Lee Youngmin, Her Jin Gang, Choi Youngeun, Kim Heesoo
Department of Rehabilitation Therapy, Graduate School of Hallym University, Republic of Korea.
Department of Physical Therapy, Hallym College, Republic Korea.
J Phys Ther Sci. 2014 Feb;26(2):179-82. doi: 10.1589/jpts.26.179. Epub 2014 Feb 28.
[Purpose] This study examined the effects of an ankle-foot orthosis worn during balance training on lower limb muscle activity and static balance of chronic stroke patients. [Subjects] The subjects were twenty-five inpatients receiving physical therapy for chronic stroke. [Methods] The chronic stroke patients were divided into two groups: thirteen patients were assigned to the ankle-foot orthosis group, while the remaining twelve patients wore only their shoes. Each group performed balance training for 20 minutes, twice per day, 5 days per week, for 6 weeks. The lower limb muscle activities of the paralyzed side tibialis anterior, medial gastrocnemius, and the stability index were measured before and after the 6-week intervention. [Results] Comparison of the groups indicated a significant difference in the muscle activity of the paralyzed side tibialis anterior and the stability index of the eyes-open standing position. After the intervention, the ankle-foot orthosis group evidenced a significant difference in the muscle activities of the paralyzed side tibialis anterior and paralyzed side medial gastrocnemius as well as the stability index of the eyes-open standing position, eyes-closed standing position, eyes-open standing position on a sponge, and eyes-closed standing position on a sponge. The group that only wore their shoes showed significant differences in the stability indexes of eyes-open standing and eyes-open standing on a sponge. [Conclusion] Using the ankle-foot orthosis was effective during the initial training of lower limb muscle activities and the static balance training of chronic stroke patients. However, it was not effective for a variety of dynamic situations.
[目的]本研究探讨了平衡训练期间佩戴踝足矫形器对慢性卒中患者下肢肌肉活动及静态平衡的影响。[对象]研究对象为25名接受慢性卒中物理治疗的住院患者。[方法]将慢性卒中患者分为两组:13名患者被分配至踝足矫形器组,其余12名患者仅穿着鞋子。每组每天进行2次平衡训练,每次20分钟,每周训练5天,共训练6周。在6周干预前后测量患侧胫骨前肌、腓肠肌内侧头的下肢肌肉活动及稳定性指数。[结果]两组比较显示,患侧胫骨前肌的肌肉活动及睁眼站立位的稳定性指数存在显著差异。干预后,踝足矫形器组在患侧胫骨前肌和患侧腓肠肌内侧头的肌肉活动以及睁眼站立位、闭眼站立位、海绵垫上睁眼站立位和海绵垫上闭眼站立位的稳定性指数方面均有显著差异。仅穿鞋子的组在睁眼站立和海绵垫上睁眼站立的稳定性指数方面有显著差异。[结论]在慢性卒中患者下肢肌肉活动的初始训练及静态平衡训练期间,使用踝足矫形器是有效的。然而,对于各种动态情况则无效。