Ankle-Foot Orthoses: Proprioceptive Inputs and Balance Implications.

Individuals with a loss of sensation in the lower limbs frequently experience postural instability, altered gait patterns, and an increased risk of falling culminating in a decreased quality of life. Previous studies have documented that using ankle-foot orthoses (AFOs) help such individuals to maintain their balance. This study was conducted to investigate whether somatosensory cues delivered to the intact tissues of the lower limbs above the ankle joints enhance the control of posture in individuals with peripheral neuropathy. The study involved 12 individuals with sensory neuropathy because of diabetes who participated in static and dynamic balance tests with and without specially designed AFOs that provided auxiliary sensory cues to the lower limbs without stabilizing the ankle joints. During the tests, the subjects were required to alternately stand on a fixed and moving platform with their eyes alternately open or closed. Equilibrium scores and response latencies were obtained. The results showed that equilibrium scores were significantly higher in experiments with the specially modified AFOs compared with conditions without AFOs. Smaller latency scores were recorded in conditions with AFOs as well. The outcome indicates that AFOs that substitute for the lack of proprioceptive feedback may improve automatic postural responses in individuals with diabetic peripheral neuropathy. It also highlights the need for further research focused on the design of assistive means that could improve the balance and the performance of activities of daily living in individuals with proprioceptive deficits.