Immediate Effects of Ankle-Foot Orthosis Using Wire on Static Balance of Patients with Stroke with Foot Drop: A Cross-Over Study

The aim of this study was to investigate the immediate static balance effects of bare foot, UD-Flex ankle-foot orthosis (AFO), and AFO using wire (AOW) of patients with stroke with foot drop. Seventeen patients with stroke with foot drop (8 men and 9 women) were randomized to three conditions (bare foot, UD-Flex AFO, or AOW made with a flexible material). Static balance was assessed using the Zebris (Zebris GmbH, Isny, Germany) and BioRescue (RM Ingenierie, Rodez, France) pressure platform by a single examiner, who did not design the AOW. The order of testing with the equipment was random. The center of pressure path length (mm) measured using Zebris showed significant differences among the three conditions (bare foot, 484.47 +/- 208.42; UD-Flex AFO, 414.59 +/- 144.43; AOW, 318.29 +/- 157.60) (p< 0.05). The bare-foot condition was not significantly different from the UD-Flex AFO condition (p> 0.05), but was significantly different from the AOW condition (p< 0.05). The surface area ellipse (mm(2)) measured using BioRescue showed significant differences among the three conditions (bare foot, 241.35 +/- 153.76; UD-Flex AFO, 277.41 +/- 381.83; AOW, 68.06 +/- 48.98) (p< 0.05). The bare-foot condition was not significantly different from the UD-Flex AFO condition (p> 0.05), but the AOW condition was significantly different from the bare-foot (p< 0.05) and from the UD-Flex AFO conditions (p< 0.05). We suggest using the AOW made of flexible materials and wire instead of the UD-Flex AFO to improve immediate static balance of patients with stroke with foot drop after stroke. Further studies on the effects of dynamic balance and gait are required.