Kunkel Dorit, Potter Julia, Mamode Louis
a Faculty of Health Sciences , University of Southampton , Southampton , UK.
Disabil Rehabil. 2017 Jun;39(12):1149-1154. doi: 10.1080/09638288.2016.1189605. Epub 2016 Jun 23.
The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers.
Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity.
Twenty-three stroke participants (mean age 75.09 ± 7.57 years; 12 fallers) and 16 controls (mean age 73.44 ± 8.35 years) took part. Within the stroke group, reduced 1st MPJ sensation (p = 0.016) and 1st MPJ ROM (p = 0.025) were observed in the affected foot in comparison to the non-affected foot; no other differences were apparent. Pooled data (for both feet) was used to explore between stroke/control (n = 78 feet) and stroke faller/non-faller (n = 46 feet) group differences. In comparison to the control group, stroke participants exhibited reduced sensation of the 1st MPJ (p = 0.020), higher Foot Posture Index scores (indicating greater foot pronation, p = 0.008) and reduced foot function (p = 0.003). Stroke fallers exhibited significantly greater foot pronation in comparison to non-fallers (p = 0.027).
Results indicated differences in foot and ankle characteristics post stroke in comparison to healthy controls. These changes may negatively impact functional ability and the ability to preserve balance. Further research is warranted to explore the influence of foot problems on balance ability and falls in people with stroke. Implications for Rehabilitation Foot problems are common post stroke. As foot problems have been linked to increased fall risk among the general population we recommend that it would be beneficial to include foot and ankle assessments or a referral to a podiatrist for people with stroke who report foot problems. Further research is needed to explore if we can improve functional performance post stroke and reduce fall risk if treatment or prevention of foot problems can be included in stroke rehabilitation.
本研究旨在探索和比较中风患者与健康对照者的足踝特征；以及中风跌倒者与未跌倒者之间的足踝特征。
从社区群体中招募参与者，并完成标准化测试，评估感觉、足部姿势、足部功能、踝关节背屈以及第一跖趾关节活动范围（第1跖趾关节活动度）、拇外翻的存在情况和严重程度。
23名中风参与者（平均年龄75.09±7.57岁；12名跌倒者）和16名对照者（平均年龄73.44±8.35岁）参与了研究。在中风组中，与未受影响的脚相比，受影响的脚的第1跖趾关节感觉（p = 0.016）和第1跖趾关节活动度（p = 0.025）降低；未观察到其他差异。汇总数据（双脚）用于探索中风/对照（n = 78只脚）和中风跌倒者/未跌倒者（n = 46只脚）组之间的差异。与对照组相比，中风参与者的第1跖趾关节感觉降低（p = 0.020）、足部姿势指数得分更高（表明足部旋前更大，p = 0.008）且足部功能降低（p = 0.003）。与未跌倒者相比，中风跌倒者的足部旋前明显更大（p = 0.027）。
结果表明，与健康对照者相比，中风后足踝特征存在差异。这些变化可能对功能能力和维持平衡的能力产生负面影响。有必要进一步研究以探索足部问题对中风患者平衡能力和跌倒的影响。康复意义足部问题在中风后很常见。由于足部问题与普通人群中跌倒风险增加有关，我们建议，对于报告有足部问题的中风患者，进行足踝评估或转诊至足病医生处将是有益的。需要进一步研究以探索，如果在中风康复中纳入足部问题的治疗或预防措施，是否可以改善中风后的功能表现并降低跌倒风险。
