expert Opinion
Acute ankle injuries
These specially designed straps secure on
both the brace and on each other, allowing
them to be used as both the figure-eight
and the top locking straps over the laces
The superior construction and longer length
of the straps also allows more leverage to be
applied for a much more secure fit and gives
the user the option to secure their ankle
in slight eversion to better prevent ankle
injuries.
Acute soft tissue injuries
Lateral ligament injury
Mediolateral ankle instability
Rheumatoid Arthritis
Osteoarthritis
Stage I PTTD
‘This mild supporting brace, is quite complex to
fit. However, once in place, it is secure.’
Evaluation
Features
Evaluation
Exclusive ANKLE LOK® offset panel traps the laces between the inner and outer flap
to hold the laces tighter longer than any other brace.
Exclusive close spaced eyelets concentrate the holding power where it’s needed
most creating the most effective heel lock.
Full elastic back ensures complete unrestricted blood flow to the Achilles’ tendon
and virtually eliminates the chance for blistering.
Internal U-shaped spiral stays provide extra support and further minimize the chance
for ankle injury.
Arch fits the contour of the foot and is seamless so it virtually eliminates irritation to
the bottom of the foot.
Cost
£30.24
Evidence
PEG Observations
The brace is a lace fastening with removable medial and lateral stays. The brace
comes unlaced so time consuming to do up, the brace gives very mild support as the
plastic stays are thin and flexible. The seam at the back of the heel has a potential to
irritate.
•
•
Has little to offer over Form Fit or Steeper Easy Sport Brace.
Very adjustable, however difficult with patients with low hand function. Must use
fig 8 model.
Chart Title
3.6
Features
BioSkin’s Standard Ankle Skin™ is an economical way to control swelling and support
ankles with minor instability. The Standard Ankle support is constructed of BioSkin’s
patented, thin, breathable material which makes the support comfortable to wear
and easy to put inside a shoe while providing excellent compression.
Cost
£23.50
Evidence
PEG Observations
The brace is easy to don and doff, a lot easier to get into the shoe but offers very
mild support possible by increasing proprioceptive. The brace is very comfortable to
wear.
•
•
•
•
Only very mild support from this brace.
Can come up on the small side of the sizing chart i.e. tight on a particular size
Small made.
Bioskin are always far too small than whatever measures I obtain.
Chart Title
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
2.8
2.7
Ease of Adjustment
3.5
3.4
Quality of
instructions
Ease of Fitting
Ossur Bioskin Standard Ankle Brace
3.3
Range of sizes
Average
3.2
3.1
3
2.9
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Beagle Swede-O Lok Ankle Brace
30
Range of sizes
Average
31
Specialist or Low Level Support Braces
Air Heel (Aircast)
Airlift PTTD Brace
Supplier
Donjoy
Supplier
Donjoy
Application
•
•
•
•
Application
•
Expert Opinion
Plantar fasciitis
Achilles tendonitis
Tendonitis
Heel Pain
•
•
•
‘This unique brace provides cushionning and
comfort around the arch and ankle area.’
Expert Opinion
Evaluation
The AirHeel is specifically designed to treat plantar fasciitis, Achilles tendonitis, and
heel pain. Using two interconnected aircells located under the foot arch and in back
of the heel, the AirHeel applies pulsating compression with every step to help reduce
swelling and discomfort, and enhance circulation. The AirHeel is made of lightweight
breathable fabric and is simple to apply - just slip it on like a sock and adjust the fit
with one strap.
Cost
£32.50
Evidence
PEG Observations
Features
Foot support and ankle stabilization are provided by the AirLift integrated aircell
and semi-rigid shells. The aircell, located under the foot arch, is adjustable using the
Hand Bulb (included with the brace). When inflated, the aircell can accommodate
variances in arch shapes and heights and comfortably lifts the foot arch to achieve
a more natural foot position. For ease-of-use, aircell inflation can be adjusted while
wearing foot wear. The semi-rigid shells are anatomically designed to the shape of
the ankle for secure support and stabilization. These shells help realign the ankle and
support the patient.
Please refer to clinical research (page 6), for evidence
Cost
£40
Not a particularly comparable brace as it is quite unique. Provides cushion just
forward of the heel towards the medial arch. Provides comfort round arch area and
