The Comparison of the Effects of Flexible vs Rigid Ankle-foot orthoses on Balance and Walking Performance in Individuals With Multiple Sclerosis: A Crossover Study

Abstract

Objectives: Ankle-Foot orthoses are used to minimize the impact of weakness in ankle dorsiflexion muscles. The study on different orthotic types defines the optimal design, which effectively improves the users’ mobility. This study investigated the potential benefits and risks of a Dictus-band (flexible orthotic), compared with a thermoplastic (fixed) ankle-foot orthosis on the mobility of individuals with Multiple Sclerosis (MS). Methods: Fifteen subjects with MS and dorsiflexion ankle weakness volunteered in this randomized crossover study. The study participants received either a Dictus-band or a thermoplastic ankle-foot orthosis worn on the weaker leg, compared to barefoot as the control condition. Postural stability during standing, forward reach test, timed up and go test, and walking speed in the 10-meter walking test were compared between the study conditions. Results: There were no significant differences in the postural stability and forward reach tests between study conditions (p>0.5). When the research participants used a Dictus-band, compared to the fixed ankle-foot orthosis, the time required to complete the timed up and go was significantly reduced P<0.01; Mean±SD difference: 6.4±1.4; 95% Confidence Interval (CI): 2.7-10.2, and walking speed was increased in the 10-meter walking test (P<0.01; Mean±SD difference: 0.46±0.8; 95%CI: 0.23-0.69). There was no difference in the timed up and go and 10-meter walking test data between the barefoot and Dictus-band conditions (p>0.5). No adverse or safety events were sustained in this research. Discussion: The present study data provided initial evidence for the lack of detrimental effects of using the Dictus-band in subjects with MS and ankle dorsiflexion deficiencies. © 2021