The Effects of Custom-Made Knee-Ankle-Foot Orthosis on Physical Function and Activities of Daily Living in Patients with Severe Hemiplegia in Acute Stroke

Abstract

Objective: We investigated whether there was a difference in improvements in physical function and activities of daily living between a group that received custom made Knee-ankle-foot orthosis for acute-phase stroke patients with severe hemiplegia and a group that received intervention using standard Knee-ankle-foot orthosis.

Subjects and Methods: Thirty-seven patients were admitted to the hospital, 16 patients (10 males, 6 females, age: 66.5 ± 10.27 years old) in the orthotic group and 21 patients (12 males, 9 females, age: 72.90 ± 10.59 years old) in the non orthotic group, who used the long leg orthosis provided by the hospital. The group was defined as follows. Br. stage, BBS, FMS, FAC, and FIM were evaluated at admission and at discharge and compared. ANCOVA was performed for discharge FIM, adjusting for admission FIM, age, and stroke subtype. Immobility-related complications during hospitalization were also investigated.

Results: The orthotic group had significantly higher BBS, total FIM, FIM cognitive, FIM eating, and FIM transfer scores. However, ANCOVA showed no significant difference in total FIM at discharge. There was also no difference in immobility-related complications.

Conclusion: Although the orthotic group showed better outcomes in unadjusted analyses, these differences were not significant after adjustment for background factors.