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Journal of the Korean Academy of Rehabilitation Medicine 2011;35(2):188-194.
Effects of Dynamic Ankle-Foot Orthosis on Postural Balance Control in Hemiparetic Patients.
Kim, Hong Min , Chun, Min Ho , Kim, Chung Reen , Park, Ji Young
1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. mhchun@amc.seoul.kr
2Department of Rehabilitation Medicine, Eonyang Hospital, Ulsan 689-812, Korea.
3Department of Rehabilitation Medicine, Philip Hospital, Seoul 138-170, Korea.
Abstract
Objective
To determine the effects of dynamic ankle foot orthosis (AFO) on balance control by comparing it with conventional plastic AFO and barefoot conditions in hemiparetic patients. Method Fifteen hemiparetic patients with brain lesions were recruited for this study. All subjects were capable of standing up independently and had a modified Ashworth score of less than two. The postural control capabilities of the subjects were assessed using the timed up and go (TUG) test, and Tetrax tetra-ataxiametric posturography. The stability index, weight distribution index, and synchronization index were measured at six different head positions with dynamic AFO, conventional AFO and under barefoot conditions.
Results
There were nine males and six females, whose average age was 45.1 years. There was a significantly even weight distribution for the dynamic AFO and conventional AFO conditions relative to the barefoot condition in neutral, right-sided head, and left-sided head with eyes closed (p<0.05). And there was significantly increased stability in left sided-head, neck flexed positions with eyes closed for dynamic AFO and conventional AFO (p<0.05). However, there was no significant difference in weight distribution or stability between dynamic and conventional AFO conditions, except the stability in right-sided head position with eyes closed. Conclusion In this study, the balance control of hemiparetic patients with dynamic AFO was better than in the barefoot condition, and was similar to conventional AFO. Therefore, we suggest that dynamic AFO may be a useful orthosis for hemiparetic patients with mild to moderate spasticity with poor balance control and foot drop.
Key Words: Balance, Hemiplegia, Ankle foot orthosis


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