ankle, does not offer any support biomechanically.
Evidence
PEG Observations
The brace is a firm ankle brace specifically designed for PTTD, the brace has
moderate support but is bulky. Also has an inflatable medial arch control which
may become uncomfortable if over inflated, if under inflated will not relieve PTTD
symptoms. The brace comes with Velcro strapping to give good support.
•
•
•
•
Limited use, varying degrees of success.
Good, single purpose brace for acute condition. Reasonably low profile.
Very good plantarfasia treatment.
DJ Ortho Air Heel
4.05
4
3.95
3.9
3.85
3.8
3.75
3.7
3.65
3.6
•
•
•
•
Decent brace. Use this as starting point of PTTD Treatment stage 3+, to see if
ankle support is effective, if so, I make custom brace.
This wears out very quickly.
Good, single purpose brace. A bit bulky so footwear choice is very limited. Good
for acute pain.
A good Orthotic and I find I can use with FFO’s.
A lot of patients find too bulky for footwear so stop wearing it. Functionally
works well.
DJ Ortho Airlift PTTD
Ease of
Adjustment
Quality of
instructions
Ease of Fitting
DJ Ortho Air Heel
32
‘This firm brace offers a good level of support.
However, the adjustable aircells offer a degree of
flexibility that may allow the user to over/under
inflate.’
Evaluation
Features
Posterior tibial tendondysfunctionin stage I
and early stage II
Adult acquired flat foot
Post operative
Rehabilitation
Range of sizes
3.9
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
Ease of Adjustment
Quality of
instructions
Ease of Fitting
DJ Ortho Airlift PTTD
Range of sizes
33
Ankle Sleeve
Dyna Ankle
Supplier
Steeper
Supplier
Ottobock
Application
•
•
•
Application
•
•
Expert Opinion
Expert Opinion
‘This brace is very comfortable and cool to wear.
However, does only offer mild support.’
‘This brace offers good support for mild lateral
instability. Whilst it is slightly more complicated
to fit, once positioned the conformity is good.’
Unstable ankle
Ligamentous Laxity
Inversion / eversion injury
Evaluation
Evaluation
Features
Two-strap fastening for ease of application allows support to strap on like a sock.
Universal left/right application.
Cost
£9.95
Evidence
PEG Observations
The brace is easy to don and doff and easy to get into the shoe, however the support
is mild. The product is made with the addition of coolmax material which wicks away
the moisture from the skin. This brace is very comfortable to wear.
•
Features
The Dyna Ankle is primarily used to treat lateral ligament ruptures, but it is also very
suitable for the treatment of medial ligament ruptures. Plantar flexion and supination
are restricted through a dynamic restraint, while the degree of pronation and dorsal
extension motion is unrestricted.
Cost
£74
Evidence
PEG Observations
It is worth mentioning that this brace was also evaluated as a foot up device.
Good device for mild lateral instability whilst offering some dorsiflexion assistance
simultaneously. For a good fit the patient must be able to reach a plantargrade
position. With rigid nature of the brace it wouldn’t be suitable to someone who has
any form of oedema. Requires a good amount of dexterity to fasten straps however
once positioned the straps are elastic and conform to the contours of the foot and
ankle well.
•
•
Very little orthotic value, supports of this type available in every chemist, never
normally referred to the Orthotist.
In stock usually, so easy to access.
•
Lateral ligament rupture
Medial ligament rupture
Steeper Ankle Sleeve Plus
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3
2.9
•
•
•
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Steeper Ankle Sleeve Plus
•
Range of sizes
Poor hand dexterity can be an issue with the strapping configuration.
Good for flaccid drop foot with a tendency to fall into supination. Not useful if
there is increased tone.
Fits a narrow foot. Complicate for a patient to put on without assistance.
Not used this much but when I have fitted it, it gives good support and is usually
tolerated by the patient.
Calf too small and calf strap too short but function of brace ideal for some
patients.
Great for flaccid foot drop with mild flaccid inversion.
Ottobock - DynaAnkle
4
3.5
3
2.5
2
1.5
1
0.5
0
34
Ease of Adjustment
Quality of
instructions
Ease of Fitting
Ottobock Dyna Ankle
Range of sizes
35
Mayflower House
14 Pontefract Road
LEEDS
LS10 1TB
Tel: +44 (0) 870 240 4133
Email: [email protected]
www.steepergroup.com

PEG Ankle Braces

Transcription

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