I was just immediately given an AFO, then a hinged AFO. I seriously
believe that an AFO actually hinders recovery, you do no training of
your dorsiflexion while wearing an AFO. I went cold turkey on using one
on a 21 day canoe trip in Canada and Alaska, 3 years after stroke. It
forced me to immediately strengthen my ankle to keep it from rolling and
get toe clearance. Didn't fall on that trip.
European Journal of Physical and Rehabilitation Medicine,
09 Sep 2021,
DOI:
10.23736/s1973-9087.21.07048-9 PMID: 34498833
Share this article
Share with emailShare with linkedinShare with facebook
Abstract
Background
Ankle-foot
orthoses are used to improve gait stability in patients with
post-stroke gait; however, there is not enough evidence to support their
beneficial impact on gait stability.Aim
To investigate the effects of ankle-foot orthoses on post-stroke gait stability.Design
An experimental study with repeated measurements of gait parameters with and without orthosis.Setting
Inpatients and outpatients in the Fujita Health University Hospital.Population
Thirty-two patients (22 males; mean age 48.3±20.0 years) with poststroke hemiparesis participated in the study.Methods
Three-dimensional
treadmill gait analysis was performed with and without ankle-foot
orthosis for each participant. Spatiotemporal parameters, their
coefficient of variation, and margin of stability were evaluated. Toe
clearance, another major target of orthosis, was also examined. The
effect of orthosis in the patients with severe (not able to move within
the full range of motion, defying gravity) and mild ankle impairment
(able to move within the full range but have problem with speed and/or
smoothness of the ankle movement) was compared.Results
In the
total group comparison, the decrease in the coefficient of variation of
step width (P=0.012), and margin of stability on the paretic side
(P=0.023) were observed. In the severe ankle impairment groups, the
decreased in the coefficient of variation of the non-paretic step length
(P=0.007), stride length (P=0.037), and step width (P=0.033) and margin
of stability on the paretic side (P=0.006) were observed. No
significant effects were observed in the mild ankle impairment group;
rather, the coefficient of variation of non-paretic step length
increased with the use of orthosis in this group (P=0.043); however, toe
clearance increased with the use of ankle-foot orthosis (P=0.041).Conclusions
Ankle-foot
orthoses improved gait stability indices; however, the effect was
either not significant or showed possible worsening in the patients with
mild ankle impairment, while the effect on toe clearance was
significant. These results suggest that the effects of using orthoses in
patients with mild impairment should be carefully evaluated.
No comments:
Post a Comment