Zissimopoulos Angelika, Fatone Stefania, Gard Steven
1Northwestern University Prosthetics-Orthotics Center, Dept. of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Chicago, IL, USA.
Prosthet Orthot Int. 2014 Apr;38(2):148-54. doi: 10.1177/0309364613490445. Epub 2013 Jun 24.
One intervention often used to address physical impairments post stroke is an ankle-foot orthosis. Ankle-foot orthoses may improve walking speed, stride length, and gait pattern. However, effects on balance, crucial for safe ambulation, are thus far inconclusive. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one's ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation (as defined by the International Classification of Functioning, Disability, and Health) than physical performance measures of gait or balance.
We investigated whether self-efficacy, or balance confidence when referred to in the context of balance capabilities, is improved with ankle-foot orthosis use.
Repeated measures study design.
Balance confidence was measured using the Activities-specific Balance Confidence Scale in 15 persons with chronic poststroke hemiplegia, with and without their regular ankle-foot orthosis.
Activities-specific Balance Confidence Scale scores were significantly higher (p ≤ 0.01) for the ankle-foot orthosis condition compared to no ankle-foot orthosis.
One mechanism by which ankle-foot orthosis use may influence balance is improved balance confidence. Future work should explore the specific mechanisms underlying this improvement in self-efficacy. Clinical relevance Self-efficacy may be an important factor to consider when evaluating functioning post stroke. Rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations, particularly in the fall-prone poststroke population. Study results provide evidence for improvements in balance confidence with ankle-foot orthosis use.
中风后常用于解决身体功能障碍的一种干预措施是踝足矫形器。踝足矫形器可能会提高步行速度、步幅和步态模式。然而，其对平衡（安全行走的关键因素）的影响至今尚无定论。已证明对功能能力有贡献的平衡的一个方面是自我效能感。自我效能感被定义为个体相信自己在特定情况下能够成功的信念，与活动和参与（如国际功能、残疾和健康分类所定义）的关联比步态或平衡的身体表现测量更为紧密。
我们研究了使用踝足矫形器是否能提高自我效能感，或在平衡能力背景下提及的平衡信心。
重复测量研究设计。
使用特定活动平衡信心量表对15名慢性中风后偏瘫患者在佩戴和不佩戴常规踝足矫形器的情况下测量平衡信心。
与不使用踝足矫形器相比，使用踝足矫形器时特定活动平衡信心量表得分显著更高（p≤0.01）。
使用踝足矫形器可能影响平衡的一种机制是提高平衡信心。未来的工作应探索这种自我效能感提高的具体潜在机制。临床相关性自我效能感可能是评估中风后功能时需要考虑的一个重要因素。提高平衡信心的康复干预措施可能有助于恢复病理性人群的参与和整体功能，特别是在容易跌倒的中风后人群中。研究结果为使用踝足矫形器可提高平衡信心提供了证据。
