플라스틱 AFO (Ankle Foot Orthosis)의 슈 인서트 길이 차이가 뇌졸중 환자의 보행 및 동적 안정성에 미치는 영향 = The Effect of Shoe Insert Length on Plastic AFO (Ankle Foot Orthosis) on Stroke Patient’s Gait and Dynamic Stability

다국어 초록 (Multilingual Abstract)

Background/Aims: This study examined the effects of ankle–foot orthoses (AFOs) with different shoe-insert lengths on spatiotemporal variables, kinematic and kinetic parameters, and dynamic stability in stroke patients. Methods: Eleven patients with right hemiplegia (hemorrhage 6, infarction 5) undergoing rehabilitation at S Convalescent Hospital in Changwon participated. The mean onset duration was 23.64±9.84 months, and the modified Ashworth scale was grade 1∼2. Gait was assessed under three conditions: without an AFO, with a full-length AFO, and with a ¾-length AFO on the paretic side. A wireless inertial sensor (G-walk) measured spatiotemporal, kinematic, and kinetic variables. Dynamic stability was evaluated using the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS). Result: Non-affected stride length, cadence, velocity, and gait symmetry significantly increased when walking with the ¾ AFO compared to no AFO (p＜0.05). Pelvic tilt, obliquity, and rotation showed no significant kinematic differences across conditions, and kinetic variables also showed no significant changes. TUG and BBS scores significantly improved when using the ¾ AFO compared to no AFO or the full-length AFO (p＜0.05). Conclusion: A ¾-length AFO is effective for stroke patients with mild spasticity by securing the forefoot rocker, enhancing stability, and facilitating toe-off, thereby promoting a more natural gait pattern.