Sung Eun Jung, Chun Min Ho, Hong Ja Young, Do Kyung Hee
Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2016 Feb;40(1):135-41. doi: 10.5535/arm.2016.40.1.135. Epub 2016 Feb 26.
To assess the effectiveness of the resting foot splint to prevent ankle contracture.
We performed a randomized controlled trial in 33 patients with brain injury with ankle dorsiflexor weakness (muscle power ≤grade 2). Both groups continued conventional customized physical therapy, but the patients in the foot splint group were advised to wear a resting foot splint for more than 12 hours per day for 3 weeks. The data were assessed before and 3 weeks after the study. The primary outcome was the change in ankle dorsiflexion angle after 3 weeks.
Before the study, there were no differences between groups in gender, age, time post-injury, brain injury type, initial edema, spasticity, passive range of ankle dorsiflexion, Fugl-Meyer score (FMS), or Functional Ambulation Classification. A significant improvement in ankle dorsiflexion angle, and FMS was found after 3 weeks in both groups. The splint group showed more spasticity than the control group after 3 weeks (p=0.04). The change of ankle dorsiflexion angle, foot circumference, spasticity, and FMS after adjusting initial value and spasticity were not significantly different between the 2 groups.
Wearing a resting foot splint for 3 weeks did not affect joint mobility in patients with subacute brain injury regularly attending personalized rehabilitation programs. Further studies of larger sample sizes with well controlled in spasticity are required to evaluate the effects of the resting foot splint.
评估静息足支具预防踝关节挛缩的有效性。
我们对33例踝关节背屈肌无力（肌力≤2级）的脑损伤患者进行了一项随机对照试验。两组均继续接受常规定制物理治疗，但足支具组患者被建议每天佩戴静息足支具超过12小时，持续3周。在研究前和研究3周后对数据进行评估。主要结局是3周后踝关节背屈角度的变化。
研究前，两组在性别、年龄、受伤时间、脑损伤类型、初始水肿、痉挛、踝关节被动背屈范围、Fugl-Meyer评分（FMS）或功能步行分类方面均无差异。两组在3周后踝关节背屈角度和FMS均有显著改善。3周后，支具组比对照组表现出更多的痉挛（p = 0.04）。调整初始值和痉挛后，两组踝关节背屈角度、足周长、痉挛和FMS的变化无显著差异。
对于定期参加个性化康复计划的亚急性脑损伤患者，佩戴静息足支具3周对关节活动度没有影响。需要进一步开展更大样本量且痉挛控制良好的研究来评估静息足支具的效果。
