踝足裝具對於中風患者步態和功能性活動的效果：系統性回顧與統合分析

Systematic Review and Meta Analysis: Effects of Ankle-foot Orthoses on Gait and Function in Patients with Stroke

王斐誼(Fei-Yi Wang) ； 鄭方瑜(Fang-Yu Cheng) ； 連怡婷(I-Ting Lien) ； 王瑞瑤(Ray-Yau Wang) ； 楊雅如(Yea-Ru Yang)

《物理治療》 36卷4期 (2011/12) Pp. 274-284

摘要

Background and Purpose: Reduced gait performance and functional mobility are common problems after stroke. Ankle-foot orthoses are widely used assistive devices in patients with stroke. The purpose of this study was to investigate the effects of ankle-foot orthoses on gait performance and functional mobility in patients with stroke. Methods: We searched PubMed, Cochrane library, Chinese Electronic Periodical Services, and National Digital Library of Theses and Dissertations in Taiwan during the period of June 2000 to May 2010 and identified studies that compared gait performance while wearing AFO with not wearing AFO in patients with stroke. Outcome measures included walking speed, cadence, stride length, step length, Timed ”Up & Go” Test, and Functional Ambulation Categories. Results: Nine articles were identified for this study. In PEDro score, there were 2 points in 3, 3 points in 2 and 4 points in 4 articles. Level of evidence were both stage 2 and grades of recommendation were both grade B according to Oxford Centre for Evidence-based Medicine-Level of Evidence. Meta-analysis revealed that while wearing AFO, patients improved walking speed (Hedges's g=0.313, p＜0.001), cadence (Hedges's g=0.297, p＜0.001), stride length (Hedges's g=0.274, p=0.005), step length of affected side (Hedges's g=0.274, p=0.001), step length of sound side (Hedges's g=0.212, p=0.034), Timed ”Up & Go” Test (Hedges's g=0.334, p=0.021), and Functional Ambulation Categories (Hedges's g= 1.539, p＜0.001) as compared to no AFO condition. Conclusion: The findings suggested that wearing AFO could improve gait performance and functional mobility in patients with stroke.

關鍵字

踝足裝具 ； 中風患者 ； 步態

並列摘要

Background and Purpose: Reduced gait performance and functional mobility are common problems after stroke. Ankle-foot orthoses are widely used assistive devices in patients with stroke. The purpose of this study was to investigate the effects of ankle-foot orthoses on gait performance and functional mobility in patients with stroke. Methods: We searched PubMed, Cochrane library, Chinese Electronic Periodical Services, and National Digital Library of Theses and Dissertations in Taiwan during the period of June 2000 to May 2010 and identified studies that compared gait performance while wearing AFO with not wearing AFO in patients with stroke. Outcome measures included walking speed, cadence, stride length, step length, Timed ”Up & Go” Test, and Functional Ambulation Categories. Results: Nine articles were identified for this study. In PEDro score, there were 2 points in 3, 3 points in 2 and 4 points in 4 articles. Level of evidence were both stage 2 and grades of recommendation were both grade B according to Oxford Centre for Evidence-based Medicine-Level of Evidence. Meta-analysis revealed that while wearing AFO, patients improved walking speed (Hedges's g=0.313, p＜0.001), cadence (Hedges's g=0.297, p＜0.001), stride length (Hedges's g=0.274, p=0.005), step length of affected side (Hedges's g=0.274, p=0.001), step length of sound side (Hedges's g=0.212, p=0.034), Timed ”Up & Go” Test (Hedges's g=0.334, p=0.021), and Functional Ambulation Categories (Hedges's g= 1.539, p＜0.001) as compared to no AFO condition. Conclusion: The findings suggested that wearing AFO could improve gait performance and functional mobility in patients with stroke.

並列關鍵字

Ankle foot orthosis ； Stroke ； Gait