Article

Cerebral vascular accidents frequently impair a person's ability to ambulate secondary to impaired dorsiflexion of the ankle. Therefore, custom-made ankle-foot orthoses (AFOs) are often prescribed to patients poststroke. Yet, custom orthoses can be difficult to obtain if a patient is being treated in an inpatient facility. The purpose of this study was to determine whether a manual muscle test (MMT) score of the tibialis anterior muscle can assist decision making for usage of a posterior leaf AFO, a dynamic ankle orthosis (DAO), or no orthosis based on ankle angle during gait in subjects postcerebral vascular accident. Fifteen subjects poststroke (? = 86.3 days) participated in this study. A repeated measure design was used, and participants were asked to walk during three different conditions 1) shoes only, 2) posterior leaf AFO, and 3) DAO. Ankle joint angles during the swing phase of gait and at initial contact were investigated. A repeated measure analysis of variance was used to test for statistical significance (p <= 0.05). Participants were divided into two groups based on MMT scores of >=3+ and <=3. When the groups were compared, a significant interaction between ankle angle and brace was observed during initial contact (p = 0.001) and during midswing (p = 0.005). Individuals with a MMT of 3 or less will likely improve toe clearance during gait with use of a posterior leaf AFO. In contrast, individuals with a dorsiflexion MMT of 3+ or greater may be hindered by use of a posterior leaf AFO. If bracing is required for individuals with a MMT of 3+ or greater, a DAO may be more appropriate.

Langue : ANGLAIS