Kenworthy Sally, Parthasarathy Grant, Seale Jill
School of Health Professions, Orthotics and Prosthetics Program, Baylor College of Medicine, Houston, TX, USA.
School of Physical Therapy, South College, Knoxville, TN, USA.
Disabil Rehabil. 2025 Mar;47(6):1403-1415. doi: 10.1080/09638288.2024.2378228. Epub 2024 Jul 12.
Despite ample evidence supporting ankle foot orthoses (AFOs) for enhancing ambulation in those with neuromuscular impairment, a prevalent belief among rehabilitation professionals is that AFO use may lead to disuse and reduced muscle activity of the lower leg. To determine the effects of AFO intervention on electromyography (EMG) activity during walking in individuals with neuromuscular impairment.
Five databases were searched for studies that met the predefined inclusion criteria and were published any time through April 2024. AFO design characteristics, muscle groups measured, study design, experimental comparisons, and EMG parameters were extracted from each study. Methodological quality of the included studies was assessed using the modified PEDro scale.
Twenty studies met the inclusion criteria. AFO interventions utilized, EMG outcomes utilized, and result interpretations varied widely. In situations of hypertonicity, reduced EMG activity was deemed a positive outcome, while other studies viewed it negatively. Seven longitudinal studies found no adverse long-term impact on EMG activity.
The results of this review challenge the clinical belief that AFOs cause muscle disuse over time; however, the heterogeneity of AFO designs prevents broad statements related to which orthoses optimize muscle activity.
尽管有充分证据支持踝足矫形器（AFO）可改善神经肌肉损伤患者的行走能力，但康复专业人员中普遍存在一种观点，即使用AFO可能导致小腿废用和肌肉活动减少。本研究旨在确定AFO干预对神经肌肉损伤患者行走时肌电图（EMG）活动的影响。
检索了五个数据库，查找符合预定义纳入标准且截至2024年4月任何时间发表的研究。从每项研究中提取AFO设计特征、测量的肌肉群、研究设计、实验对照以及EMG参数。使用改良的PEDro量表评估纳入研究的方法学质量。
20项研究符合纳入标准。所采用的AFO干预措施、所采用的EMG结果以及结果解释差异很大。在张力亢进的情况下，EMG活动降低被视为积极结果，而其他研究则持负面看法。七项纵向研究发现对EMG活动没有长期不良影响。
本综述结果挑战了临床观点，即随着时间推移AFO会导致肌肉废用；然而，AFO设计的异质性使得无法就哪种矫形器能优化肌肉活动做出广泛的说明。
