Article

Little evidence exists for the orthotic management for individuals
diagnosed with diabetic neuropathy and partial foot amputation. Objective: This
pilot study examined differences in balance and pressure distribution while
individuals wore foot orthoses inside shoes (BA) and this same orthosis combined
with an above-ankle (AABA) orthosis. Study Design: Within-group repeated measures
crossover design. Methods: Participants with transmetatarsal amputation were
assessed during randomized visits with the two interventions. Using a motion
analysis system and force plates, we computed the instantaneous inclination angle
between the center of mass and center of pressure to quantify balance. The F-Scan
in-shoe sensor system was used to measure plantar pressures. Results: Improvement
in balance was measured with the use of the AABA orthosis for the participant who
had the greatest time from the timed up and go test (TUG). Plantar pressure
during terminal stance did not change between the two conditions. And, lack of
ankle mobility appears to lead to less compliance. Conclusion: Only individuals
with reduced mobility may have improved balance with an orthosis that extends
above the ankle. The TUG score may be an effective clinical exam to differentiate
those individuals who may benefit from an AABA design as compared to a BA design.
Clinical relevance Orthotic interventions aim to improve balance and distribute
plantar pressures. This study suggests that the different effects on balance
while walking with the BA and AABA devices are individually specific and the TUG
outcome measure may provide a useful means to determine the appropriate
intervention.

Langue : ANGLAIS