The objective of the study is to determine the immediate impact of ground reaction ankle foot orthoses (AFOs) on balance during static standing and during ambulation for individuals with inherited motor or sensory neuropathies.

Inherited neuropathies cause weakness and atrophy of the muscles generally in distal extremities, with or without sensory changes.  These impairments contribute to impaired balance and gait, and increase risk for falls and secondary injuries. Ground reaction AFOs are one type of lower extremity orthosis that can be prescribed to help improve gait. To our knowledge, there are no studies that look at the immediate impact of these AFOs on balance in this population.

Participants were seen in clinic by a physical therapist and orthotist.  Individuals who were clinically appropriate to trial AFOs in clinic were asked to complete the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and the 4-item Dynamic Gait Index (DGI) with and without AFOs on to assess static and dynamic balance. To minimize the ceiling effect with the DGI, AFOs were not considered an “assistive device” for any of the items.  

To date, there have been 6 participants in this study. The average DGI scores were 7.5/12 without the AFOs on and 10.5/12 with the AFOs on.  Two participants demonstrated improved performance on condition 1 of the mCTSIB, none declined. All six participants demonstrated improved performance on condition 2.  On condition 3, one participant demonstrated improvement with AFOs, while another demonstrated a decline in performance.  For condition 4, one participant demonstrated improved performance with AFOs, while four participants demonstrated a decline with the AFOs.

The findings to date suggest an immediate improvement in dynamic balance during ambulation, with mixed data on static standing balance.  We are currently enrolling for this study and will present updated results.