İnmeli Hastalarda Hedef Odaklı Eğitime Ek Olarak Uygulanan AFO’nun Alt Ekstremite Fonksiyonları, Denge, Ambulasyon ve Yaşam Kalitesi Üzerine Etkilerinin Araştırılması

Abstract

This study aims to evaluate the compared effects of plastic, static ankle – foot orthosis which is applied to stroke patients in addition to task oriented training on lower extremity functions, balance, ambulation and quality of life. It includes the individuals aged 18 and above, who had a stroke for the first time, has Brunnstorm lower extremity stage ≥3, whose functional ambulation classification is ≥2 and who have no additional physical and neurological complaints for at least 3 months after stroke. These individuals were randomly divided into three groups. The first group was given conventional physiotherapy training, the second group was given task oriented training and the third group was given plastic, static ankle-foot orthosis besides task oriented training. Patients in both groups were given exercise treatment an hour a day for five days a week for a month. Assessments were carried out twice before and after treatment. The assessment for lower extremity functions is Motricity Index, Fugl Meyer Lower Extremity Assessment. For balance; Berg Balance Scale, Timed Get up and Go Test and Functional Reach Test were applied. For ambulation; 6 Minute Walk Test, 10 Meter Walk Test, Weight Transfer Symmetry, Postural Symmetry Index and Rivermead Mobility Index were used. For the Quality of Life; Quality of Life Scale for Stroke and Stroke Impact Scale were used. For the difference between groups in data analysis, one-way analysis of variance was used in cases where parametric test conditions were met and Kruskal Wallis test was used in cases where conditions were not met. For the difference between two dependent means in dependent groups, significance test and Wilcoxon test were used. To find out the correlation between measured parameters, Spearman correlation coefficient was used. In the Conventional Physiotherapy Group, a statistically significant increase was observed in all parameters except 6-minute walking, postural symmetry and weight transfer symmetry evaluations after 4 weeks of treatment (p<0.05). In the task oriented physiotherapy group, when after-treatment and before-treatment assessments were compared, a statistically significant increase was observed in all parameters except get up and go, postural symmetry and weight transfer symmetry (p<0.05). There was a statistically significant increase in all parameters except Fugl Meyer, postural symmetry and weight transfer symmetry in task oriented physiotherapy + AFO group when assessments before and after treatment compared (p<0.05). When assessments of participant individuals after treatment were compared as groups, assessed parameters were seen to be similar (p>0.05). Besides, lower extremity functions, balance, ambulation and quality of life were found out to be as correlated parameters. As a result, even if plastic, static ankle-foot orthosis which is applied besides task oriented training has positive effects on lower extremity functions, balance, ambulation and life quality, these effects show similarities between treatment groups.