Yalla Sai V, Crews Ryan T, Fleischer Adam E, Grewal Gurtej, Ortiz Jacque, Najafi Bijan
Dr. William M. Scholl College of Podiatric Medicine, Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Dr. William M. Scholl College of Podiatric Medicine, Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Clin Biomech (Bristol). 2014 Dec;29(10):1081-8. doi: 10.1016/j.clinbiomech.2014.10.007. Epub 2014 Oct 30.
Foot and ankle problems are highly prevalent fall risks in the elderly. Ankle foot orthoses designed to stabilize the foot and ankles have been studied within specific patient groups, but their efficacy with a less restrictive elderly population is unknown. This study investigated if custom-made ankle foot orthoses improve postural stability in older adults.
Thirty ambulatory older adults averaged 73 (standard deviation=6.5) years completed Romberg's balance (eyes-open/eyes-closed), functional reach, and Timed Up and Go tests while wearing validated kinematic sensors. Each test was completed in standardized shoes with and without bilateral orthoses. Additionally, barefoot trials were conducted for the Romberg's and functional reach tests.
Compared to the barefoot and 'shoes alone' conditions, the orthoses reduced center of mass sway on average by 49.0% (P=0.087) and 40.7% (P=0.005) during eyes-open balance trials. The reduction was amplified during the eyes-closed trials with average reductions of 65.9% (P=0.000) and 47.8% (P=0.004), compared to barefoot and 'shoes alone' conditions. The orthoses did not limit functional reach distance nor timed-up and go completion times. However, the medial-lateral postural coordination while reaching was improved significantly with orthoses compared to barefoot (14.3%; P=0.030) and 'shoes alone' (13.5%; P=0.039) conditions.
Ankle foot orthoses reduced postural sway and improved lower extremity coordination in the elderly participants without limiting their ability to perform a standard activity of daily living. Additional studies are required to determine if these benefits are retained and subsequently translate into fewer falls.
足踝问题是老年人中非常普遍的跌倒风险因素。旨在稳定足部和脚踝的踝足矫形器已在特定患者群体中进行了研究，但在限制较少的老年人群体中其疗效尚不清楚。本研究调查了定制的踝足矫形器是否能改善老年人的姿势稳定性。
30名平均年龄为73岁（标准差=6.5）的能行走的老年人在佩戴经过验证的运动传感器的情况下，完成了闭目直立平衡试验（睁眼/闭眼）、功能性前伸测试和计时起立行走测试。每项测试均在穿着标准化鞋子且双侧佩戴或不佩戴矫形器的情况下完成。此外，还对闭目直立平衡试验和功能性前伸测试进行了赤脚试验。
与赤脚和“仅穿鞋子”的情况相比，在睁眼平衡试验期间，矫形器使平均重心摆动分别减少了49.0%（P=0.087）和40.7%（P=0.005）。在闭眼试验期间，这种减少更为明显，与赤脚和“仅穿鞋子”的情况相比，平均减少了65.9%（P=0.000）和47.8%（P=0.004）。矫形器并未限制功能性前伸距离或计时起立行走完成时间。然而，与赤脚（14.3%；P=0.030）和“仅穿鞋子”（13.5%；P=0.039）的情况相比，佩戴矫形器时伸手过程中的内外侧姿势协调性有显著改善。
踝足矫形器减少了老年参与者的姿势摆动，改善了下肢协调性，同时不限制他们进行标准日常生活活动的能力。需要进一步的研究来确定这些益处是否得以保持，并随后转化为更少的跌倒次数。
