Effects of Dynamic Ankle-Foot Orthosis on Postural Balance Control in Hemiparetic Patients
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Objective To determine the effects of dynamic ankle foot orthosis (AFO) on balance control by comparing it with conventional plastic AFO and barefoot conditions in hemiparetic patients. Method Fifteen hemiparetic patients with brain lesions were recruited for this study. All subjects were capable of standing up independently and had a modified Ashworth score of less than two. The postural control capabilities of the subjects were assessed using the timed up and go (TUG) test, and TetraxⓇ tetra-ataxiametric posturography. The stability index, weight distribution index, and synchronization index were measured at six different head positions with dynamic AFO, conventional AFO and under barefoot conditions. Results There were nine males and six females, whose average age was 45.1 years. There was a significantly even weight distribution for the dynamic AFO and conventional AFO conditions relative to the barefoot condition in neutral, right-sided head, and left-sided head with eyes closed (p<0.05). And there was significantly increased stability in left sided-head, neck flexed positions with eyes closed for dynamic AFO and conventional AFO (p<0.05). However, there was no significant difference in weight distribution or stability between dynamic and conventional AFO conditions, except the stability in right-sided head position with eyes closed. Conclusion In this study, the balance control of hemiparetic patients with dynamic AFO was better than in the barefoot condition, and was similar to conventional AFO. Therefore, we suggest that dynamic AFO may be a useful orthosis for hemiparetic patients with mild to moderate spasticity with poor balance control and foot drop.
Abstract
Objective To determine the effects of dynamic ankle foot orthosis (AFO) on balance control by comparing it with conventional plastic AFO and barefoot conditions in hemiparetic patients. Method Fifteen hemiparetic patients with brain lesions were recruited for this study. All subjects were capable of standing up independently and had a modified Ashworth score of less than two. The postural control capabilities of the subjects were assessed using the timed up and go (TUG) test, and TetraxⓇ tetra-ataxiametric posturography. The stability index, weight distribution index, and synchronization index were measured at six different head positions with dynamic AFO, conventional AFO and under barefoot conditions. Results There were nine males and six females, whose average age was 45.1 years. There was a significantly even weight distribution for the dynamic AFO and conventional AFO conditions relative to the barefoot condition in neutral, right-sided head, and left-sided head with eyes closed (p<0.05). And there was significantly increased stability in left sided-head, neck flexed positions with eyes closed for dynamic AFO and conventional AFO (p<0.05). However, there was no significant difference in weight distribution or stability between dynamic and conventional AFO conditions, except the stability in right-sided head position with eyes closed. Conclusion In this study, the balance control of hemiparetic patients with dynamic AFO was better than in the barefoot condition, and was similar to conventional AFO. Therefore, we suggest that dynamic AFO may be a useful orthosis for hemiparetic patients with mild to moderate spasticity with poor balance control and foot drop.
참고문헌 (17)
- Krishchiunas AI, "Falls in early in-patient rehabilitation of stroke patients", Zh Nevrol Psikhiatr Im S S Korsakova, 11, pp.47~50 (2004)
- Nyberg L, "Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies", Stroke, 26, pp.838~842 (1995)
- Rah UW, "Effects of plastic ankle-foot orthosis on hemiplegic ambulation", J Korea Acad Rehabil Med, 25, pp.836~841 (2001)
- Westberry DE, "Impact of ankle-foot orthoses on static foot alignment in children with cerebral palsy", J Bone Joint Surg Am, 89, pp.806~813 (2007)
- Mojica JA, "Effect of ankle-foot orthosis (AFO) on body sway and walking capacity of hemiparetic stroke patients", Tohoku J Exp Med, 156, pp.395~401 (1988)
- Wang RY, "Effects of an ankle-foot orthosis on balance performance in patients with hemiparesis of different durations", Clin Rehabil, 19, pp.37~44 (2005)
- Park JH, "Comparison of Gait Analysis Between Anterior and Posterior Ankle Foot Orthosis in Hemiplegic Patients", AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, 88(8), pp.630~634 (2009), American J of Physical Medicine & Rehabilitation
- Vinci P, "Poor compliance with ankle-foot- orthoses in Charcot-Marie-Tooth disease", Eur J Phys Rehabil Med, 44, pp.27~31 (2008)
- Lam WK, "Biomechanical and electromyographic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy", Gait Posture, 22, pp.189~197 (2005)
- Bleyenheuft C, "Assessment of the Chignon dynamic ankle-foot orthosis using instrumented gait analysis in hemiparetic adults", Ann Readapt Med Phys, 51, pp.154~160 (2008)
- Kohen-Raz R, "Application of tetra-ataxiametric posturography in clinical and developmental diagnosis", Percept Mot Skills, 73, pp.635~656 (1991)
- Yavuzer G, "The effects of balance training on gait late after stroke: a randomized controlled trial", Clin Rehabil, 20, pp.960~969 (2006)
- Bohannon RW, "Gait performance of hemiparetic stroke patients: selected variables", Arch Phys Med Rehabil, 68, pp.777~781 (1987)
- Weerdesteyn V, "Falls in individuals with stroke", J Rehabil Res Dev, 45, pp.1195~1213 (2008)
- Tyson SF, "The effect of a hinged ankle foot orthosis on hemiplegic gait: objective measures and users' opinions", Clin Rehabil, 15, pp.53~58 (2001)
- Wong AM, "Clinical trial of a low-temperature plastic anterior ankle foot orthosis", Am J Phys Med Rehabil, 71, pp.41~43 (1992)
- Chen CK, "Effects of an anterior ankle-foot orthosis on postural stability in stroke patients with hemiplegia", Am J Phys Med Rehabil, 87, pp.815~820 (2008)