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Rehabilitation Practice and Science

Translated Title

前葉式踝足矯具對偏癱步態之效應

Abstract

Ankle-foot orthoses (AFOs) are frequently prescribed for hemiplegia to correct the ankle joint, provide mediolateral stability and improve ambulatory safety.Metal orthoses have gradually been replaced by plastic AFOs because metal orthoses are heavy and have a poor cosmetic appearance. Conventional plastic AFOs are designed in posterior leaf type and fabricated by a lamination or vacuum-forming technique over a positive plaster model of the limb. It takes time to fabricate a plastic AFO, and the effect of correcting for inversion of a hemiplegic foot is not obvious. Wu designed a low-temperature anterior direct molding AFO called an anterior AFO. It is fabricated quickly and easily, and is custom fit. The anterior AFO is commonly used for hemiplegia with spasticity in Taiwan. The purpose of this study was to examine the effects of this anterior AFO on hemiplegic gait. A total of 24 post-stroke hemiplegic patients (17 male and 7 female, their mean age was 58.9 yeas and the duration of their disability averaged 40.3 months.) were included in this study. The Computer DynoGraphy (CDG) of the Infotronic Ultraflex System was used to collect gait data with and without an AFO. Gait analysis comprised of the temporal components of the walking cycle: walking velocity, cadence, stride length and gait symmetry. Kinetic analysis included foot pressure distribution at heel strike, pressure distribution of the lateral border of the foot during stance phase, and vertical ground reaction force at push off. The results revealed that when wearing the anterior AFO, walking velocity increased (15.62±6.33m/min vs 14.36±6.62m/min, p＜0.05), cadence increased (29.58±8.17strides/min vs 28.30±8.94strides/min, p＜0.05) and the forefoot’s weight bearing at heel strike decreased (flatfoot weight bearing instead of forefoot weight bearing)(30.22±12.33% vs 34.35±10.07%). There was no significant difference in gait symmetry, lateral foot weight bearing during stance phase and vertical reaction force at push off.

Language

Traditional Chinese

First Page

119

Last Page

128

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