Abstract
Background
Multiple sclerosis refers to a progressive autoimmune inflammatory disease in the
central nervous system usually accompanied by balance disorder. Our systematic review
aimed to investigate the effects of orthotic devices on balance control of multiple
sclerosis patients.
Methods
The search procedure was according to the population, intervention, comparison, and
outcome (PICO) strategy. We looked into PubMed, Embase, ISI Web of Knowledge, and
Scopus databases and included all studies published since 1980. Two researchers did
the searches separately and evaluated the selected papers’ quality based on the physiotherapy
evidence database (PEDro) scale and Cochrane risk of bias tool. We did a meta-analysis
to evaluate the interventions’ effects on the balance factors.
Results
We found nine studies, of which seven studies with 162 participants were included
in our meta-analysis. Four studies investigated the effect of foot orthoses, one evaluated
the effect of shoe modifications and four evaluated the effect of ankle foot orthoses.
There was no significant immediate difference between the insole and control groups
in center of pressure velocity change, C7 displacement, in both open and closed eyes
conditions. Also, there was no significant immediate difference between ankle foot
orthosis’ intervention and control groups in center of pressure velocity and displacement
changes in antero-posterior and medio-lateral directions, in both open and closed
eyes conditions. We could not do a meta-analysis for shoe modification.
Conclusion
Few studies have assessed the effects of orthoses on balance control in multiple sclerosis
patients. Studies on ankle foot and foot orthoses show inconsistent results. According
to our meta-analysis, orthotic interventions do not seem to improve the balance of
people with multiple sclerosis.
Keywords
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References
Walton C., King R., Rechtman L. et al. Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition. 2020; 26:1816–1821.
- Effects of balance exercises on people with multiple sclerosis: a pilot study.Clin. Rehabil. 2007; 21: 771-781
Mirmosayyeb O., Brand S. Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis. 2020; 9.
- Clinical tests of standing balance: performance of persons with multiple sclerosis.Arch Phys Med Rehabil. 2000; 81: 215-221
- Balance performance in three forms of multiple sclerosis.Neurol. Res. 2006; 28: 555-562
- De-stabilizing and training effects of foot orthoses in multiple sclerosis.Mult. Scler. 2006; 12: 219-226
- Do static or dynamic AFOs improve balance?.Clin. Rehabil. 2002; 16: 894-899
- Group exercise classes in people with multiple sclerosis: a pilot study.Physiother. Res. Int. 2004; 9: 104-107
- Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept.Physiother. Res. Int. 2006; 11: 104-116
- Effect of textured insoles on balance and gait in people with multiple sclerosis: an exploratory trial.Physiotherapy. 2014; 100: 142-149
- Do textured insoles affect postural control and spatiotemporal parameters of gait and plantar sensation in people with multiple sclerosis?.Pm r. 2015; 7: 17-25
- The PICO strategy for the research question construction and evidence search.Rev. Lat. Am. Enfermagem. 2007; 15: 508-511
- The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study.Aust. J. Physiother. 2009; 55: 129-133
- Reliability of the PEDro scale for rating quality of randomized controlled trials.Phys. Ther. 2003; 83: 713-721
- Evaluation of the cochrane tool for assessing risk of bias in randomized clinical trials: overview of published comments and analysis of user practice in cochrane and non-cochrane reviews.Syst. Rev. 2016; 5: 80
- Recommendations by cochrane review groups for assessment of the risk of bias in studies.BMC Med. Res. Methodol. 2008; 8: 22
- Measuring inconsistency in meta-analyses.Bmj. 2003; 327: 557-560
- Dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with multiple sclerosis.Arch. Phys. Med. Rehabil. 2015; 96 (e221): 226-232
- The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial.Clin. Rehabil. 2019; 33: 1150-1162
- The effect of shoe cushioning on gait and balance in females with multiple sclerosis.Exp. Brain Res. 2021; 239: 2593-2603
- 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.Iranian Rehabil. J. 2021; 19: 199-206
- The effects of carbon and plastic ankle-foot orthoses on gait, balance, and mobility in persons with multiple sclerosis: a pilot study.JPO. 2021; 33: 227-233
- Signaling of kinesthetic information by peripheral sensory receptors.Ann. Rev. Neurosci. 1982; 5: 171-187
- Significance of pressor input from the human feet in lateral postural control. The effect of hypothermia on galvanically induced body-sway.Acta Otolaryngol. 1990; 110: 321-327
- A systematic review of the effects of shoes and other ankle or foot appliances on balance in older people and people with peripheral nervous system disorders.Gait Posture. 2007; 25: 316-323
- Impact of ankle-foot orthoses on gait and leg muscle activity in adults with hemiplegia: systematic literature review.Physiotherapy. 2003; 89: 39-55
- A comparison of gait with solid and hinged ankle-foot orthoses in children with spastic diplegic cerebral palsy.Gait Posture. 2005; 21: 303-310
- Comparison of a dynamic and a hinged ankle-foot orthosis by gait analysis in patients with hemiplegic cerebral palsy.Gait Posture. 2002; 15: 18-24
- Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis.J. Rehabil. Med. 2004; 36: 165-168
- Functional electrical stimulation for foot drop in multiple sclerosis: a systematic review and meta-analysis of the effect on gait speed.Arch. Phys. Med. Rehabil. 2017; 98: 1435-1452
Article info
Publication history
Published online: July 05, 2022
Accepted:
June 26,
2022
Received in revised form:
June 15,
2022
Received:
December 5,
2021
Identification
Copyright
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