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02/02/2015    Sai Yalla, PhD, et al.

Scholl Faculty Publishes Study on Custom Balance AFOs (Doug Richie, DPM)

The authors would like to thank Dr. Richie for his
interest in the publication. It is admittedly
difficult to review an entire study within the
confines of a PMNews brief. The original PMNews
story did indicate all balance measures improved.
This was intended to reference the assessment of
body sway during standing trials, as well as the
media-lateral sway during functional reach test.

The center of mass sway while standing was reduced
with AFO use during both the eyes open and closed
evaluations. The “functional reach tests”
demonstrated a significant improvement in medial
lateral postural coordination during the execution
of the reach when AFOs were worn.

While there was an improvement in the control of
the execution of the reaching task, Dr. Richie
correctly identified that reach distance did not
significantly increase. In referencing the balance
results Dr. Richie also made reference to the
Timed Up and Go Tests. The time duration for that
test did not improve and the authors did not
intend to imply they did. This test was not
considered a measure of “balance.”

This test which was previously developed by
others, is intended to be a fall risk test.
Balance can impact the score (time), but the test
simply measures the time to rise from a chair,
walk ten feet, turn around, walk back and sit down
again. Balance is only one factor that influences
these times.

Based upon the times taken to the complete the
test, no conclusions specifically about balance
can be made. The critical and objective evaluation
of any treatment (device, pharmaceutical,
rehabilitative, etc.) is a long and arduous task.
This publication represents an initial
investigation upon the immediate effect of the AFO
within a purposefully non-restrictive sample of
elderly individuals.

Larger prospective studies are indeed needed to
verify any long term benefit of the device. We
thank PM News for sharing the link to the peer-
reviewed publication in Clinical Biomechanics and
allowing readers the opportunity to obtain a more
thorough understanding of the study.

Sai Yalla, PhD, Ryan Crews, MS, Adam Fleischer,
DPM, MPH, Gurtej Grewal, PhD, Jacquelyn Ortiz,
CCRP, Bijan Najafi, PhD

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