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Kurt Jackson, PT, PhD
Background/Purpose: Ankle-Foot orthoses (AFOs) are commonly used in individuals with neurologic disorders such as MS and stroke. However, a rigid style of AFO may impact an individual's ability to complete dynamic balance tasks especially reactive stepping movements in the instance of losing balance. The impact a rigid AFO has on reactive stepping has not been investigated. The primary purpose of this study was to determine the impact rigid AFOs have on reactive stepping preference in healthy young adults, thus providing preliminary data on healthy individuals’ stepping strategies that could be used for further research with more neurologically-involved populations.
Methods: Twenty healthy participants (mean age = 24±6 yrs.) with no persistent lower extremity injuries completed the testing. This study utilized a lean-and-release procedure for inducing a perturbation and subsequent recovery step. Participants were placed in a safety harness and separate belt attachment to the weight support system. Subjects were asked to lean at 10-15% of their bodyweight. Examiners released the subject unexpectedly from the belt so they were required to take a reactive step to regain their balance. This was repeated 10 times for each of the following conditions 1) with no AFO, 2) AFO on the left, 3) AFO on the right. The primary outcome measure was number of steps taken with the right foot during each condition.
Results: When wearing no AFO, participants preferred stepping with their right foot (7.0 ± 3.9) There was a significant difference (p = 0.03) in preferred reactive stepping limb between the left and right AFO conditions. Reactive stepping with the right foot was greater when an AFO was worn on the left foot (8.1 ± 3.3) compared to the right foot AFO (5.7 ± 4.4).
Conclusion: There is a significant difference in preferred reactive stepping limb when the AFO placed on right versus left lower extremity.
Clinical Relevance: Following loss of balance, AFO limb placement may influence the preferred reactive stepping limb. This should be considered when teaching neurological patients to use an AFO and during balance training.
Physical Therapy | Rehabilitation and Therapy
Twohy, Kyra; Andrews, Hunter; Christopher, Ryan; Scott, Aaron; Valentine, Katie; and Jackson, Kurt, "Effect of Ankle-Foot Orthosis on Reactive Stepping in Healthy Young Adults: A Pilot Study" (2020). University of Dayton Doctor of Physical Therapy Annual Research Symposium. 2.