Lairamore Chad, Garrison M Kevin, Bandy William, Zabel Reta
University of Central Arkansas, Conway, USA.
Prosthet Orthot Int. 2011 Dec;35(4):402-10. doi: 10.1177/0309364611417040. Epub 2011 Aug 4.
Ankle-foot orthoses (AFO) have been used to improve the gait of individuals post stroke, but their use has come into question secondary to increased understanding of motor re-learning.
The purpose of this study was to determine if there is a change in tibialis anterior muscle electromyography, ankle angle, or gait velocity when individuals post stroke walk with a posterior leaf-spring AFO (PLAFO) or a dynamic ankle orthosis (DAO).
Repeated measures.
Fifteen participants post stroke walked without an orthosis, with a PLAFO, and with a DAO. Data were gathered using electromyography, force plates, and three-dimensional motion analysis cameras. A repeated measures ANOVA was used to test for statistical significance (p ≤ 0.05).
Participants exhibited significantly less tibialis anterior muscle electromyography during the swing phase of gait with use of a DAO (p < 0.001). No change in velocity or ankle angle was exhibited with use of either orthosis.
The results support therapists' notions that bracing can lead to a decline in tibialis anterior muscle activity during the swing phase of gait. The results also showed no improvement in gait velocity when either orthosis was used by participants who could walk without an orthosis.
踝足矫形器（AFO）已被用于改善中风后患者的步态，但随着对运动再学习的深入理解，其使用受到了质疑。
本研究的目的是确定中风后患者使用后叶弹簧式踝足矫形器（PLAFO）或动态踝足矫形器（DAO）行走时，胫前肌肌电图、踝关节角度或步态速度是否会发生变化。
重复测量。
15名中风后患者分别在不使用矫形器、使用PLAFO和使用DAO的情况下行走。使用肌电图、测力板和三维运动分析摄像头收集数据。采用重复测量方差分析来检验统计学意义（p≤0.05）。
使用DAO时，参与者在步态摆动期的胫前肌肌电图明显减少（p<0.001）。使用任何一种矫形器时，速度或踝关节角度均无变化。
结果支持治疗师的观点，即支具会导致步态摆动期胫前肌活动下降。结果还表明，对于能够不使用矫形器行走的参与者，使用任何一种矫形器时步态速度均无改善。
