The effects of different types of ankle-foot orthoses on postural responses in individuals with walking impairments

The aim of this study was to examine the immediate and long-term effects of different ankle-foot orthosis (AFO) types on postural responses in patients with various pathological conditions who, because of their walking disorders, wore an AFO. A total of 37 patients with different pathological conditions who visited the outpatient clinic for orthotics because of walking problems, already used or were referred for an AFO and had no other impairments that may influence balance were included in the study. The participants were divided into four groups according to the type of AFO that they wore. The postural responses were assessed with and without AFO using two force-plates following perturbations in different directions at the level of the pelvis. The centre of pressure was examined in the sagittal and frontal plane and compared with the normative data from healthy individuals. The results showed an improvement in postural responses to the lateral and backward perturbation directions when wearing the AFO, particularly responses in the anterior-posterior direction. The best results were achieved with the custom-made posterior leaf spring AFO for correction of equinovarus deformity. The time of wearing the AFO had an impact on postural responses in perturbation directions where the patients could not rely only on AFO. The custom-made AFO improved overall postural responses, especially dynamic stability, in lateral directions, whereas all stiff AFOs contributed towards an improvement in responses to all perturbations to the affected side. Results showed that long-term use of an AFO can be important for the overall improvement of postural responses. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.