Effect of eight-point binding in static balance and distribution of plantar pressure after stroke

ABSTRACT The equinovarus foot is a common sequela after a cerebrovascular accident (CVA), the biomechanical changes of hemiparetic ankle interfere in balance and body asymmetry after a stroke. Several resources are used to minimize these changes, among them stands out the eight-point binding, which aims to provide proprioceptive information and promote the biomechanical alignment of the ankle, thus acting against the mechanisms leading to equinovarus foot. However, there is still no evidence of the effect of eight-point binding in static balance and plantar pressure distribution of the hemiparetic ankle. Thus, the aim of this study was to evaluate the immediate effect of eight-point binding on static balance and plantar pressure distribution in patients with hemiparesis due to stroke. To this end, we evaluated 30 subjects with chronic hemiparesis who were evaluated at three different times: without bandaging, with bandaging, and after five minutes of use of bandaging. The subjects were positioned on a force platform to assess balance and plantar pressure. For data analysis we used ANOVA for repeated measures, assuming α≤0.05 risk. There was no statistically significant difference in static balance and plantar pressure distribution after the use of eight-point binding in any of the evaluated moments in this study. It follows that a single application of the eight-point binding is not able to generate clinical changes in static balance and plantar distribution. It is suggested that further studies need to be conducted to examine the effect of prolonged use of eight-point binding.

摘要：马蹄内翻足（equinovarus foot）是脑血管意外（cerebrovascular accident, CVA）后常见的后遗症，脑卒中后偏瘫踝关节的生物力学改变会干扰患者的平衡能力并引发身体不对称。目前已有多种干预手段用于减轻此类病理改变，其中八点固定法（eight-point binding）应用较为突出，该方法旨在为患者提供本体感觉信息并促进踝关节生物力学对位，从而对抗导致马蹄内翻足的发病机制。然而，目前仍缺乏八点固定法对偏瘫踝关节静态平衡与足底压力分布影响的相关研究证据。因此，本研究旨在评估八点固定法对脑卒中后偏瘫患者静态平衡与足底压力分布的即刻效应。
本研究共纳入30名慢性偏瘫受试者，分别在三个不同时段开展评估：未使用固定带时、使用固定带即刻、使用固定带5分钟后。受试者被安置在测力台（force platform）上以完成平衡能力与足底压力的检测。数据分析采用重复测量方差分析（ANOVA for repeated measures），设定检验水准α≤0.05。
研究结果显示，在所有评估时段中，使用八点固定法后受试者的静态平衡能力与足底压力分布均未出现统计学意义上的显著差异。由此可知，单次应用八点固定法无法使静态平衡与足底压力分布产生具有临床意义的改变。建议后续开展相关研究，以探讨长期使用八点固定法的干预效果。