前葉式踝足矯具對偏癱患者姿勢穩定、重心轉移及步態特性之效應

中風後之偏癱患者常以踝足矯具來矯正踝關節，提高穩定度及增進行 走安全。因為鐵鞋過重及不美觀，所以已漸由塑膠式踝足矯具取代。而高 溫、打模成型之後葉式塑膠踝足矯具製作費時，矯正偏癱患者內翻足之效 果似乎不甚理想。吳鑫漢設計以低溫成型塑材製作前葉式踝足矯具，普遍 應用於國內偏癱患者的步態矯正上。 本研究以24位中風之偏癱患者為 對象，利用足底壓步態分析儀(InfotronicUltraflex System)，評估低溫 成型之前葉式踝足矯具對姿勢穩定、重心轉移及步態的影響。結果顯示穿 戴前葉式踝足矯具時，患者姿勢穩定度及對稱性沒有顯著差異；而重心轉 移及患側下肢載重能力增加。關於步態特性，穿戴踝足矯具時，步行速度 及步幅數增加；腳跟著地期前腳載重減少，但步態對稱性、著地期外側腳 底壓力及離地期地面垂直作用力則沒有顯著差異。

Ankle-foot orthoses (AFOs) are frequently prescribed for hemiplegia to correct ankle joint, provide mediolateral stability and improve ambulatory safety. Metal orthoses have gradually been replaced by plastic AFOs, because they are heavy and have a poor cosmetic appearance. Conventional plastic AFOs are designed in posterior leaf type and fabricated by lamination or vacuum-forming technique over a positive plaster model of the limb. It takes time to be fabricated, and it seems that the effect of correcting for inversion of hemiplegic foot is not obvious. Wu designed a low-temperatureanterior direct molding AFO. It is fabricated quickly and easily, and is custom fit. The anterior AFO is commonly used for hemiplegia with spasticityin Taiwan. The purpose of this study was to examine the effects of this anterior AFO on postural stability, weight shifting and gait characteristicsof hemiplegia. The Infotronic Ultraflex System was used to collect data with and without AFO in twenty four post-stroke hemiplegia. The results revealed that wearinganterior AFO, there was no significant difference in postural sway and postural symmetry; there was a significant improvement in weight shifting and weight bearing through affected leg. In gait characteristics, with the use ofan anterior AFO, walking velocity and cadence increased. Using the AFO alsoresulted in a decrease of forefoot's weight bearing at heel strike (flatfoot weight bearing instead of forefoot weight bearing). There was no significant difference in gait symmetry, lateral foot weight bearing during stance phaseand vertical reaction force at push off.