臨床問題：前置／後置式足踝裝具應用於中風病人之步態矯正

目的：以質證醫學為基礎來探討及選擇前置／後置式足踝裝具應用於中風病人之步態矯正。方法：在PubMed和MEDLINE資料庫鍵入“anterior and posterior ankle foot orthosis”等關鍵字搜尋，並經人工閱讀題目與摘要後，共選出三篇適合臨床應用的參考文獻。結果：第一篇研究發現相對於裸足時，使用前置式或後置式足踝裝具皆能明顯提升中風偏癱病患的行走速度和步長，且兩者並無顯著差異。第二篇研究認為相較於前置式足踝裝具和裸足，後置式足踝裝具於擺盪期能增加較多背屈角度；而前置式足踝裝具與其他兩者相比，於著地初期能減少足內翻角度方面為最顯著。第三篇研究認為穿著足踝裝具確實對中風偏癱病態的步態有所幫助，而符合東方國家特殊文化需求的前置式足踝裝具其效果亦不亞於後置式足踝裝具。結論：前置式足踝裝具，對於中風偏癱病患行走時站立期膝蓋穩定度不足以及過度足內翻的問題，有良好的步態矯正效果。

關鍵字

足踝裝具；中風；步態

並列摘要

Purpose: To discuss the effect of anterior/posterior ankle-foot orthoses on stroke patients' gait correction is base on the evidence base medicine. Methods: Clinical trials were searched through PubMed and MEDLINE, using ”anterior and posterior ankle foot orthosis (AFO)”. Three articles were included. Results: The first study showed that wearing AFO comparing to barefoot would improve the gait speed and step length, regardless of the type. Neither anterior AFO nor posterior AFO could diminish the foot drag; however, non-significant difference was found between the two types. The second study revealed that posterior AFO provides more ankle dorsiflexion than anterior AFO and barefoot. Besides, anterior type had the best effect on controlling ankle inversion. The third study argued that anterior AFO fit the Asian demand of walking barefoot indoors and the effect was not different to posterior AFO. Conclusion: Anterior type AFO had good corrective effects on knee instability and ankle hyper-inversion during stance phase for stroke patients.

並列關鍵字

Ankle-foot orthosis ； Stroke ； Gait

延伸閱讀

陳瓊玲、楊國德、吳鑫漢、江炳焱（1998）。前葉式踝足矯具對偏癱步態之效應。中華民國復健醫學會雜誌，26(3)，119-128。https://www.airitilibrary.com/Article/Detail?DocID=10253009-199809-26-3-119-128-a
江永舜、馮文信、林震枝（2015）。新型足踝裝具對半側偏癱個案報告。實證自然醫學，1(2)，27-34。https://www.airitilibrary.com/Article/Detail?DocID=P20150806001-201503-201508060027-201508060027-27-34
林冠吟、楊文傑、楊嘉豪、江原義弘、賴建宏（2023）。【論文摘要】前踝足裝具與改良定製關節式踝足裝具對腦中風患者行走姿勢的比較。物理治療，48(2)，133-133。https://doi.org/10.6215/FJPT.202306.P08
陳美羽、葉純妤、傅書毅（2017）。改良式踝足矯具對於中風病患之雙腳承重對稱性以及步態之影響：先驅研究。物理治療，42(2)，166-166。https://doi.org/10.6215/FJPT.2017.73.P18
Rao, N., Wening, J., Hasso, D., Gnanapragasam, G., Perera, P., Srigiriraju, P., & Aruin, A. S. (2014). The Effects of Two Different Ankle-Foot Orthoses on Gait of Patients with Acute Hemiparetic Cerebrovascular Accident. Rehabilitation Research and Practice, (2014), 42-48. https://doi.org/10.1155/2014/301469

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臨床問題：前置／後置式足踝裝具應用於中風病人之步態矯正

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