Anterior versus posterior plastic ankle foot orthoses for ankle spasticity: which one is better?

摘要

A randomized crossover study was done to compare the effectiveness of anterior versus posterior plastic ankle foot orthoses (AFOs) for treatment of ankle spasticity in ten stroke patients. They were random to treat with anterior plastic AFOs or posterior plastic AFOs and then were crossover to treat with the other ones. Comparison between before and after using both types of AFOs revealed statistically significant improvement of passive range of motion (PROM), Modified Ashworth scale (MAS), walking velocity, stretch reflex and walking root mean square (RMS) amplitudes of medial gastrocnemius muscles at p<0.05, except walking velocity and statistically significant increment of walking RMS amplitudes of medial gastrocnemius muscles at p<0.05 when using posterior plastic AFOs. Comparison between two types of orthoses revealed statistically significant improvement of walking RMS amplitudes of medial gastrocnemius muscles in anterior plastic AFOs more than posterior plastic AFOs at p<0.05. In conclusion, anterior plastic AFOs were more effective in reduction of dynamic ankle spasticity during walking than posterior plastic AFOs. Moreover, there were increment of dynamic spasticity when using posterior plastic AFOs.