They went about this research wrong. The question to answer is; Which method leads to better ambulation without the AFO? The whole point is to walk them out of the AFO.
http://lermagazine.com/issues/march/eight-weeks-of-early-afo-use-significantly-enhances-benefits-of-stroke-rehabilitation
Use of an ankle foot orthosis (AFO) within six weeks of stroke
results in better balance outcomes and earlier independent ambulation
than if AFO use is delayed, according to research from the Netherlands.
Investigators from Roessingh Research & Development in Enschede
randomized 18 patients to receive AFOs at either the time of inclusion
in the study (within six weeks of stroke) or eight weeks later. Both
groups received the same rehabilitation, with a focus on balance and
ambulation, the only difference being that the “late” group did the
first eight weeks of rehabilitation without an AFO while the “early”
group did all rehabilitation while wearing AFOs. Balance measures were
assessed every two weeks for 16 weeks.
AFOs were prefabricated nonarticulated devices made from
polypropylene in three different rigidities to accommodate a range of
patient needs. Device fitting involved particular attention to the
alignment of the AFO within the shoe and the alignment of the knee and
hip, said Jaap Buurke, PT, PhD, scientific manager of the research
cluster Restoration and Human Function at Roessingh Research &
Development, who presented his group’s findings at the ISPO World
Congress in Hyderabad on behalf of graduate student Corien Nikamp.
At follow up, both groups demonstrated significant improvement on the
Berg Balance Scale and Functional Ambulation Categories balance tests,
but improvements in the early AFO group were more pronounced and
occurred earlier than in the late group. Early AFO users achieved
independent ambulation earlier than those in the late group, and there
was a trend toward better outcomes on the 10-m walk test, six-minute
walk test, and Timed Up and Go test for the early group.
More at link.
I would like to know how the group that didn't wear an AFO walked. My PT had to tie my foot to my calf with an Ace bandage because I could not lift my toes.
ReplyDeleteMine taped my toes upright to my ankle, That didn't last long, I broke the tape.
DeleteI had tape and two Ace bandages plus my shoe and it didn't help.
Delete