scholarly journals The effect of different shoes on functional mobility and energy expenditure in post-stroke hemiplegic patients using ankle–foot orthosis

2016 ◽  
Vol 40 (5) ◽  
pp. 591-597 ◽  
Author(s):  
Farzad Farmani ◽  
Mohammad Ali Mohseni Bandpei ◽  
Mahmood Bahramizadeh ◽  
Gholamreza Aminian ◽  
Mohammad Reza Nikoo ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Walking Speed ◽  
Functional Mobility ◽  
Timed Up And Go ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Group I ◽  
Ankle Foot Orthoses ◽  
Rocker Shoes ◽  
Foot Orthosis

Background:Ankle–foot orthoses could be utilized both with and without shoes. While several studies have shown that ankle–foot orthoses improve gait abilities in hemiplegic patients, it remains unclear whether they should be used with shoes or without.Objectives:The study purpose was to compare the effect of standard shoes and rocker shoes on functional mobility in post-stroke hemiplegic patients utilizing ankle–foot orthosis.Study design:Randomized clinical study.Methods:Thirty post-stroke hemiplegic patients participated in this study randomly assigned to two groups. Group I received standard shoes + ankle–foot orthosis and group II were provided with rocker shoes + ankle–foot orthosis. Their functional mobility and energy expenditure parameters including timed up and go, timed up stairs, timed down stairs, preferred walking speed, and oxygen (O2) cost (mL/kg/m) were measured.Results:In group I, no significant changes were seen in outcome measures after wearing standard shoes. While in group II, O2cost and timed up and go time significantly decreased, and preferred walking speed increased when patients wore rocker shoes. Also, there was a significant difference between rocker shoes and standard shoes in improvement of timed up and go, preferred walking speed, and O2cost.Conclusion:When patients using ankle–foot orthosis wore rocker shoes, their functional mobility improved and oxygen cost diminished. Also, rocker shoes was significantly more effective than standard shoes in improving functional mobility parameters.Clinical relevanceThis study suggests that in post-stroke hemiplegic patients using ankle–foot orthosis, wearing rocker shoes can lead to much more improved functional mobility and decreased energy expenditure compared to ankle–foot orthosis only. Thus, in stroke patients, the combination of ankle–foot orthosis-rocker shoes is recommended for both rehabilitation programs and ankle–foot orthosis efficacy investigations.

scholarly journals The Comparison of the Effects of Flexible vs Rigid Ankle-foot orthoses on Balance and Walking Performance in Individuals With Multiple Sclerosis: A Crossover Study

2021 ◽  
Vol 19 (2) ◽  
pp. 199-206
Author(s):  
Sama-Sadat Parian ◽  
◽  
Niloufar Fereshtenejad ◽  
Susan Hillier ◽  
Ebrahim Sadeghi-Demneh ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Crossover Study ◽  
Postural Stability ◽  
Walking Speed ◽  
Foot Orthoses ◽  
Timed Up And Go ◽  
Walking Test ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis

Objectives: Ankle-Foot orthoses are used to minimize the impact of weakness in ankle dorsiflexion muscles. The study on different orthotic types defines the optimal design, which effectively improves the users’ mobility. This study investigated the potential benefits and risks of a Dictus-band (flexible orthotic), compared with a thermoplastic (fixed) ankle-foot orthosis on the mobility of individuals with Multiple Sclerosis (MS). Methods: Fifteen subjects with MS and dorsiflexion ankle weakness volunteered in this randomized crossover study. The study participants received either a Dictus-band or a thermoplastic ankle-foot orthosis worn on the weaker leg, compared to barefoot as the control condition. Postural stability during standing, forward reach test, timed up and go test, and walking speed in the 10-meter walking test were compared between the study conditions. Results: There were no significant differences in the postural stability and forward reach tests between study conditions (P>0.5). When the research participants used a Dictus-band, compared to the fixed ankle-foot orthosis, the time required to complete the timed up and go was significantly reduced [P<0.01; Mean±SD difference: 6.4±1.4; 95% Confidence Interval (CI): 2.7-10.2], and walking speed was increased in the 10-meter walking test (P<0.01; Mean±SD difference: 0.46±0.8; 95%CI: 0.23-0.69). There was no difference in the timed up and go and 10-meter walking test data between the barefoot and Dictus-band conditions (P>0.5). No adverse or safety events were sustained in this research. Discussion: The present study data provided initial evidence for the lack of detrimental effects of using the Dictus-band in subjects with MS and ankle dorsiflexion deficiencies.

scholarly journals A Model to Predict the Effect of Ankle Joint Misalignment on Calf Band Movement in Ankle-Foot Orthoses

2007 ◽  
Vol 31 (1) ◽  
pp. 76-87 ◽  
Author(s):  
Stefania Fatone ◽  
Andrew H. Hansen
Keyword(s):  
Ankle Joint ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Dimensional Model ◽  
Ankle Foot Orthosis ◽  
Ankle Joints ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis ◽  
Anterior Posterior

