Article

Effects of an ankle-foot orthosis on balance performance in patients with hemiparesis of different durations.

Institute and Faculty of Physical Therapy, National Yang-Ming University, Shih-Pai, Taipei, Taiwan.
Clinical Rehabilitation (impact factor: 2.12). 02/2005; 19(1):37-44. pp.37-44
Source: PubMed

ABSTRACT To examine the effects of an ankle-foot orthosis (AFO) on balance performance in patients with hemiparesis of short and long duration.
Within-subject random order of intervention, cross-sectional study design.
Medical centres and district hospitals.
Forty-two subjects with hemiparesis of short duration (< six months) and 61 subjects of long duration ( > 12 months).
The balance and gait ability of subjects were evaluated both with an AFO and without. The static and dynamic balance activities were evaluated by the Balance Master System, whereas the functional balance was assessed with the Berg Balance Scale. The speed and cadence were also measured during a 10-metre walk. Paired t-test was used to determine the effect of the AFO.
In subjects with hemiparesis of short duration, we found that subjects wearing an AFO showed significant improvements in (1) weight-bearing distribution during quiet standing (p = 0.042, 95% confidence interval (CI) 0.521, 7.325), (2) body sway during standing on foam surface with eyes open (p = 0.020, 95% CI 0.020, 0.680) and eyes closed (p = 0.041, 95% CI 0.023, 0.921), (3) movement velocity during limit of stability test (LOS)--toward the affected side (p = 0.037, 95% CI - 0.978, - 0.042) and nonaffected side (p = 0.008, 95% CI -2.223, - 0.377), (4) maximal excursion toward the affected side (p= 0.042, 95% CI -19.546, -0.071), and (5) speed (p=0.028, 95% CI -0.204, -0.017) and cadence (p= 0.021, 95% CI - 22.983, - 1.864). Such effects were not observed in subjects with hemiparesis of long duration.
For the subjects with hemiparesis of short duration, the AFO improves the symmetry in quiet and dynamic standing balances. It also increases speed and cadence. However, its effectiveness is minimal for patients of long duration.

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Keywords

10-metre walk
 
61 subjects
 
95% confidence interval
 
affected side
 
ankle-foot orthosis
 
Balance Master System
 
balance performance
 
Berg Balance Scale
 
cross-sectional study design
 
dynamic balance activities
 
eyes open
 
foam surface
 
functional balance
 
gait ability
 
Medical centres
 
nonaffected side
 
short duration
 
significant improvements
 
stability test
 
Within-subject random order