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腿前式踝足矯具在中風患者站立平衡之效應
Effects of Anterior Ankle-Foot Orthosis on Standing Balance of Stroke Patients
摘要
本研究目的為檢視腿前式踝足矯具（anterior ankle-foot orthosis, AAFO）在中風患者站立之靜態及動態平衡的效果，以平衡儀（Balance Master）的感覺組合測驗（Sensory Organization Test）及穩定限度測驗（Limit of Stability Test）作為研究工具，使用壓力中心數據計算靜態站立穩定度、對稱性、重心轉移最大移動範圍及重心轉移後最大患側承重比率。本研究採重複量測之實驗設計，共24位中風患者參與研究，評量穿戴及不穿戴AAFO在感覺組合及穩定限度測驗之表現，使用配對t檢定比較有無穿戴AAFO在上述測驗之差異情形。結果顯示中風患者穿戴AAFO在穩定限度測驗中，身體重心轉移至患側斜前方（p ＜ .001）及患側（p = .002）之最大移動範圍顯著增加。此外，中風患者穿戴AAFO重心轉移至患側（p = .003）及患側斜後方（p ＜ .001）後之最大患側承重比率顯著增加。但中風患者穿戴AAFO於感覺組合測驗評量之站立穩定度及站立對稱性無顯著差異（p ＞ .01）。本研究發現中風患者穿戴腿前式踝足矯具能夠改善重心轉移至患側時之患側方向穩定限度範圍與承重。因此，建議中風患者可穿戴AAFO來執行重心轉移之活動以增進其動態平衡表現。
並列摘要
The objective of this study was to examine the effects of anterior ankle-foot orthosis (AAFO) on the static and dynamic balance of standing in stroke patients. Static and dynamic balance were measured by the Sensory Organization Test (SOT) and the Limit of Stability (LOS) test of the SMART Balance Master. Stance stability, stance symmetry, maximal weight-shifting distance and maximal affected side weight-bearing percentage were calculated from center of pressure (COP) measures. Twenty-four stroke subjects participated in a repeated measures study. The static and dynamic balance of the subjects were measured with and without an AAFO. Paired t-tests were used to determine the difference between balance performance with and without an AAFO. The results show that stance stability and stance symmetry measured by the SOT did not improve when the subjects wore an AAFO (p ＜ .01). There were significant increases in the maximal distance of weight shifting toward the affected-forward (p ＜ .001) and the affected side (p = .002) during the LOS test. There were also significant increases in the maximal affected weight-bearing percentage after weight shifting toward the affected side (p = .003) and the affected-backward side (p ＜ .001) during the LOS test. This study revealed that the stroke subjects wearing an AAFO could improve the maximal distance of the limit of stability and the percentage of weight bearing of the affected side during weight shifting toward the affected side. Therefore, we suggest stroke patients should wear an AAFO to improve dynamic balance performance during weight-shifting activities.
延伸閱讀
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