Accurate alignment of anatomical and mechanical joint axes is one of the major biomechanical principles pertaining to articulated orthoses, yet knowledge of the potential effects of axis misalignment is limited. The purpose of this project was to model the effects of systematic linear (proximal-distal and anterior-posterior) misalignments of single axis mechanical ankle joints in an ankle-foot orthosis (AFO) in order to determine the degree and direction of calf band travel that would occur over a functional range of motion. Sagittal plane misalignments of the ankle joint centres of an AFO were simulated using a simple two-dimensional model for both a range of ankle angles and a typical able-bodied ankle kinematic curve for self-selected normal walking speed. The model assumed that no movement occurred between the foot and the foot-plate of the AFO. The model predicted that for anterior (positive horizontal) misalignments, dorsiflexion movements would cause the calf band to travel proximally (i.e., up the leg) and plantar flexion movements would cause the calf band to travel distally (i.e., down the leg). The opposite was predicted for posterior (negative horizontal) misalignments. Proximal (positive vertical) misalignments would cause only distal movements of the calf band while distal (negative vertical) misalignments would cause only proximal movements of the calf band. Anterior-posterior misalignments were found to have a much larger effect on the amount of calf band travel than proximal-distal misalignments.

scholarly journals The effect of ankle–foot orthoses on self-reported balance confidence in persons with chronic poststroke hemiplegia

2013 ◽  
Vol 38 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Angelika Zissimopoulos ◽  
Stefania Fatone ◽  
Steven Gard
Keyword(s):  
Study Design ◽  
Self Efficacy ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Balance Confidence ◽  
Post Stroke ◽  
Study Results ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis ◽  
Confidence Scale

Background: One intervention often used to address physical impairments post stroke is an ankle–foot orthosis. Ankle–foot orthoses may improve walking speed, stride length, and gait pattern. However, effects on balance, crucial for safe ambulation, are thus far inconclusive. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one’s ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation (as defined by the International Classification of Functioning, Disability, and Health) than physical performance measures of gait or balance. Objectives: We investigated whether self-efficacy, or balance confidence when referred to in the context of balance capabilities, is improved with ankle–foot orthosis use. Study design: Repeated measures study design. Methods: Balance confidence was measured using the Activities-specific Balance Confidence Scale in 15 persons with chronic poststroke hemiplegia, with and without their regular ankle–foot orthosis. Results: Activities-specific Balance Confidence Scale scores were significantly higher ( p ≤ 0.01) for the ankle–foot orthosis condition compared to no ankle–foot orthosis. Conclusions: One mechanism by which ankle–foot orthosis use may influence balance is improved balance confidence. Future work should explore the specific mechanisms underlying this improvement in self-efficacy. Clinical relevance Self-efficacy may be an important factor to consider when evaluating functioning post stroke. Rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations, particularly in the fall-prone poststroke population. Study results provide evidence for improvements in balance confidence with ankle–foot orthosis use.

The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Vol 34 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Saeed Shahabi ◽  
Hosein Shabaninejad ◽  
Mohammad Kamali ◽  
Maryam Jalali ◽  
Ahmad Ahmadi Teymourlouy
Keyword(s):  
Confidence Interval ◽  
Publication Bias ◽  
Walking Speed ◽  
Risk Of Bias ◽  
Foot Orthoses ◽  
Quality Of Evidence ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis

Objective: The aim of this study was to evaluate the effects of ankle-foot orthoses on speed walking in patients with stroke. Data sources: PubMed, Embase, Web of Science, Scopus, CENTRAL, PEDro, RehabData, RECAL, and ProQuest were searched from inception until 30 September 2019. Review methods: This study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. Risk of bias assessment was performed using the Cochrane Risk of Bias Tool. Begg’s test and Egger’s regression method were used to assess the publication bias. Trim and fill analysis was also used to adjust any potential publication bias. Sensitivity analysis was performed to evaluate the effect of individual studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results: Overall, 14 studies were included with a total of 1186 participants. A small-to-moderate and non-significant improvement in favor of the ankle-foot orthosis versus without ankle-foot orthosis (standardized mean difference (SMD) = 0.41, 95% confidence interval = −0.15 to 0.96), similar effects of ankle-foot orthosis and functional electrical stimulation (SMD = 0.00, 95% confidence interval = −0.16 to 0.16), and a small and non-significant improvement in favor of ankle-foot orthosis versus another type of ankle-foot orthosis (SMD = 0.22, 95% confidence interval = −0.05 to 0.49) in walking speed were found. However, the quality of evidence for all comparisons was low or very low. Conclusion: Despite reported positive effects in some studies, there is no firm evidence of any benefit of ankle-foot orthoses on walking speed.

scholarly journals Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Stride Length ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Meta Analysis ◽  
Step Length ◽  
Stride Time ◽  
Plane Angle ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

Kinematic and kinetic benefits of implantable peroneal nerve stimulation in people with post-stroke drop foot using an ankle-foot orthosis

2018 ◽  
Vol 36 (4) ◽  
pp. 547-558 ◽  
Author(s):  
Frank Berenpas ◽  
Sven Schiemanck ◽  
Anita Beelen ◽  
Frans Nollet ◽  
Vivian Weerdesteyn ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Peroneal Nerve ◽  
Drop Foot ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Peroneal Nerve Stimulation ◽  
Foot Orthosis
Sign in / Sign up

Export Citation Format

Share Document