Do ankle orthoses improve ankle proprioceptive thresholds or unipedal balance in older persons with peripheral neuropathy?
OBJECTIVE
To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population.


METHODS
Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance using a foot cradle system and a series of 100 rotational stimuli, in 11 older neuropathic subjects (8 men; age 72 +/- 7.1 yr) with and without ankle orthoses.


RESULTS
The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with vs. without the orthoses (1.06 +/- 0.56 vs. 1.13 +/- 0.39 degrees, respectively; P = 0.955 and 6.1 +/- 6.5 vs. 6.2 +/- 5.4 secs, respectively; P = 0.922).


CONCLUSIONS
Ankle orthoses that provide medial-lateral support do not seem to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically induced stiffening of the ankle rather than a change in ankle afferent function.
Son
Jaebum
J
Department of Mechanical Engineering, Biomechanical Research Laboratory, University of Michigan, Ann Arbor, MI, USA.
Ashton-Miller
James A
JA
Richardson
James K
JK
D000368:Aged; D000843:Ankle Joint; D003929:Diabetic Neuropathies / Q000150:complications*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D004856:Postural Balance; D020886:Somatosensory Disorders / Q000209:etiology / Q000628:therapy*
J Psychosom Res. 2003 Feb;54(2):129-39
12573734
Arch Phys Med Rehabil. 2002 Nov;83(11):1553-8
12422324
J Athl Train. 2008 Jan-Mar;43(1):37-43
18335011
Exp Brain Res. 1990;82(1):167-77
2257901
Muscle Nerve. 2005 Jan;31(1):113-23
15536624
J Am Geriatr Soc. 1999 Jun;47(6):681-4
10366166
Arch Phys Med Rehabil. 1995 Sep;76(9):850-6
7668957
J Am Geriatr Soc. 2004 Apr;52(4):510-5
15066064
Arch Phys Med Rehabil. 1996 Nov;77(11):1152-6
8931527
Gait Posture. 2007 Feb;25(2):316-23
16687248
J Formos Med Assoc. 2006 Dec;105(12):992-1000
17185241
Clin Biomech (Bristol, Avon). 2001 Jul;16(6):522-8
11427295
Am J Phys Med Rehabil. 2007 Feb;86(2):125-32
17251694
J Am Geriatr Soc. 1992 Oct;40(10):1008-12
1328346
J Orthop Sports Phys Ther. 1994 Dec;20(6):287-95
7849748
Am J Sports Med. 1994 Mar-Apr;22(2):223-9
8198191
Age Ageing. 1995 Jan;24(1):58-66
7762464
J Orthop Sports Phys Ther. 2004 Aug;34(8):449-60
15373008
Diabetes Care. 1997 Jun;20(6):929-34
9167102
Neurosci Lett. 2003 Oct 30;350(3):137-40
14550913
Phys Ther. 1984 Jul;64(7):1067-70
6739548
Arch Phys Med Rehabil. 1992 Apr;73(4):348-54
1554308
Int J Sports Med. 1993 Apr;14(3):140-9
8509242
J Gerontol A Biol Sci Med Sci. 1995 Jul;50(4):M211-5
7614243
Br J Psychiatry. 1984 Sep;145:263-8
6478119
JAMA. 1994 Jan 12;271(2):128-33
8264067
Neurosci Lett. 2006 Oct 2;406(1-2):23-6
16904264
BMC Musculoskelet Disord. 2007 Sep 12;8:89
17850663
Diabet Med. 1992 Jun;9(5):469-74
1611836
Diabetes. 2006 Apr;55(4):1106-13
16567535
Arch Phys Med Rehabil. 1998 Aug;79(8):939-44
9710166
Diabetes Care. 1994 Nov;17(11):1281-9
7821168
Knee Surg Sports Traumatol Arthrosc. 1995;3(1):39-46
7773820
Knee Surg Sports Traumatol Arthrosc. 2001 May;9(3):128-36
11420785
Int J Sports Med. 2007 Mar;28(3):243-6
17024642
Muscle Nerve. 2009 Feb;39(2):150-7
19145650