Nolan Karen J, Savalia Krupa K, Lequerica Anthony H, Elovic Elie P
Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA.
PM R. 2009 Jun;1(6):524-9. doi: 10.1016/j.pmrj.2009.04.011.
To objectively evaluate the effect of ankle foot orthotics (AFOs) on functional ambulation in individuals with hemiplegia secondary to stroke using quantifiable outcome measures.
With-without repeated measures design.
Rehabilitation research center.
Eighteen adults with stroke-related hemiplegia 6 months using a prescribed AFO.
Not applicable.
The distance (m) and velocity (m/s) during the 6-Minute Walk Test (6MWT) and total time (s) and velocity (m/s) during the 25-ft walk (25ftW). Secondary analysis evaluated the 6MWT and 25ftW grouped by the time component of the Ambulatory Index (AI).
Distance walked during the 6MWT was significantly greater with AFO (228.54 +/- 103.93) than without AFO (197.49 +/- 104.13), P = .002. Time to complete the 25ftW was significantly greater without AFO (21.22 +/- 20.57) than with AFO (15.49 +/- 14.65), P = .010. There was a significant difference in average velocity between the 25ftW and 6MWT during the with AFO condition, P = .010. Secondary analysis grouped by the AI time showed that as level of function decreases, brace effect on functional ambulation increases (Group 3: 25ftW with AFO, P = .040).
AFO usage in hemiplegic stroke patients improves functional ambulation, particularly in individuals with a slower gait velocity. The 25ftW, with and without AFO, may be useful to the patient and clinician when determining the importance of brace utilization. Speed modulation was improved when the AFO was added to the paretic limb, and AI grouping indicated that the AFO was more beneficial in people with a slower gait velocity (>20 seconds for the 25ftW). A more definitive study is needed to more completely address this issue. As an exploratory study, the feasibility of different walking assessments was determined so that future studies can validate which objective measures can be used and easily implemented in clinical settings.
采用可量化的结果指标，客观评估踝足矫形器（AFO）对中风继发偏瘫患者功能性步行的影响。
有-无重复测量设计。
康复研究中心。
18名中风相关性偏瘫成人，使用规定的AFO达6个月。
不适用。
6分钟步行试验（6MWT）期间的距离（米）和速度（米/秒），以及25英尺步行（25ftW）期间的总时间（秒）和速度（米/秒）。二级分析按动态指数（AI）的时间成分对6MWT和25ftW进行分组评估。
使用AFO时6MWT期间行走的距离（228.54±103.93）显著大于不使用AFO时（197.49±104.13），P = 0.002。不使用AFO时完成25ftW的时间（21.22±20.57）显著长于使用AFO时（15.49±14.65），P = 0.010。在使用AFO的情况下，25ftW和6MWT之间的平均速度存在显著差异，P = 0.010。按AI时间分组的二级分析表明，随着功能水平降低，支具对功能性步行的影响增加（第3组：使用AFO的25ftW，P = 0.040）。
偏瘫中风患者使用AFO可改善功能性步行，尤其是步态速度较慢的个体。在确定使用支具的重要性时，使用和不使用AFO的25ftW对患者和临床医生可能有用。当在患侧肢体添加AFO时，速度调节得到改善，AI分组表明AFO对步态速度较慢（25ftW超过20秒）的人更有益。需要进行更明确的研究以更全面地解决这个问题。作为一项探索性研究，确定了不同步行评估的可行性，以便未来的研究能够验证哪些客观指标可在临床环境中使用并易于实施。
