Clinical Trial of a Low Temperature Plastic AFO - the MIT AFO

低溫成形改良式塑膠踝足矯具之臨床應用

黃美涓(May-Kuen Wong) ； 鄧復旦(Fuk-Tan Tang) ； 吳鑫漢(Shin-Han Wu) ； 陳正明(Chang-Ming Chen)

《中華民國復健醫學會雜誌》 19期 (1991/12) Pp. 37-43

摘要

低溫成形塑膠支架製作簡便快捷，易就各種設計或需要隨時加以修改，是支架製作的流行發展趨勢。以往由於材料耐用性不夠，應用在下肢支架並不普及。
本研究利用低溫成形塑膠中耐用性較佳的orfit產品，設計出一種快速裝置的踝足矯具。此矯具是前方固定形支架，將腳底由蹠趾關節後方托往脛骨前方，踝關節固定在上屈0～5度位置，並可視需要改善垂足或內、外翻足，命名為MIT-AFO(metatarsal into AFO)。此支架相常適合於赤足室內行走，不會在地面滑動。
急性半身偏癱病患68人在步行訓練中試用MIT-AFO，其中46位獲得良好滿意度(67.6%) ，15位中等滿意(22.1%)，不滿意者則有7位(10.3%)。其中2位穿著後腳踝痙攣持續反射增強，4位則有支架破裂的現象。
為與傳統後方固定式AFO作比較，本研究利用6位腦中風１至7年，能獨立步行，但足踝穩定度不夠的病患，用orfit材料製出兩種AFO，連續穿著3天以後，分別作步態分析。結果發現兩種支架穿著後均可改善原來的不良步態，尤其是足底壓力分佈可趨向較正常化。但前、後固定型支架兩者之間效果比較則無顯著差異。
由於MIT-AFO塑造過程簡單，不需特殊設備，且適合赤足及穿鞋步行，值得推廣。

並列摘要

The modification of a new design in orthosis usually has its clinical indication. In this study, a low temperature thermoplastic AFO was designed in anterior leaf type, called MIT (metatarsal into tibial )AFO, basically to meet the need of indoors barefoot walking in Taiwan. It could be easily molded and remolded to fit the foot, as well as to adjust the position of foot and ankle.
Sixty-eight patients with acute hemiplegia were fitted with this MIT-AFO during ambulation training, 46had good fitting (67.6%), 15 in fair grade (22.1%), and 7 in poor grade (10.3%). Two patients were observed to have ankle clonus, 4 patients experienced breakage or tear of the AFO with in 4 weeks.
The gait characteristics were measured in 6 chronic hemiplegia to compare the effect of MIT-AFO with posterior leaf AFO (Teufel style). Their gait pattern did impove by AFO fitting, especially from the foot pressure distributions, but no significant difference between the patients with two AFOs was found.

並列關鍵字

Ankle foot orthosis ； low temperature plastic AFO ； Biomechanics