Differences in activities of daily living between people with subacute stroke who received knee-ankle-foot and ankle-foot orthoses at admission

• Published in: Journal of Physical Therapy Science 2018, Vol.30(10), pp.1245-1250
• Main Authors: Ota, Tomohiro, Hashidate, Hiroyuki, Shimizu, Natsuki, Saito, Akihiko
• Format: Article
• Language: English
• Subjects: Activities of daily living; Ankle; Disability; Lower-limb orthosis; Original; Stroke
• ISSN: 0915-5287; 2187-5626
• DOI: 10.1589/jpts.30.1245

[Purpose] This study aimed to identify the preferential factor of activities of daily living disabilities for selecting between knee-ankle-foot orthosis and ankle-foot orthosis prescription in the early stage after admission. [Participants and Methods] This study included 442 inpatients who had a subacute stroke and received either knee-ankle-foot orthosis or ankle-foot orthosis after admission (mean age, 69 years). The functional independence measure was investigated within 1 week after admission. [Results] Inpatients who had a stroke and received knee-ankle-foot orthosis had significantly lower scores for all individual functional independence measure items than those who received ankle-foot orthosis. Logistic regression analysis revealed that functional independence measure transfer (bed, chair, and wheelchair) was closely associated with the difference in the prescribed lower limb orthosis after multivariate adjustment. [Conclusion] Compared with ankle-foot orthosis, knee-ankle-foot orthosis was prescribed to inpatients with more-severe disabilities, and the difference in the disability related to performing transfer activities was more noticeable than that in disability related to mobility between inpatients for whom knee-ankle-foot orthosis was prescribed and those for whom ankle-foot orthosis was prescribed. To provide effective rehabilitation for people who had a subacute stroke, for whom use of knee-ankle-foot orthosis or ankle-foot orthosis is recommended. The evaluation and intervention focused on standing performance related to performing transfer such as sit-to-stand, standing, moving while standing, and stepping might be a priority in the early stage after admission.