GaReC project

Recovery of balance and gait capacity is the primary aim in patients with neurological or muscular disorders to optimise daily functioning. Despite the training effort during rehabilitation, many patients remain with gait and balance impairments. Orthotic devices, like orthopaedic shoes or ankle-foot-orthoses (AFOs), are commonly prescribed to improve balance and gait. During the process of the prescription of orthotic devices, a multidisciplinary team of a rehabilitation physician, orthotist, shoe technician and physiotherapist work together.

Currently, this process of prescription and evaluation of orthotic devices is not optimally organised in clinical practice. For an optimal orthotic design, the patient characteristics and their functional disorders (balance and gait problems) need to be assessed. However, for the majority of patients, the orthotic design choices are based on subjective assessment and optimised by trial and error later on in the process. As a consequence, a large group of patients receive suboptimal orthotics. Moreover, suboptimal orthotics lead to non-use of the expensive orthotic devices and numerous repeat visits and thus higher costs. Therefore, the purpose of this project is to optimise the process by developing a decision tool for orthotics, which is called the GaReC (Gait Rehabilitation Clinical decision tool). The GaReC decision tool will use objective measurements in order to prescribe and evaluate orthotics in a more standardised objective way.

The following studies are part of the GaReC project:

• The effect of orthopaedic shoes on postural stability, walking and gait adaptability in individuals with HMSN
• The use of a single sensor on the shank to align AFOs
• Tuning AFOs using a 2D gait analysis
• Patient’s preference as guidance in the decision-making process of prescribing of AFOs

Sponsoren: OIM en Health Holland