Article

OBJECTIVE: To systematically review the evidence on the effects of an ankle-foot
orthosis on gait biomechanics after stroke. DATA SOURCES: The following databases
were searched; AMED, CINHAL, Cochrane Library (Stroke section), Medline, PubMed,
Science Direct and Scopus. Previous reviews, reference lists and citation
tracking of the selected articles were screened and the authors of selected
trials contacted for any further unpublished data. REVIEW METHODS: Controlled
trials of an ankle-foot orthosis on gait biomechanics in stroke survivors were
identified. A modified PEDro score evaluated trial quality; those scoring 4/8 or
more were selected. Information on the trial design, population, intervention,
outcomes, and mean and standard deviation values for the treatment and control
groups were extracted. Continuous outcomes were pooled according to their mean
difference and 95% confidence intervals in a fixed-effect model. RESULTS: Twenty
trials involving 314 participants were selected.
An ankle-foot orthosis had a
positive effect on ankle kinematics (P < 0.00001-0.0002); knee kinematics in
stance phase (P < 0.0001-0.01); kinetics (P = 0.0001) and energy cost (P =
0.004), but not on knee kinematics in swing phase
(P = 0.84), hip kinematics (P <
0.18-0.89) or energy expenditure (P = 0.43). There were insufficient data for
pooled analysis of individual joint moments, muscle activity or spasticity. All trials, except one, evaluated immediate effects only. CONCLUSIONS: An ankle-foot
orthosis can improve the ankle and knee kinematics, kinetics and energy cost of
walking in stroke survivors.

Langue : ANGLAIS