Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
International University of Health and Welfare, Tokyo, Japan.
Disabil Rehabil. 2022 Jan;44(2):166-176. doi: 10.1080/09638288.2020.1762767. Epub 2020 May 20.
This systematic review is aimed at evaluating the efficacy of AFO types and comparison between them on the energy expenditure metrics of walking in individuals who had suffered a stroke with (sub)acute or chronic evolution.
The following databases were searched; PubMed, Scopus, ISI Web of Knowledge, Embase and Cochrane Library based on the population intervention comparison outcome (PICO) method.
A total of 15 trials involving 195 participants were selected for the final evaluation. All trials, except one, examined individuals in chronic phase. Although the evidence from the selected studies was generally weak, the consensus was that an AFO may have a positive immediate effect on the energy expenditure metrics including energy cost, physiological cost index, mechanical work and vertical center of mass trajectory on the affected leg, in both overground walking and treadmill walking in adults with chronic stroke. There were insufficient studies to evaluate the medium term efficacy of wearing an AFO combined with gait training on metabolic cost parameters during ambulation. There were also insufficient studies for comparison among different designs of AFOs.
An AFO can immediately improve energy expenditure metrics of walking in stroke survivors. There is a need for further well-designed randomized trials to evaluate long-term effect of gait training using AFOs and comparison among the different types of orthoses.IMPLICATIONS FOR REHABILITATIONAn AFO can immediately improve the energy expenditure metrics during walking after stroke.Measurement of energetic parameters of walking wearing a orthotic device such as an AFO can evaluate gait economy in stroke populations.
本系统评价旨在评估 AFO 类型在急性或慢性脑卒中患者行走能量消耗指标方面的疗效及其之间的比较。
根据人群干预比较结局（PICO）方法，检索以下数据库：PubMed、Scopus、ISI Web of Knowledge、Embase 和 Cochrane Library。
共选择了 15 项试验，涉及 195 名参与者进行最终评估。除了一项试验外，所有试验都检查了慢性期的个体。尽管来自选定研究的证据通常较弱，但共识是 AFO 可能对能量消耗指标产生积极的即时影响，包括能量消耗、生理成本指数、机械工作和垂直重心轨迹，无论是在慢性脑卒中成人的地面行走还是跑步机行走中。关于穿着 AFO 联合步态训练对行走代谢成本参数的中期疗效评估的研究还不够充分。对于不同设计的 AFO 之间的比较也缺乏足够的研究。
AFO 可以立即改善脑卒中幸存者的行走能量消耗指标。需要进一步进行精心设计的随机试验，以评估使用 AFO 进行步态训练的长期效果，并比较不同类型的矫形器。
AFO 可以立即改善脑卒中后行走时的能量消耗指标。测量穿着矫形器（如 AFO）行走时的能量参数可以评估脑卒中人群的步态经济性。
