Article

Tone-reducing ankle-foot orthoses (TRAFOs) are said to improve the control and
functioning of spastic lower limbs by their biomechanic and neurophysiologic
effects. Unfortunately, there is limited evidence in literature to support the
theory that TRAFOs can effectively decrease spasticity in the foot and ankle
neurophysiologically.
The primary purpose of this investigation was to determine
the neurophysiologic effect of TRAFOs on soleus muscle reflex excitability in
subjects with spasticity following stroke while standing.
A repeated-measures
intervention study was conducted on 15 adult subjects with stroke who were
recruited from the community. Custom-made articulated ankle-foot orthoses (AFOs)
and TRAFOs with orthokinetic compression garments (OCGs) were fabricated for each
subject. Five conditions were tested: (1) Shoes only, (2) AFO, (3) TRAFO, (4)
TRAFO with OCG, (5) shoes only, to determine if the TRAFOs were most effective in
decreasing spasticity as assessed by the ratio of maximum Hoffmann reflex
amplitude to maximum muscle response amplitude (Hmax:Mmax ratio) of the soleus.
The results found that there were no significant treatment effects for the
interventions (F = 0.992,
df = 2.167, p = 0.388), however, when analysed
subject-by-subject, four subjects displayed significant increases in their
Hmax:Mmax ratios to at least one treatment condition. Overall, the results
demonstrated that the tone-reducing devices had no significant neurophysiologic
effect on soleus reflex excitability in subjects with spasticity, however
individual responses showed that the TRAFOs increased spasticity in some individuals.

Langue : ANGLAIS