Comparison of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance in the gait of stroke patients: A randomized controlled trial
Comparison of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance in the gait of stroke patients: A randomized controlled trial
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DOI：
10.1177/0309364618774055
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发表时间：
2018-10-01
影响因子：
1.5
通讯作者：
Motojima, Naoyuki
中科院分区：
文献类型：
--
作者：
Yamamoto, Sumiko;Tanaka, Souji;Motojima, Naoyuki
背景资料：踝足矫形器的跖屈阻力对踝关节和膝关节的影响是众所周知的，但其对中风患者步态过程中髋关节和上身运动的影响尚不清楚。目的：比较具有跖屈止点的踝足矫形器和具有跖屈阻力的踝足矫形器对中风患者亚急性期步态的影响。研究设计：随机对照试验方法：42例亚急性期脑卒中患者（平均年龄59.9 ± 10.9岁，男36例，女4例），随机分为两组，每组均采用踝足矫形器。患者接受物理治疗师使用指定的踝足矫形器进行步态训练2周。采用三维运动分析方法测量训练前无踝足矫形器时的穿鞋步态和训练后有踝足矫形器时的步态。两组患者的骨盆和胸部倾斜角差异有统计学意义。与不使用踝足矫形器的步态相比，使用踝足矫形器行走时患者的骨盆在跖屈停止时表现为前倾，使用踝足矫形器行走时患者的胸廓在跖屈阻力时表现为前倾减少。踝关节的区别-足部矫形器在矢状面跖屈阻力方面的功能影响了亚急性期脑卒中患者步态期间上身和骨盆的对齐。临床相关性保持直立姿势在步态康复中很重要。本研究结果显示，具有跖屈阻力的踝足矫形器有助于中风患者在亚急性期的步态中更好地调整上半身和骨盆。这种类型的踝足矫形器可能是有益的患者上半身和骨盆对线不良。
Background: The effect of plantar flexion resistance of ankle-foot orthoses on the ankle and knee joints is well known, but its effect on the hip joint and upper body movement during the gait of stroke patients remains unclear.Objectives: To compare the effect of an ankle-foot orthosis with plantar flexion stop and an ankle-foot orthosis with plantar flexion resistance on the gait of stroke patients in the subacute phase.Study design: Randomized controlled trial.Methods: A total of 42 stroke patients (mean age=59.910.9years, 36 men and 4 women) in the subacute phase were randomized to each ankle-foot orthosis group in a parallel controlled trial with no blinding. Patients received gait training from physiotherapists using the specified ankle-foot orthosis for 2weeks. Shod gait without an ankle-foot orthosis before training and gait with an ankle-foot orthosis after training were measured by three-dimensional motion analysis.Results: A total of 20 patients were analyzed in each group. Significant differences were found in pelvic and thoracic tilt angles between the two groups. Compared with the gait without an ankle-foot orthosis, the pelvis showed forward tilt when patients walked with an ankle-foot orthosis with plantar flexion stop, and the thorax showed decreased forward tilt when the patients walked with an ankle-foot orthosis with plantar flexion resistance.Conclusion: The difference in ankle-foot orthosis function in sagittal plantar flexion resistance affected the alignment of the upper body and the pelvis during the gait of stroke patients in the subacute phase.Clinical relevance Maintaining upright posture is important in gait rehabilitation. The findings of this study suggest that the ankle-foot orthosis with plantar flexion resistance facilitated better alignment of the upper body and pelvis during the gait of stroke patients in subacute phase. This type of ankle-foot orthosis could be beneficial for patients with malalignment of the upper body and pelvis.