Researchers at Northwestern University Prosthetics-Orthotics Center (NUPOC), Chicago, Illinois, and the U.S. Department of Veterans Affairs (VA) have found that AFO use improves balance confidence in patients with chronic poststroke hemiplegia.
AFOs may improve walking speed, stride length, and gait pattern in this population. However, effects on balance, crucial for safe ambulation, are thus far inconclusive, according to the study. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one’s ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation, as defined by the International Classification of Functioning, Disability, and Health, than physical performance measures of gait or balance.
To investigate whether balance confidence is improved with AFO use, the researchers measured 15 patients with poststroke hemiplegia using the Activities-specific Balance Confidence (ABC) Scale. They obtained two data sets, one with and one without AFO use. They found that the ABC scores were significantly higher with AFO use.
Balance confidence, or self-efficacy-defined as the belief in one’s ability to succeed in particular in balance capabilities, is more strongly associated with activity and participation, as defined by the International Classification of Functioning, Disability, and Health, than physical performance measures of gait or balance.
According to the researchers, study results provide evidence for improvements in balance confidence with AFO use, and rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations. They conclude that future work should explore the specific mechanisms underlying the improvement in balance confidence as part of evaluating poststroke function.
The study was published June 24 in Prosthetics and Orthotics International.
