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Rehabilitation Practice and Science

Translated Title

慢性中風患者使用前葉式足踝支架之平衡效用

Abstract

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and (8) down [HF] with eyes closed on a solid surface. Each position lasted for 32 seconds. Patients underwent the evaluation with and without A-AFO conditions at random. The system software elaborates four posture control parameters, namely, stability, weight distribution, synchronization, and Fourier analysis of the intensity of sway, as reference. Results: Fifty-one patients (men: 34 (67%) subjects), with a median age of 54 years, participated in the study. The median time since the onset of stroke was 48 months. The A-AFO showed significantly better effects on (1) general stability (p= 0.01), (2) heel-toe synchrony in both the affected and unaffected legs (p＜0.01), (3) synchrony between the two heels (p＜ 0.01), (4) increased weight-bearing on the affected forefoot (p＜ 0.01), and (5) reduction of medium to high frequency sway (0.75–1.00 Hz; p＜ 0.01) than standing barefoot. These effects were more apparent under conditions with a mild sensory challenge. However, under conditions of no sensory deprivation (NO) or no vision and vestibular feedback (PC), wearing an A-AFO did not show any benefit for postural control. Wearing an A-AFO did not increase weight-bearing on the affected leg; moreover, it increased weight-bearing on the affected forefoot compared to that on the hindfoot. Conclusion: When patients with stroke wear an A-AFO for a long time, their general stability and heel-toe synchrony can be improved under conditions with a mild sensory challenge. However, weight-bearing on the affected leg is not enhanced.

Language

Traditional Chinese

First Page

97

Last Page

104

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