Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.

Abstract

BACKGROUND:

Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use.

OBJECTIVE:

The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation.

STUDY DESIGN:

Crossover trial with randomized order of conditions tested.

METHODS:

The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized).

RESULTS:

While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant.

CONCLUSION:

While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms).

CLINICAL RELEVANCE:

Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance.

• Authors: Angelika Zissimopoulos, Stefania Fatone, Steven Gard
• Journal: Prosthetics and orthotics international (Prosthet Orthot Int) Vol. 39 Issue 5 Pg. 372-9 (Oct 2015) ISSN: 1746-1553 [Electronic] France
• PMID: 24878846 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: © The International Society for Prosthetics and Orthotics 2014.

Topics

• Adult
• Cross-Over Studies
• Equipment Design
• Female
• Foot (physiopathology)
• Foot Orthoses
• Gait (physiology)
• Humans
• Male
• Middle Aged
• Range of Motion, Articular (physiology)
• Stroke (complications, physiopathology)
• Stroke Rehabilitation