腿前式踝足矯具在中風患者平衡及移動能力之效果

張心怡

doi:10.6834/CSMU.2013.00084

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腿前式踝足矯具在中風患者平衡及移動能力之效果

Effects of the anterior ankle-foot orthosis on balance and mobility in stroke patients.

張心怡 , Masters　　Advisor：陳瓊玲　　

繁體中文 DOI： 10.6834/CSMU.2013.00084

腿前式踝足矯具；穩定限制；重心轉移；移動能力； anterior ankle-foot orthosis ； limit of stability ； weight shifting ； mobility

Abstract │ Reference (96) │ Altmetrics

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Objective：The objective of this study was to examine the effects of the anterior ankle-foot orthosis(AAFO) on static and dynamic balance, and mobility in stroke patients.
Methods：Twenty-four stroke subjects completed the study. Subjects were measured with and without an AAFO, the sequence of which was randomized. The static and dynamic balance abilities were measured by the Sensory Organization Test (SOT), Limit of Stability (LOS) and Rhythmic Weight Shift (RWS) of the SMART Balance Master. Mobility was measured using the Timed Up and Go test and the Timed up and down stairs test. Paired t test was used to determine the difference of balance and mobility performances measured with and without the AAFO.
Results: The results showed that the stance stability and symmetry in the Sensory Organization Test did not improve when the subjects wearing an AAFO. There were significant improvements in (1) the maximal distance during LOS weight-shifting toward the affected-forward(p=.000) and the affected side(p=.002), (2) the maximal affected weight-bearing percentage after LOS toward the affected side(p=.003) and the affected-backward side(p=.000), (3) the gap to keep up with the ideal speed for the fast speed of lateral weight-shifting(p=.01), (4) stability for the slow (p=.002, p=.000)and fast (p=.001, p=.000) speed of lateral and forward-backward weight-shifting respectively, and (5) the Timed up and down stairs tests(p=.000).
Conclusion and Suggestion：This study found that the stroke subjects wearing an AAFO could improve the distance of the limit of stability toward the affected side and the weight bearing of the affected side, the keep up with the ideal speed of lateral rhythmic weight-shifting, the stability of lateral and forward-backward rhythmic weight-shifting, and go up and down stairs. Furthermore, the subjects reported that the confidence in safety was increased by using the AAFO. Therefore, we suggest that when performing the weight shifting activities and go up and down stairs, the stroke patients can wear the AAFO to improve the functional performance and safety.

Reference ( 96 ) 〈TOP〉

王斐誼、鄭方瑜、連怡婷、王瑞瑤、楊雅如（2011）。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。中華民國物理治療協會雜誌，36(4)，274-284。
連結：
張玄松、陳貞夙、龍希文、楊樑怡、鄧復旦、倪壽民（2007）。踝足裝具對於中風患者站立平衡能力與行走表現的影響：比較前置型與後置型踝足裝具的效益。台灣職能治療研究與實務，3(2)，94-109。
連結：
陳瓊玲、楊國德、吳鑫漢與江炳焱（民87）。前葉式踝足矯具對偏癱步態之效應。中華復健醫誌，26(3)，119-127.
連結：
Abe, H., Michimata, A., Sugawara, K., Sugaya, N., and Izumi, S. I. (2009). Improving gait stability in stroke hemiplegic patients with a plastic ankle-foot orthosis. Tohoku Journal of Experimenral Medicine, 218, 193-199.
連結：
Arnadottir, S. A. and Mercer, V. S. (2000). Effects of footwear on measurements of balance and gait in women between the ages of 65 and 93 years. Physical Therapy, 80, 17-27.
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