Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial

Changhong Wang, Rahul Goel, Qianzi Zhang, Brian Lepow, Bijan Najafi

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To examine the effects of bilateral custom-made ankle-foot orthoses (AFOs) to prevent falls for older adults with concern about or at risk for falling over 12-month daily use. DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Community-dwelling older adults. INTERVENTION: Half of the participants were randomly allocated to an intervention group (IG) that received fitted walking shoes and bilateral custom-made AFOs, and the other half were randomly allocated to a control group (CG) that only received fitted walking shoes. MEASUREMENTS: Self-reported fall history of 12-month duration was investigated at baseline and 12-month follow-up for both groups. Fall incidence rate and proportion of fallers were used as outcome measures to determine effects of 12-month footwear intervention in either group. PARTICIPANTS: Adults aged 65 years and older with concern about or at risk for falling (n = 44). RESULTS: No significant between-group differences in participant characteristics were observed at the baseline (P =.144-.882). Within the IG, significant reductions were found in the fall incidence rate (P =.039) and the proportion of fallers (P =.036) at the 12-month follow-up compared to the baseline. Within the CG, no significant change was found at the 12-month follow-up compared to the baseline for the fall incidence rate (P =.217) or the proportion of fallers (P =.757). When comparing the IG with the CG, there was no significant difference in the change from the baseline to the 12-month follow-up for the fall incidence rate (P =.572) or the proportion of fallers (P =.080). CONCLUSION: This study failed to demonstrate a significant benefit of bilateral custom-made AFOs to reduce falls compared to fitted walking shoes. However, the AFO users had significant reductions in falls compared to the preceding year. A future study with a larger sample size is recommended to confirm these observations. CLINICAL TRIAL REGISTRATION—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02819011.

Original languageEnglish (US)
JournalJournal of the American Geriatrics Society
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Foot Orthoses
Ankle
Shoes
Randomized Controlled Trials
Walking
Incidence
Control Groups
Independent Living
Sample Size
Outcome Assessment (Health Care)
Clinical Trials

Keywords

  • ankle-foot orthoses
  • fall prevention
  • footwear
  • older adults

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses for Fall Prevention in Older Adults : A Randomized Controlled Trial. / Wang, Changhong; Goel, Rahul; Zhang, Qianzi; Lepow, Brian; Najafi, Bijan.

In: Journal of the American Geriatrics Society, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To examine the effects of bilateral custom-made ankle-foot orthoses (AFOs) to prevent falls for older adults with concern about or at risk for falling over 12-month daily use. DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Community-dwelling older adults. INTERVENTION: Half of the participants were randomly allocated to an intervention group (IG) that received fitted walking shoes and bilateral custom-made AFOs, and the other half were randomly allocated to a control group (CG) that only received fitted walking shoes. MEASUREMENTS: Self-reported fall history of 12-month duration was investigated at baseline and 12-month follow-up for both groups. Fall incidence rate and proportion of fallers were used as outcome measures to determine effects of 12-month footwear intervention in either group. PARTICIPANTS: Adults aged 65 years and older with concern about or at risk for falling (n = 44). RESULTS: No significant between-group differences in participant characteristics were observed at the baseline (P =.144-.882). Within the IG, significant reductions were found in the fall incidence rate (P =.039) and the proportion of fallers (P =.036) at the 12-month follow-up compared to the baseline. Within the CG, no significant change was found at the 12-month follow-up compared to the baseline for the fall incidence rate (P =.217) or the proportion of fallers (P =.757). When comparing the IG with the CG, there was no significant difference in the change from the baseline to the 12-month follow-up for the fall incidence rate (P =.572) or the proportion of fallers (P =.080). CONCLUSION: This study failed to demonstrate a significant benefit of bilateral custom-made AFOs to reduce falls compared to fitted walking shoes. However, the AFO users had significant reductions in falls compared to the preceding year. A future study with a larger sample size is recommended to confirm these observations. CLINICAL TRIAL REGISTRATION—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02819011.",
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N2 - OBJECTIVE: To examine the effects of bilateral custom-made ankle-foot orthoses (AFOs) to prevent falls for older adults with concern about or at risk for falling over 12-month daily use. DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Community-dwelling older adults. INTERVENTION: Half of the participants were randomly allocated to an intervention group (IG) that received fitted walking shoes and bilateral custom-made AFOs, and the other half were randomly allocated to a control group (CG) that only received fitted walking shoes. MEASUREMENTS: Self-reported fall history of 12-month duration was investigated at baseline and 12-month follow-up for both groups. Fall incidence rate and proportion of fallers were used as outcome measures to determine effects of 12-month footwear intervention in either group. PARTICIPANTS: Adults aged 65 years and older with concern about or at risk for falling (n = 44). RESULTS: No significant between-group differences in participant characteristics were observed at the baseline (P =.144-.882). Within the IG, significant reductions were found in the fall incidence rate (P =.039) and the proportion of fallers (P =.036) at the 12-month follow-up compared to the baseline. Within the CG, no significant change was found at the 12-month follow-up compared to the baseline for the fall incidence rate (P =.217) or the proportion of fallers (P =.757). When comparing the IG with the CG, there was no significant difference in the change from the baseline to the 12-month follow-up for the fall incidence rate (P =.572) or the proportion of fallers (P =.080). CONCLUSION: This study failed to demonstrate a significant benefit of bilateral custom-made AFOs to reduce falls compared to fitted walking shoes. However, the AFO users had significant reductions in falls compared to the preceding year. A future study with a larger sample size is recommended to confirm these observations. CLINICAL TRIAL REGISTRATION—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02819011.

AB - OBJECTIVE: To examine the effects of bilateral custom-made ankle-foot orthoses (AFOs) to prevent falls for older adults with concern about or at risk for falling over 12-month daily use. DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Community-dwelling older adults. INTERVENTION: Half of the participants were randomly allocated to an intervention group (IG) that received fitted walking shoes and bilateral custom-made AFOs, and the other half were randomly allocated to a control group (CG) that only received fitted walking shoes. MEASUREMENTS: Self-reported fall history of 12-month duration was investigated at baseline and 12-month follow-up for both groups. Fall incidence rate and proportion of fallers were used as outcome measures to determine effects of 12-month footwear intervention in either group. PARTICIPANTS: Adults aged 65 years and older with concern about or at risk for falling (n = 44). RESULTS: No significant between-group differences in participant characteristics were observed at the baseline (P =.144-.882). Within the IG, significant reductions were found in the fall incidence rate (P =.039) and the proportion of fallers (P =.036) at the 12-month follow-up compared to the baseline. Within the CG, no significant change was found at the 12-month follow-up compared to the baseline for the fall incidence rate (P =.217) or the proportion of fallers (P =.757). When comparing the IG with the CG, there was no significant difference in the change from the baseline to the 12-month follow-up for the fall incidence rate (P =.572) or the proportion of fallers (P =.080). CONCLUSION: This study failed to demonstrate a significant benefit of bilateral custom-made AFOs to reduce falls compared to fitted walking shoes. However, the AFO users had significant reductions in falls compared to the preceding year. A future study with a larger sample size is recommended to confirm these observations. CLINICAL TRIAL REGISTRATION—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02819011.

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