Article

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.
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.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS