Immediate effect of AFOs on postural stability in older adults

Jürgen with WalkOn on stairs. Moving naturally. You can move naturally with the WalkOn during the day. When you crouch down or walk up a set of stairs for example, you can put a natural load on the forefoot. The WalkOn is ideally suited for numerous everyday situations. Otto Bock

Custom made AFOs have a positive, immediate effect on postural stability in older adults.

Highlights
  • Stability and coordination were measured while wearing ankle foot orthoses (AFO).
  • Participants were a minimally restrictive sample of older adults aged 65 + years.
  • Standing balance, functional reach (FR) and timed up and go (TUG) were performed.
  • AFO did not impact FR distance or TUG completion time.
  • Postural sway and lower extremity coordination were improved with AFO.
Background

Foot and ankle problems are highly prevalent fall risks in the elderly. Ankle foot orthoses designed to stabilize the foot and ankles have been studied within specific patient groups, but their efficacy with a less restrictive elderly population is unknown.

This study investigated if custom-made ankle foot orthoses improve postural stability in older adults.

Methods

Thirty ambulatory older adults averaged 73 (standard deviation = 6.5) years completed Romberg’s balance (eyes-open/eyes-closed), functional reach, and Timed Up and Go tests while wearing validated kinematic sensors.

Each test was completed in standardized shoes with and without bilateral orthoses. Additionally, barefoot trials were conducted for the Romberg’s and functional reach tests.

Findings

Compared to the barefoot and ‘shoes alone’ conditions, the orthoses reduced center of mass sway on average by 49.0% (P = 0.087) and 40.7% (P = 0.005) during eyes-open balance trials. The reduction was amplified during the eyes-closed trials with average reductions of 65.9% (P = 0.000) and 47.8% (P = 0.004), compared to barefoot and ‘shoes alone’ conditions.

The orthoses did not limit functional reach distance nor timed-up and go completion times. However, the medial-lateral postural coordination while reaching was improved significantly with orthoses compared to barefoot (14.3%; P = 0.030) and ‘shoes alone’ (13.5%; P = 0.039) conditions.

Interpretation

Ankle foot orthoses reduced postural sway and improved lower extremity coordination in the elderly participants without limiting their ability to perform a standard activity of daily living.

Additional studies are required to determine if these benefits are retained and subsequently translate into fewer falls.

  References
An-immediate-effect-of-custom-made-ankle-foot-orthoses-on-postural-stability-in-older-adults-Yalla-2014

An immediate effect of custom-made ankle foot orthoses on postural stability in older adults, Yalla SV, Crews RT, Fleischer AE, Grewal G, Ortiz J, Najafi B. Clin Biomech (Bristol, Avon). 2014 Dec;29(10):1081-8. doi: 10.1016/j.clinbiomech.2014.10.007. Epub 2014 Oct 30. Full text

Also see
James Robinson: AFOs give him the confidence to stay active in retirement Lower Extremity Review
Post-stroke balance: AFO use may improve self-efficacy Lower Extremity Review
Jeff Seitzer: AFOs and staying fit help manage his mild symptoms Lower Extremity Review
Post-stroke balance: AFO use may improve self-efficacy Lower Extremity Review

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