Document Type : Original Articles
Authors
1 Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2 Physiotherapy Research Center, School of rehabilitation ,Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Background: One of the disorders in stroke patients is asymmetrical posture, which leads to decreased movement and balance control. An ankle-foot orthosis (AFO) is the most common orthopedic device used in patients with post-stroke hemiplegia, and are often utilized with shoes. The purpose of this study was to investigate the effect, in stroke patients, of rocker bottom shoes on an AFO in the clinical assessments of balance compared to standard shoes on an AFO.
Methods: This quasi-experimental study involved 10 chronic stroke patients. The evaluated individuals were under four conditions using rocker bottom shoes and standard shoes coupled with a rigid AFO immediately, and after a 3-week adaptation. The walking speed was assessed using a 10-m walk test (10 MWT), and the clinical assessments of balance were evaluated using the Timed-Up and Go test (TUG) and the Functional Reach Test (FRT).
Results: The findings revealed that wearing rocker bottom shoes on the AFO significantly increased walking speed, the distance on the FRT, and reduced the TUG compared to wearing standard shoes on the AFO (p < 0.05).
Conclusion: The study indicated that stroke patients showed an improvement in walking speed and functional balance when utilizing the AFOs with rocker bottom shoes. This outcome could be a possibility in application by doctors to prescribe this type of footwear for individuals who have had a stroke.
Keywords
in mortality from stroke, 1968 to 1994. stroke. 2000;31(7):1588-601.
2. Ahlsiö B, Britton M, Murray V, Theorell T. Disablement and
quality of life after stroke. stroke. 1984;15(5):886-90.
3. Geurts AC, de Haart M, van Nes IJ, Duysens J. A review of standing
balance recovery from stroke. Gait Posture. 2005;22(3):267-81.
4. Tyson SF, Kent RM. Effects of an ankle-foot orthosis on balance
and walking after stroke: a systematic review and pooled metaanalysis.
Arch Phys Med Rehabil. 2013;94(7):1377-85.
5. Daryabor A, Arazpour M, Aminian G. Effect of different designs
of ankle-foot orthoses on gait in patients with stroke: A systematic
review. Gait Posture. 2018;62:268-79.
6. Padilla MG, Rueda FM, Diego IA. Effect of ankle-foot orthosis
on postural control after stroke: A systematic review. Neurología (English Edition). 2014;29(7):423-32.
7. Wang R-Y, Yen L-L, Lee C-C, Lin P-Y, Wang M-F, Yang Y-R.
Effects of an ankle-foot orthosis on balance performance in
patients with hemiparesis of different durations. Clin. Rehabil.
2005;19(1):37-44.
8. Pohl M, Mehrholz J. Immediate effects of an individually designed
functional ankle-foot orthosis on stance and gait in hemiparetic
patients. Clin. Rehabil. 2006;20(4):324-30.
9. Lehmann J. Biomechanics of ankle-foot orthoses: Prescription
and design. 1979.
10. Ferreira LAB, Neto HP, Christovão TCL, Duarte NA, Lazzari
RD, Galli M, et al. Effect of ankle-foot orthosis on gait velocity
and cadence of stroke patients: a systematic review. J. Phys.
2013;25(11):1503-8.
11. Gök H, Küçükdeveci A, Altinkaynak H, Yavuzer G, Ergin S.
Effects of ankle-foot orthoses on hemiparetic gait. Clin. Rehabil.
2003;17(2):137-9.
12. Brown D, Wertsch JJ, Harris GF, Klein J, Janisse D. Effect
of rocker soles on plantar pressures. Arch Phys Med Rehabil.
2004;85(1):81-6.
13. Jagadamma KC, Owen E, Coutts FJ, Herman J, Yirrell J, Mercer
TH, et al. The effects of tuning an ankle-foot orthosis footwear
combination on kinematics and kinetics of the knee joint of an
adult with hemiplegia. Prosthet. Orthot. Int. 2010;34(3):270-6.
14. Farmani F, Mohseni-Bandpei M-A, Bahramizadeh M, Aminian
G, Abdoli A, Sadeghi-Goghari M. The influence of rocker bar
ankle foot orthosis on gait in patients with chronic hemiplegia.
J Stroke Cerebrovasc. 2016;25(8):2078-82.
15. Pardo V, Galen S, Gahimer JE, Goldberg A. Effects of custommolded
and prefabricated hinged ankle-foot orthoses on gait
parameters and functional mobility in adults with hemiplegia:
a preliminary report. JPO: J Prosthet Orthot. 2015;27(1):33-8.
16. Webster JB, Murphy DP. Atlas of Orthoses and Assistive Devices:
Elsevier; 2019.
17. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic
functional mobility for frail elderly persons. J. Am. Geriatr. Soc.
1991;39(2):142-8.
18. Duncan PW, Studenski S, Chandler J, Prescott B. Functional
reach: predictive validity in a sample of elderly male veterans. J.
Gerontol. 1992;47(3): 93-8.
19. Sobhani S, Zwerver J, van den Heuvel E, Postema K, Dekker R,
Hijmans JM. Rocker shoes reduce Achilles tendon load in running
and walking in patients with chronic Achilles tendinopathy.
J SCI MED SPORT. 2015;18(2):133-8.
20. Trepman E, Yeo S-J. Nonoperative treatment of metatarsophalangeal
joint synovitis. Foot Ankle Int. 1995;16(12):771-7.
21. Chapman J, Preece S, Braunstein B, Höhne A, Nester C,
Brueggemann P, et al. Effect of rocker shoe design features on
forefoot plantar pressures in people with and without diabetes.
Clin Biomech. 2013;28(6):679-85.
22. Sobhani S, van den Heuvel ER, Dekker R, Postema K, Kluitenberg
B, Bredeweg SW, et al. Biomechanics of running with rocker
shoes. J Sci Med Sport. 2017;20(1):38-44.
23. Arazpour M, Hutchins SW, Ahmadi Bani M, Curran S,
Bahramizadeh M, Saberi H, et al. The influence of a rocker
sole adaptation on gait parameters in spinal cord injury patients
ambulating with the advanced reciprocating gait orthosis–a pilot
study. Disabil Rehabil Assist Technol. 2015;10(1):89-92
24. Oludare SO. The influence of rocker profile footwear on rollover
during walking. 2014.
25. Salem Y, Pappas E. Overground gait training for individuals with
chronic stroke: a Cochrane systematic review. J Neurol Phys Ther.
2009;33(4):179-86.
26. Flansbjer U-B, Holmbäck AM, Downham D, Patten C, Lexell
J. Reliability of gait performance tests in men and women with
hemiparesis after stroke. J Rehabil Med. 2005;37(2):75-82.
27. Tyson SF, DeSouza LH. Reliability and validity of functional
balance tests post stroke. Clin. Rehabil. 2004;18(8):916-23.
28. Lin S-C, Chen CP, Tang SF, Wong AM, Hsieh J-H, Chen W-P.
Changes in windlass effect in response to different shoe and
insole designs during walking. Gait Posture. 2013;37(2):235-41.
29. Wu W-L, Rosenbaum D, Su F-C. The effects of rocker
sole and SACH heel on kinematics in gait. Med Eng Phys.
2004;26(8):639-46.
30. Landry SC, Nigg BM, Tecante KE. Walking in an unstable Masai
Barefoot Technology (MBT) shoe introduces kinematic and
kinetic changes at the hip, knee and ankle before and after a 6-week
accommodation period: a comprehensive analysis using principal
component analysis (PCA). Footwear Sci. 2012;4(2):101-14.