Review article (meta-analysis)Effects of an Ankle-Foot Orthosis on Balance and Walking After Stroke: A Systematic Review and Pooled Meta-Analysis
Section snippets
Search strategy to identify relevant studies
The following trials registers and databases were searched: Cochrane Stroke, Movement Disorders and Injuries Groups, MEDLINE, Embase, CINAHL, AMED, PsycINFO, and the Physiotherapy Evidence Database. All searches were completed in November 2011. To identify further published, unpublished, and ongoing trials, we searched the reference lists of the articles identified, review articles, and books, and contacted the lead authors of published studies, other researchers in field clinical and research
Description of studies
We screened 120 abstracts and the full texts of 43 articles and identified 13 trials involving 334 patients that met the inclusion criteria and were included in the analysis (see table 1). The aim of the selected trials was to assess the immediate or short-term effect of the AFOs, and testing was completed in a single testing session, thereby avoiding the contaminating effect from rehabilitation or spontaneous recovery and minimizing the random error caused by testing over a prolonged period.
Discussion
This systematic review assessed the effects of an AFO on balance, walking, and mobility for people with stroke. The available evidence suggests that an AFO can improve these factors, but only the immediate, short-term effects have been assessed. The effects on other aspects of mobility and balance (postural sway and timed mobility tests) showed a positive trend favoring an AFO but failed to reach statistical significance, while the effects on functional balance were mixed. The small numbers of
Conclusions
Using an AFO can make an immediate improvement in mobility (functional ambulation categories), walking (speed and step/stride length), and some aspects of balance (weight distribution in standing) while the AFO is worn. The AFO did not affect other aspects of mobility (timed stair climb and Timed Up & Go test) and balance (postural sway). The results support the use of an AFO to improve walking and some aspects of balance; however, the long-term effect of AFO usage has not been investigated,
Supplier
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Cochrane IMS. Available at: http://ims.cochrane.org/.
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