Abstract: Objective To investigate the effects of bare foot, soft plastic ankle-foot orthosis (sAFO) and hard plastic ankle-foot orthosis (hAFO) on balance and gait in the elderly hemiplegic patients with stroke. Methods A total of fifty-two elderly hemiplegic patients with stroke (38 male, 14 female) were enrolled in this study. Under the two status of opening and closing eyes respectively, the Pro-Kin balance evaluation training instrument was used to evaluate the static standing balance function under three conditions of bare foot, sAFO and hAFO. The feet stood at the optimal distance under each condition, and the main measurement parameters including the standard deviation of longitudinal swing (SDoLS), the standard deviation of horizontal swing (SDoHS), mean longitudinal velocity (MLV), mean horizontal velocity (MHV), the ellipse area of motion (EAM) and the length of motion (LM) were recorded. The Tinetti Performance-Oriented Mobility Assessment (POMA) was used to evaluate the dynamic balance and gait. Results The optimum distance between feet of bare foot, sAFO and hAFO was (15.46±4.65) cm, (17.87±5.5) cm, (18.43±5.45) cm respectively. In the state of opening the eyes, MHV, EAM, LM of standing with the sAFO condition were significantly lower than those with the bare-foot condition (P<0.05); In the state of closing the eyes, SDoHS, MHV, EAM, LM of standing with the sAFO condition were significantly lower than those with the bare-foot condition (P<0.05); In the state of opening the eyes, SDoLS, SDoHS, MHV,EAM, LM of standing with the hAFO condition were significantly lower than those with the bare-foot condition (P<0.05); In the state of closing the eyes, SDoLS, SDoHS, MHV, EAM, LM of standing with the hAFO condition were significantly lower than those with the bare-foot condition (P<0.05); In the state of opening the eyes, SDoHS of standing with hAFO condition was significantly lower than that with sAFO condition (P<0.05); In the state of closing the eyes, SDoLS of standing with hAFO condition was significantly lower than that with sAFO condition (P<0.05). The scores of Tinetti POMA, POMA-B and POMA-G with the sAFO condition were significantly higher than those with the bare-foot condition (P<0.05); The scores of Tinetti POMA and POMA-B with the hAFO condition were significantly higher than those of the bare-foot condition (P<0.05); The scores of Tinetti POMA and POMA-G with the sAFO condition were significantly higher than those with the hAFO condition (P<0.05). Conclusions Both sAFO and hAFO can improve the static and dynamic balance function of the elderly hemiplegic patients with stroke, and sAFO is more effective in improving gait function.

Key words: ankle-foot orthosis, stroke, balance, gait