Abstract
The aim of this study was to investigate the immediate static balance effects of bare foot, UD-Flex ankle–foot orthosis (AFO), and AFO using wire (AOW) of patients with stroke with foot drop. Seventeen patients with stroke with foot drop (8 men and 9 women) were randomized to three conditions (bare foot, UD-Flex AFO, or AOW made with a flexible material). Static balance was assessed using the Zebris (Zebris GmbH, Isny, Germany) and BioRescue (RM Ingenierie, Rodez, France) pressure platform by a single examiner, who did not design the AOW. The order of testing with the equipment was random. The center of pressure path length (mm) measured using Zebris showed significant differences among the three conditions (bare foot, 484.47 ± 208.42; UD-Flex AFO, 414.59 ± 144.43; AOW, 318.29 ± 157.60) (p < 0.05). The bare-foot condition was not significantly different from the UD-Flex AFO condition (p > 0.05), but was significantly different from the AOW condition (p < 0.05). The surface area ellipse (mm2) measured using BioRescue showed significant differences among the three conditions (bare foot, 241.35 ± 153.76; UD-Flex AFO, 277.41 ± 381.83; AOW, 68.06 ± 48.98) (p < 0.05). The bare-foot condition was not significantly different from the UD-Flex AFO condition (p > 0.05), but the AOW condition was significantly different from the bare-foot (p < 0.05) and from the UD-Flex AFO conditions (p < 0.05). We suggest using the AOW made of flexible materials and wire instead of the UD-Flex AFO to improve immediate static balance of patients with stroke with foot drop after stroke. Further studies on the effects of dynamic balance and gait are required.
Highlights
Stroke impairs motor and sensory functions, causing difficulties in postural control [1], leading to postural instability and difficulties in balance and gait [2]
The BioRescue measurements showed significantly improved static balance when using AFO using wire (AOW) compared with the bare-foot and UD-Flex and Zebris measurements compared to the bare-foot condition
ankle–foot orthosis (AFO) conditions and the Zebris measurements showed significantly increased static balance when showed significantly improved static balance when using AOW compared with the bare-foot and using the AOW compared with the bare-foot condition
Summary
Stroke impairs motor and sensory functions, causing difficulties in postural control [1], leading to postural instability and difficulties in balance and gait [2]. In addition to spasticity [5] and muscle weakness [6], foot drop due to plantarflexion stiffness and dorsiflexion weakness is a major cause of poor balance in patients with stroke [7]. Foot drop occurs in 20% of stroke patients [8] and results from a weakening of the dorsiflexors or spasticity of the plantarflexors, causing reduced gait velocity, inefficient gait, and increased risk of falling [9]. Patients with stroke have difficulty controlling posture due to motor and sensory function abnormalities, thereby affecting balance and walking [1,2]
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