Long-Term Effect of an Anterior Ankle-Foot Orthosis on Functional Walking Ability of Chronic Stroke Patients

Introduction: Stroke is currently the main cause of permanent disability in adults. The impairments are a combination of sensory, motor, cognitive and emotional changes that result in restrictions on the ability to perform basic activities of daily living (BADL). Postural control is affected and causes problems with static and dynamic balance, thus increasing the risk of falls and secondary injuries. The purpose of this review was to compile the literature to date, and assess the impact of ankle-foot orthosis (AFO) on postural control and gait in individuals who have suffered a stroke. Development:The review included randomised and controlled trials that examined the effects of AFO in stroke patients between 18 and 80 years old, with acute or chronic evolution. No search limits on the date of the studies were included, and the search lasted until April 2011. The following databases were used: Pubmed, Trip Database, Cochrane library, Embase, ISI Web Knowledge, CINHAL and PEDro. Intervention succeeded in improving some gait parameters, such as speed and cadence. However it is not clear if there was improvement in the symmetry, postural sway or balance.Conclusions: Because of the limitations of this systematic review, due to the clinical diversity of the studies and the methodological limitations, these results should be considered with caution. Accidente cerebrovascular; Control postural; Equilibrio; Marcha; Ortesis tobillo pie Efecto de la ortesis de tobillo pie en el control postural tras el accidente cerebrovascular: revisión sistemática Resumen Introducción: El accidente cerebrovascular (ictus) actualmente es la primera causa de discapacidad permanente en la edad adulta por sus consecuentes secuelas, quedando una combinación de deficiencias sensoriales, motoras, cognitivas y emocionales que conducen a restricciones en su capacidad para realizar actividades básicas de la vida diaria (ABVD). El control postural se afecta y da lugar a problemas en el equilibrio estático y dinámico que incrementan el riesgo de caídas. El objetivo de la revisión consiste en realizar una revisión sistemática que permita valorar los efectos de las ortesis de tobillo (OTP) en el control postural y en la marcha, en sujetos que han presentado un ictus.Desarrollo: Se incluyeron ensayos controlados y aleatorizados que analizasen los efectos de las ortesis de tobillo en pacientes con ictus de entre 18 y 80 años, con evolución aguda o crónica. La búsqueda de ensayos no tuvo limitación en fecha de inicio y se extendió hasta marzo de 2011. Se emplearon las bases de datos Pubmed, Trip Database, Cochrane Library Plus, Embase, ISI Web knowledge, CINHAL y PEDro.Conclusiones: La intervención logró mejorar algunos parámetros de la marcha como velocidad y cadencia. Sin embargo, no está clara la mejora en la simetría del peso, el balanceo postural o el equilibrio. Las limitaciones de esta revisión sistemática, debidas a la gran diversidad clínica de los estudios que incluye y las limitaciones metodológicas de estos, justifican una lectura precavida de...

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“…Six authors provided the requested data. [56][57][58][59][60][61] Only published data were used for the rest of the studies. 97 patients.…”

Section: Methodological Qualitymentioning

confidence: 99%

Effect of ankle-foot orthosis on postural control after stroke: A systematic review

Padilla

Molina‐Rueda

Diego

2014

Neurología (English Edition)

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“…Se escribió a través de correo electró-nico a trece autores 38,55-66 solicitando aclaración acerca de algunos aspectos del diseño o información no indicada con el fin de completar las evaluaciones de calidad. Seis autores proporcionaron los datos solicitados [56][57][58][59][60][61] . Para el resto de los estudios solo se usaron los datos publicados.…”

Section: Calidad Metodológicaunclassified

Efecto de la ortesis de tobillo pie en el control postural tras el accidente cerebrovascular: revisión sistemática

Padilla¹,

Molina‐Rueda²,

Diego³

2014

Neurología

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“…As demonstrated by Hung et al, 42 the 6MWT could be used in conjunction with the mEFAP to assess all these mobility tasks. Hung et al 42 used both these measures to assess the effect of an anterior AFO on functional mobility and walking endurance of persons post-stroke.…”

Section: Defining the Mobility Domainmentioning

confidence: 99%

“…Sub-scores and total mEFAP scores for three studies of subjects ambulating without orthoses at different times post stroke: subjects >90 days post-stroke from Sheffler et al 51 ; subjects >1 year post-stroke from Liaw et al 52 ; and subjects a mean of 33.5 months post-stroke from Hung et al 42 Figure 3. Sub-scores and total mEFAP scores for two studies of post-stroke subjects walking with and without AFOs: subjects >90 days post-stroke from Sheffler et al 51 and subjects a mean of 33.5 months post-stroke from Hung et al 42 Figure 4. mEFAP sub-scores comparing the effects of both an AFO and peroneal nerve stimulator (ODFS) to walking without either device (from Sheffler et al 51 ). Total mEFAP scores shown were calculated from the sub-scores presented in the paper by Sheffler et al 51 • • Selection and integration of outcome measures into clinical practice is a process.…”

Section: Key Pointsmentioning

confidence: 99%

“…These data suggest that there is a hierarchy in the sub-tasks wherein the 5mWT is relatively easy to perform and the obstacle test relatively hard. The mEFAP has been used to demonstrate improvements in mobility tasks with use of an AFO 42,51 (Figure 3) as well as to compare the effects of different orthotic interventions on functional ambulation poststroke 51 (Figure 4).…”

Section: Application Of Outcome Measures In the Orthotic Management Omentioning

confidence: 99%

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You’ve heard about outcome measures, so how do you use them? Integrating clinically relevant outcome measures in orthotic management of stroke

Robinson

Fatone

2013

Prosthetics &Amp; Orthotics International

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In today's healthcare environment it is increasingly important to be able to quantify the amount of change associated with a given intervention; this can be accomplished using one or more appropriate outcome measures. However, the selection and integration of outcome measures within clinical practice requires careful consideration. This includes identification of the measure construct which can be assisted by the International Classification of Functioning, Disability, and Health; selection of outcome measures based on need, appropriateness and feasibility; and careful use in regular clinical practice including data collection, analysis and re-assessment of the process. We describe this process, focusing on orthotic management of stroke, in particular the improvement of mobility as a common goal. Clinical relevanceThe growing emphasis on improved documentation of patient care and outcomes requires that clinicians integrate clinically relevant outcome measures into their practice. We suggest a process to assist clinicians integrate outcome measures into clinical practice with a particular emphasis on the orthotic management of stroke.

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Long-Term Effect of an Anterior Ankle-Foot Orthosis on Functional Walking Ability of Chronic Stroke Patients

Abstract: The effects of the anterior ankle-foot orthosis on stroke patients' functional walking ability and fall efficacy were significant. Patients who were of younger age or with low walking ability or both were more suitable for using the anterior ankle-foot orthosis.

Cited by 28 publications

References 31 publications

Effect of ankle-foot orthosis on postural control after stroke: A systematic review

Effect of ankle-foot orthosis on postural control after stroke: A systematic review

Efecto de la ortesis de tobillo pie en el control postural tras el accidente cerebrovascular: revisión sistemática

You’ve heard about outcome measures, so how do you use them? Integrating clinically relevant outcome measures in orthotic management of stroke

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